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Review
. 2022 Nov 10;8(11):e11555.
doi: 10.1016/j.heliyon.2022.e11555. eCollection 2022 Nov.

A systematic review and meta-analysis of the Ethiopian cohort of adult hypertensive people's adherence to healthy behaviors

Teshager Woldegiyorgis Abate  1 , Haileyesus Gedamu  1 , Emiru Ayalew  1 , Ashenafi Genanew  2 , Temesgen Ergetie  3 , Getasew Tesfa  4
Affiliations
Review

A systematic review and meta-analysis of the Ethiopian cohort of adult hypertensive people's adherence to healthy behaviors

Teshager Woldegiyorgis Abate et al. Heliyon. .

Abstract

Background: Adherence to healthy behavior has become increasingly important in recent years for better blood pressure management. For the management and prevention of hypertension, it is a strong recommendation. But there have been a number of observational studies conducted in Ethiopia on hypertensive people's healthy lifestyle choices. An extensive review, however, that would have provided even a sliver of supporting data for developing an intervention, is missing. The purpose of this review and meta-analysis was to fill in this gap.

Methods: The meta-analysis of an observational study was followed by a systematic review. Searches and extracts from the databases CINAHL (EBSCO), MEDLINE (via Ovid), PubMed, EmCare, and Google Scholar have been conducted by three reviewers. Only studies with low and moderate risk were included in the analysis after the quality of the articles was evaluated by two independent reviewers using the Newcastle-Ottawa Scale. After accounting for heterogeneity and publication bias, this study presented the estimated overall and six major domains of adherence to healthy behaviors among hypertensive adult individuals. The PROSPERO database had this systematic review registered under protocol number CRD 42020206150.

Results: The overall estimated adherence to healthy lifestyle habits among Ethiopian hypertensive adult individuals was 42.45% (95% CI: 33.51-51.38, I2 = 95.2%). We also investigate the adherence of major domains of healthy behaviors, such as the estimated healthy dietary adherence: 50.86% (95% CI: 39.61-62.11%), the estimated adherence to physical activity: 48.74% (95% CI: 36.60-60.96), and the estimated adherence to sodium intake: 51.79% (95% CI: 36.77-66.8). The following variables were statistically significant predictors of adherence to the overall health behavior: education level (Pooled Odds Ratio (POR): 2.8; 95% CI: 1.98-3.63, I2 = 0.0%), duration of hypertension (POR: 3.1; 95% CI: 1.80-4.32, I2 = 0.0%), and hypertensive people who was knowledgeable of hypertension (POR: 6.8; 95% CI: 1.05-12.58, I2 = 89.3%).

Conclusions: Less than half of the hypertension population in Ethiopia had healthy lifestyle behaviors. A low percentage of hypertensive adults also had adhered to salt (sodium) intake, physical activity, and weight management. So, intervention programs should focus on the health faithfulness of the specific section of adherence to healthy lifestyle practice according to recommended lifestyle practice guidelines.

Keywords: Adults; Ethiopia; Healthy lifestyle modification; Hypertension; Meta-analysis; Self-care practice.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The flow chart for a selection of studies for a meta-analysis and systematic review of the percentage of hypertensive individuals adhering to healthy behaviors in Ethiopia in 2020.
Figure 2
Figure 2
A meta-analysis (forest plot) of the percentage of hypertensive people in Ethiopia who generally adhere to healthy behaviors.
Figure 3
Figure 3
Meta funnels representation of the percentage of total adherence to healthy behavior among hypertensive individuals in Ethiopia in 2020, with SE PIV (standard error of proportion) shown on the Y-axis and log PIV (logarithm of proportion) on the X-axis.
Figure 4
Figure 4
One-leave-out sensitivity analysis for research on the percentage of overall adherence to healthy habits among hypertensive individuals in Ethiopia, 2020.
Figure 5
Figure 5
A meta-analysis of educational level associated with adherence to overall healthy behaviors among hypertensive people in Ethiopian, 2020.
Figure 6
Figure 6
A meta-analysis of duration of hypertension associated with overall adherence of healthy behaviors among hypertensive people in Ethiopia, 2020.
Figure 7
Figure 7
A meta-analysis of knowledge towards hypertension associated with adherence to overall healthy behaviors among hypertensive people in Ethiopia, 2020.
See this image and copyright information in PMC

References

    1. Mills K.T., Stefanescu A., He J. The global epidemiology of hypertension. Nat. Rev. Nephrol. 2020:1–15. - PMC - PubMed
    1. Organization WH . World Health Organization; 2013. A Global Brief on Hypertension: Silent Killer, Global Public Health Crisis: World Health Day 2013.
    1. Zhou B., Bentham J., Di Cesare M., Bixby H., Danaei G., Cowan M.J., et al. Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19· 1 million participants. Lancet. 2017;389(10064):37–55. - PMC - PubMed
    1. World Health organization Hypertension Fact Sheet. https://www.who.int/news-room/fact-sheets/detail/hypertension 2019 cited 2020 9/8/2020.
    1. Kario K., Chen C.-H., Park S., Park C.-G., Hoshide S., Cheng H.-M., et al. Consensus document on improving hypertension management in Asian patients, taking into account Asian characteristics. Hypertension. 2018;71(3):375–382. - PubMed

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