Prevalence and Mitigation of Cardiovascular Disease Risk Factors Among the Corporate Workforce in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

Abstract

Cardiovascular disease (CVDs) is the leading cause of mortality worldwide. Corporate workplaces have been identified as important environmental factors that can increase the risk and severity of CVDs. Evidence indicates that the risk and severity of CVDs can be effectively reduced by mitigating modifiable behavioural and intermediate risk factors. Although the prevalence of CVDs and their associated risk factors is increasing in sub-Saharan Africa (SSA), most published data from the region are hospital-based and may not be true estimates. This study investigated the prevalence and distribution of CVD risk factors among the corporate workforce in SSA and the effects of workplace wellness programmes (WWP) on these risk factors. Accordingly, a systematic search was performed using Google Scholar, Cochrane Library, PubMed, MEDLINE, Scopus and Science Direct for articles published between January 2010 and March 2024. A total of 105 studies (n = 76,027) across nine countries met the eligibility criteria and were analysed. The pooled prevalence of the risk factors was unhealthy diet (80%), high salt intake (32%), stress (58%), poor sleep (59%), physical inactivity (PI, 59%), alcohol consumption (29%), harmful alcohol consumption (26%), tobacco smoking (7%), khat chewing (6%), overweight (36%), obesity (23%), central obesity (44%), high blood pressure (29%), high total cholesterol (33%), high low-density lipoprotein cholesterol (LDL-c) (41%), low high-density lipoprotein cholesterol (HDL-c) (45%), hypertriglyceridaemia (17%), dysglycaemia (9%), and metabolic syndrome (MS; 45%). The highest prevalence of unhealthy diet and PI was recorded in East Africa and Central Africa, respectively, whereas West Africa had the highest prevalence of high body mass index (BMI). Ethiopia had the highest prevalence of unhealthy diets, whereas Nigeria had the highest prevalence of stress and poor sleep. The healthcare sector had the highest cluster of risk factors and the highest prevalence of unhealthy diets. Only 5.7% of the studies implemented WWP, which had significant mitigating effects on most risk factors. This study concluded that the prevalence of most modifiable CVD risk factors is high among the corporate workforce in SSA, which is higher than that in the general population in most cases, and a well-designed WWP can significantly mitigate these risk factors.

Keywords: " "cardiovascular disease risk factors; behavioural risk factors; corporate workers; corporate workplace; intermediate risk factors; pico (population; preferred reporting items for systematic reviews and meta-analyses(prisma); risk of cardiovascular diseases; sub-saharan africa; workplace wellness program.

Figure 1. PRISMA flow diagram for the studies included in the systematic review and meta-analysis.

PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses

Figure 2. Forest plot of the prevalence of a generally unhealthy diet among the corporate workforce in Sub-Saharan Africa.

Figure 3. Forest plot of the prevalence of regular high salt intake among the corporate workforce in Sub-Saharan Africa.

Figure 4. Forest plot of the prevalence of stress among the corporate workforce in Sub-Saharan Africa.

Figure 5. Forest plot of the prevalence of poor sleep among the corporate workforce in Sub-Saharan Africa.

Figure 6. Forest plot of the prevalence of physical inactivity among the corporate workforce in Sub-Saharan Africa.

Figure 7. Forest plot of the prevalence of current alcohol consumption among the corporate workforce in Sub-Saharan Africa.

Figure 8. Forest plot of the prevalence of harmful alcohol consumption among the corporate workforce in Sub-Saharan Africa.

Figure 9. Forest plot of the prevalence of current tobacco smoking among the corporate workforce in Sub-Saharan Africa.

Figure 10. Forest plot of the prevalence of khat chewing among the corporate workforce in Sub-Saharan Africa.

Figure 11. Forest plot of the prevalence of overweight among the corporate workforce in Sub-Saharan Africa.

Figure 12. Forest plot of the prevalence of obesity among the corporate workforce in Sub-Saharan Africa.

Figure 13. Forest plot of the prevalence of central obesity among the corporate workforce in Sub-Saharan Africa.

Figure 14. Forest plot of the prevalence of high blood pressure among the corporate workforce in Sub-Saharan Africa.

Figure 15. Forest plot of the prevalence of the high total cholesterol (TC) level among the corporate workforce in Sub-Saharan Africa.

Figure 16. Forest plot of the prevalence of the high low-density lipoprotein (LDL) cholesterol level among the corporate workforce in Sub-Saharan Africa.

Figure 17. Forest plot of the prevalence of the low high-density lipoprotein (HDL) cholesterol level among the corporate workforce in Sub-Saharan Africa.

Figure 18. Forest plot of the prevalence of dysglycaemia among the corporate workforce in Sub-Saharan Africa.

Figure 19. Forest plot of the prevalence of the metabolic syndrome among the corporate workforce in Sub-Saharan Africa.

Figure 20. Forest plot showing the pre and post-intervention pooled prevalence for tobacco smoking.

Figure 21. Forest plot showing the pooled prevalence of unhealthy diet before and after the intervention.

Figure 22. Forest plot showing the pooled prevalence of physical inactivity before and after the intervention.

Figure 23. Funnel plot showing publication bias for the studies included in this meta-analysis.