Burden of undiagnosed hypertension in sub-saharan Africa: a systematic review and meta-analysis.
The burden of hypertension in Sub-Saharan Africa has been increasing over the past few decades. However, a large proportion of the population with hypertension remains undiagnosed, untreated, or inadequately treated, contributing to the rising burden of cardiovascular disease in the region. We conducted a systematic review and meta-analysis to assess the recent burden of hypertension in Sub-Saharan Africa, based on studies published between 2000 and 2013. We pooled data from 33 surveys involving over 110 414 participants of mean age 40 years. Hypertension prevalence varied widely across the studies (range 15%-70%), partly because of differences in participant mean ages (31-76 years). The predicted prevalence of hypertension at mean participant ages of 30, 40, 50, and 60 years were 16%, 26%, 35%, and 44%, respectively, with a pooled prevalence of 30% (95% confidence interval, 27%-34%). Of those with hypertension, only between 7% and 56% (pooled prevalence: 27%; 95% confidence interval, 23%-31%) were aware of their hypertensive status before the surveys. Overall, 18% (95% confidence interval, 14%-22%) of individuals with hypertension were receiving treatment across the studies, and only 7% (95% confidence interval, 5%-8%) had controlled blood pressure. This review found a high prevalence of hypertension, as well as low percentage of hypertension awareness, treatment, and control in Sub-Saharan Africa, highlighting the need for implementation of timely and appropriate strategies for diagnosis, control, and prevention.
From the Department of Medicine, Kings College London, London, UK (F.A.); Department of Medicine, Weill Cornell Medical College, New York, NY (S.E.); Veteran Affairs Pittsburgh Health Care System, PA (S.E.); Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK (S.K.); Department of Medicine, Jamaica Medical Center, New York, NY (B.T.); Hubert Department of Public Health, Rollins School of Public Health, Emory University, Atlanta, GA (J.B.E.-T.); MedStar Health, Baltimore, MD (J.B.E.-T.); South African Medical Research Council and University of Cape Town, Cape Town, South Africa (A.P.K.); The George Institute for Global Health, Sydney, Australia (A.P.K.); and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands (A.P.K.).
Feven
F
Ataklte
From the Department of Medicine, Kings College London, London, UK (F.A.); Department of Medicine, Weill Cornell Medical College, New York, NY (S.E.); Veteran Affairs Pittsburgh Health Care System, PA (S.E.); Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK (S.K.); Department of Medicine, Jamaica Medical Center, New York, NY (B.T.); Hubert Department of Public Health, Rollins School of Public Health, Emory University, Atlanta, GA (J.B.E.-T.); MedStar Health, Baltimore, MD (J.B.E.-T.); South African Medical Research Council and University of Cape Town, Cape Town, South Africa (A.P.K.); The George Institute for Global Health, Sydney, Australia (A.P.K.); and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands (A.P.K.). see9003@med.cornell.edu.
Sebhat
S
Erqou
From the Department of Medicine, Kings College London, London, UK (F.A.); Department of Medicine, Weill Cornell Medical College, New York, NY (S.E.); Veteran Affairs Pittsburgh Health Care System, PA (S.E.); Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK (S.K.); Department of Medicine, Jamaica Medical Center, New York, NY (B.T.); Hubert Department of Public Health, Rollins School of Public Health, Emory University, Atlanta, GA (J.B.E.-T.); MedStar Health, Baltimore, MD (J.B.E.-T.); South African Medical Research Council and University of Cape Town, Cape Town, South Africa (A.P.K.); The George Institute for Global Health, Sydney, Australia (A.P.K.); and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands (A.P.K.).
Stephen
S
Kaptoge
From the Department of Medicine, Kings College London, London, UK (F.A.); Department of Medicine, Weill Cornell Medical College, New York, NY (S.E.); Veteran Affairs Pittsburgh Health Care System, PA (S.E.); Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK (S.K.); Department of Medicine, Jamaica Medical Center, New York, NY (B.T.); Hubert Department of Public Health, Rollins School of Public Health, Emory University, Atlanta, GA (J.B.E.-T.); MedStar Health, Baltimore, MD (J.B.E.-T.); South African Medical Research Council and University of Cape Town, Cape Town, South Africa (A.P.K.); The George Institute for Global Health, Sydney, Australia (A.P.K.); and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands (A.P.K.).
Betiglu
B
Taye
From the Department of Medicine, Kings College London, London, UK (F.A.); Department of Medicine, Weill Cornell Medical College, New York, NY (S.E.); Veteran Affairs Pittsburgh Health Care System, PA (S.E.); Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK (S.K.); Department of Medicine, Jamaica Medical Center, New York, NY (B.T.); Hubert Department of Public Health, Rollins School of Public Health, Emory University, Atlanta, GA (J.B.E.-T.); MedStar Health, Baltimore, MD (J.B.E.-T.); South African Medical Research Council and University of Cape Town, Cape Town, South Africa (A.P.K.); The George Institute for Global Health, Sydney, Australia (A.P.K.); and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands (A.P.K.).
Justin B
JB
Echouffo-Tcheugui
From the Department of Medicine, Kings College London, London, UK (F.A.); Department of Medicine, Weill Cornell Medical College, New York, NY (S.E.); Veteran Affairs Pittsburgh Health Care System, PA (S.E.); Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK (S.K.); Department of Medicine, Jamaica Medical Center, New York, NY (B.T.); Hubert Department of Public Health, Rollins School of Public Health, Emory University, Atlanta, GA (J.B.E.-T.); MedStar Health, Baltimore, MD (J.B.E.-T.); South African Medical Research Council and University of Cape Town, Cape Town, South Africa (A.P.K.); The George Institute for Global Health, Sydney, Australia (A.P.K.); and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands (A.P.K.).
Andre P
AP
Kengne
D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D017677:Age Distribution; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence
D000959:Antihypertensive Agents
Africa south of the Sahara; cardiovascular diseases; hypertension; review