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Meta-Analysis
. 2025 Oct 24;121(12):1815-1829.
doi: 10.1093/cvr/cvaf125.

Prevalence of hypertension in Africa in the last two decades: systematic review and meta-analysis

Paul Olowoyo  1   2 , Akinkunmi Paul Okekunle  3   4 , Osahon Jeffery Asowata  5 , Segun Atolani  1   2 , Moustafa I Morsy  6 , Elisabetta Caiazzo  6   7 , Bamba Gaye  8   9   10 , David Danladi Kadan  5 , Dario Bruzzese  11 , Tomasz J Guzik  12   13   14 , Pasquale Maffia  6   7   14   15 , Mayowa O Owolabi  14   16   17   18
Affiliations
Meta-Analysis

Prevalence of hypertension in Africa in the last two decades: systematic review and meta-analysis

Paul Olowoyo et al. Cardiovasc Res. .

Abstract

Despite being the most common cardiovascular risk factor, the actual burden of hypertension is poorly characterized in Africa. We meta-analysed the most extensive pooled data to determine the overall prevalence of hypertension in Africa. Following Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, we systematically searched Google Scholar, PubMed, ScienceDirect, and Web of Science databases to retrieve prevalence studies only on hypertension among Africans published between 2002 and 2023. Furthermore, we meta-analysed the crude and age-adjusted prevalences of hypertension using a random effect model due to the expected high heterogeneity, with logit transformation of the original proportions. Seventy-eight (out of an initial 779 screened) articles with complete data were included, with a total number of hypertension cases of 71 004 and a denominator population of 286 575, mostly from community-based studies in 23 countries. The pooled crude prevalence of hypertension was 28.5/100 persons [95% confidence interval (CI): 25.3-31.8%] and a 95% prediction interval of 7.6-65.6%; the pooled prevalence increased with age and was highest among the aged ≥75 years: 51.4% (95% CI: 42.0-60.6%) and remained highest in the Southern Africa region overall (34.8%) and in the last decade (2013-23; 44.5%). The point estimate of the pooled crude prevalence was higher among urban dwellers, 32.9% (95% CI: 26.8-39.5%), than rural residents, 26.3% (95% CI: 20.4-33.3%). In a subset of 21 articles reporting age stratification consistent with the World Health Organization standard population, the pooled age-standardized prevalence was 27.2/100 persons (95% CI: 20.9-33.6%). The burden of hypertension remains high, especially in urban areas and with increasing age. Frequent screening and treatment are recommended, especially in urban areas.

Keywords: Africa; Blood pressure; Cardiovascular diseases; Hypertension.

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Conflict of interest statement

Conflict of interest: none declared.

Figures

Graphical Abstract
Graphical Abstract
Graphical abstract of prevalence of hypertension in Africa in the last two decades.
Figure 1
Figure 1
PRISMA flowchart of study selection.
Figure 2
Figure 2
Geographic distribution of included studies assessing the crude prevalence of hypertension by countries of participant recruitment in Africa.
Figure 3
Figure 3
Forest plots for the pooled crude prevalence of hypertension per 100 persons in Africa.
Figure 4
Figure 4
Distribution of the crude prevalence of hypertension by country-specific estimates in the overall study (A), by region of Africa (B), between 2002 and 2012 (C) and after 2012 (D).
Figure 5
Figure 5
Age-adjusted prevalence of hypertension in Africa.
See this image and copyright information in PMC

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