Adal Ousman, Kebede Natnael, Delie Amare Mebrat, Bogale Eyob Ketema, Anagaw Tadele Fentabil, Tiruneh Misganaw Guadie, Fenta Eneyew Talie, Endeshaw Destaw
Department of Emergency and Critical Care Nursing Medicine, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar City, Ethiopia.
Department of Health Promotion, School of Public Health College of Medicine Health Sciences, Wollo University, Dessie City, MSc, Ethiopia.
Int J Cardiol Cardiovasc Risk Prev. 2024 May 15;21:200285. doi: 10.1016/j.ijcrp.2024.200285. eCollection 2024 Jun.
Hypertensive crises are a leading cause of visits to emergency departments, carrying grave health implications. A significant number of patients presenting with these crises have a known history of hypertension.
The aim of this systematic review and meta-analysis is to examine the combined prevalence of hypertensive crises among individuals with either a history of hypertension or unknown status (newly diagnosed with a hypertensive crisis).
This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered with the Prospective Register of Systematic Reviews (PROSPERO). Research databases, including PubMed, Embase, Scopus, Africa Index Medicus, Science Direct, HINARI, and Google Scholar, were systematically searched. Study quality was evaluated using the Newcastle-Ottawa Scale, while publication bias was explored through Egger's regression test, funnel plots, and sensitivity analyses. Data collection adhered to the Joanna Briggs Institute (JBI) format. Meta-analysis was performed using STATA version 17, employing the random-effects DerSimonian-Laird model.
Amongst the 15 studies analyzed, the application of the random-effects DerSimonian-Laird statistical model indicated that the prevalence of hypertensive crisis was determined to be 9.09 %, with a 95 % confidence interval (CI) ranging from 7.41 % to 10.77 %. Factors such as poor medication adherence (POR 5.00; 95 % CI: 3.61, 6.93), patients with comorbidities (POR 4.73; 95 % CI: 3.29, 6.80), patients with a history of hypertension (POR 5.64; 95 % CI: 4.57, 6.94), patients aged >65 (POR 2.77; 95 % CI: 2.16, 6.59), and excessive alcohol intake (POR 5.01; 95 % CI: 3.82, 6.58) were associated with higher odds of hypertensive crisis.
The findings indicate a markedly higher incidence of hypertensive crisis among hospital-presenting patients in Africa. Factors such as medication non-adherence, co-existing comorbidities, historical hypertension, being over 65, and alcohol misuse significantly contribute to this condition. These insights call for a comprehensive healthcare strategy that targets both the management of hypertension and its complications, aiming to improve the overall health outcomes of affected patients.
高血压急症是急诊就诊的主要原因，对健康有严重影响。许多出现这些急症的患者有高血压病史。
本系统评价和荟萃分析的目的是研究有高血压病史或情况不明（新诊断为高血压急症）的个体中高血压急症的综合患病率。
本评价遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南，并在系统评价前瞻性注册库（PROSPERO）中注册。对包括PubMed、Embase、Scopus、非洲医学索引、科学Direct、HINARI和谷歌学术在内的研究数据库进行了系统检索。使用纽卡斯尔-渥太华量表评估研究质量，通过Egger回归检验、漏斗图和敏感性分析探讨发表偏倚。数据收集遵循乔安娜·布里格斯研究所（JBI）格式。使用STATA 17版，采用随机效应DerSimonian-Laird模型进行荟萃分析。
在分析的15项研究中，随机效应DerSimonian-Laird统计模型的应用表明，高血压急症的患病率为9.09%，95%置信区间（CI）为7.41%至10.77%。药物依从性差（比值比5.00；95%CI：3.61，6.93）、合并症患者（比值比4.73；95%CI：3.29，6.80）、有高血压病史的患者（比值比5.64；95%CI：4.57，6.94）、年龄>65岁的患者（比值比2.77；95%CI：2.16，6.59）和过量饮酒（比值比5.01；95%CI：3.82，6.58）与高血压急症的较高几率相关。
研究结果表明，非洲医院就诊患者中高血压急症的发病率明显更高。药物不依从、并存合并症、既往高血压、65岁以上以及酒精滥用等因素是导致这种情况的重要原因。这些见解呼吁制定一项全面的医疗保健策略，既要针对高血压的管理，也要针对其并发症，旨在改善受影响患者的整体健康结果。
