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Meta-Analysis
. 2024 Jun 13;19(6):e0301547.
doi: 10.1371/journal.pone.0301547. eCollection 2024.

Uncontrolled hypertension among hypertensive patients in Sub-Saharan Africa: A systematic review and meta-analysis

Tigabu Munye Aytenew  1 , Amare Kassaw  2 , Amare Simegn  3 , Gedefaye Nibret Mihretie  3 , Sintayehu Asnakew  4 , Yohannes Tesfahun Kassie  5 , Solomon Demis  6 , Demewoz Kefale  2 , Shegaw Zeleke  1 , Worku Necho Asferie  6
Affiliations
Meta-Analysis

Uncontrolled hypertension among hypertensive patients in Sub-Saharan Africa: A systematic review and meta-analysis

Tigabu Munye Aytenew et al. PLoS One. .

Abstract

Introduction: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flow chart showing the studies selection process, 2023.
Fig 2
Fig 2. Forest plot showing the pooled prevalence of uncontrolled hypertension in SSA, 2023.
Fig 3
Fig 3. Funnel plot showing the publication bias of uncontrolled hypertension in SSA, 2023.
Fig 4
Fig 4. Sensitivity analysis of uncontrolled hypertension in SSA, 2023.
See this image and copyright information in PMC

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