Aytenew Tigabu Munye, Kassaw Amare, Simegn Amare, Nibret Mihretie Gedefaye, Asnakew Sintayehu, Tesfahun Kassie Yohannes, Demis Solomon, Kefale Demewoz, Zeleke Shegaw, Necho Asferie Worku
Department of Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
PLoS One. 2024 Jun 13;19(6):e0301547. doi: 10.1371/journal.pone.0301547. eCollection 2024.
Hypertension is a major global public health problem. It currently affects more than 1.4 billion people worldwide, projected to increase to 1.6 billion by 2025. Despite numerous primary studies have been conducted to determine the prevalence of uncontrolled hypertension and identify its associated factors among hypertensive patients in Sub-Saharan Africa, these studies presented inconsistent findings. Therefore, this review aimed to determine the pooled prevalence of uncontrolled hypertension and identify its associated factors.
We have searched PubMed, Google Scholar, and Web of Science databases extensively for all relevant studies. A manual search of the reference lists of included studies was performed. A weighted inverse-variance random-effects model was used to compute the overall pooled prevalence of uncontrolled hypertension and the effect size of its associated factors. Variations across the included studies were checked using forest plot, funnel plot, I2 statistics, and Egger's test.
A total of twenty-six primary studies with a sample size of 11,600 participants were included in the final meta-analysis. The pooled prevalence of uncontrolled hypertension was 50.29% (95% CI: 41.88, 58.69; I2 = 98.98%; P<0.001). Age of the patient [AOR = 1.57: 95% CI: 1.004, 2.44], duration of diagnosis [AOR = 2.57: 95% CI: 1.18, 5.57], non-adherence to physical activity [AOR = 2.13: 95% CI: 1.15, 3.95], khat chewing [AOR = 3.83: 95% CI: 1.59, 9.24] and habitual coffee consumption [AOR = 10.79: 95% CI: 1.84, 63.24] were significantly associated with uncontrolled hypertension among hypertensive patients.
The pooled prevalence of uncontrolled hypertension was considerably high. Older age, duration of diagnosis, non-adherence to physical activity, khat chewing and habitual coffee consumption were independent predictors of uncontrolled hypertension. Therefore, health professionals and other responsible stakeholders should encourage hypertensive patients to adhere to regular physical activity, and abstain from khat chewing and habitual coffee consumption. Early identification of hypertension and management of comorbidities is crucial, and it should be emphasized to control hypertension easily.
高血压是一个重大的全球公共卫生问题。目前全球有超过14亿人受其影响，预计到2025年将增至16亿。尽管已经开展了大量的初步研究来确定撒哈拉以南非洲高血压患者中未控制高血压的患病率并确定其相关因素，但这些研究结果并不一致。因此，本综述旨在确定未控制高血压的合并患病率并确定其相关因素。
我们广泛检索了PubMed、谷歌学术和科学网数据库中的所有相关研究。对纳入研究的参考文献列表进行了手工检索。采用加权逆方差随机效应模型计算未控制高血压的总体合并患病率及其相关因素的效应量。使用森林图、漏斗图、I²统计量和埃格检验检查纳入研究之间的差异。
最终的荟萃分析共纳入了26项样本量为11600名参与者的初步研究。未控制高血压的合并患病率为50.29%（95%置信区间：41.88，58.69；I² = 98.98%；P<0.001）。患者年龄[AOR = 1.57：95%置信区间：1.004，2.44]、诊断时长[AOR = 2.57：95%置信区间：1.18，5.57]、不坚持体育活动[AOR = 2.13：95%置信区间：1.15，3.95]、咀嚼恰特草[AOR = 3.83：95%置信区间：1.59，9.24]和习惯性饮用咖啡[AOR = 10.79：95%置信区间：1.84，63.24]与高血压患者未控制高血压显著相关。
未控制高血压的合并患病率相当高。年龄较大、诊断时长、不坚持体育活动、咀嚼恰特草和习惯性饮用咖啡是未控制高血压的独立预测因素。因此，卫生专业人员和其他相关利益攸关方应鼓励高血压患者坚持定期体育活动，戒除咀嚼恰特草和习惯性饮用咖啡的习惯。早期识别高血压和管理合并症至关重要，应强调这一点以轻松控制高血压。
