Back to Search
Start Over
The impact of interventions for the primary prevention of hypertension in Sub-Saharan Africa: A systematic review and meta-analysis.
- Source :
- PLoS ONE; 7/19/2019, Vol. 14 Issue 7, p1-16, 16p
- Publication Year :
- 2019
-
Abstract
- Background: The prevalence of hypertension is highest in the African Region with 46% of adults aged 25 and above diagnosed with hypertension, while the lowest prevalence of 35% is found in the Americas. There is sparse evidence on the approaches used to prevent hypertension in Sub-Saharan Africa and the effectiveness of these approaches. It is therefore imperative that a systematic review; which synthesises all the available evidence on the approaches and their impact is conducted to inform public health policy and practice. Objective: To synthesise evidence on the interventions used for the primary prevention of hypertension in Sub-Saharan Africa and to evaluate the effectiveness of these interventions in reducing blood pressure, hypertension prevalence and the risk factors for hypertension. Methods and results: This systematic review was reported per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Bibliographic databases were searched on the 4<superscript>th</superscript>-17<superscript>th</superscript> of January 2018 from 1970 to January 2018 and on the 5<superscript>th</superscript> of May 2019 from 1970 to May 2019, for studies focusing on the primary prevention of hypertension in communities in Sub-Saharan Africa. A narrative synthesis was conducted based on study interventions and outcomes. Also, a meta-analysis was carried out using pooled mean differences; using a random effects model of generic inverse variance option in RevMan. A total of 854 studies were identified after deduplication, with thirteen studies meeting the inclusion criteria. Six studies with varying interventions and methodologies observed a significant pooled reduction in systolic blood pressure of -3.3mmHg (95%CI -4.64 to -1.96) and a reduction of -2.26mmHg (95%CI -6.36 to 1.85) in diastolic blood pressure, which was not statistically significant (p = 0.28). Also, moderate to significant heterogeneity was observed (I<superscript>2</superscript> = 68% and 99%) for the systolic and diastolic blood pressure respectively. Intervention and study design accounted for 100% heterogeneity for both systolic and diastolic blood pressure (r<superscript>2</superscript> = 100%). Conclusion: Health promotion and interventions targeting various risk factors of hypertension and, salt consumption restriction interventions have been employed in Sub-Saharan Africa with varying levels of success. We recommend that higher quality studies and a meta-analysis are needed to evaluate the impact of these interventions and to inform public health policy and practice. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 19326203
- Volume :
- 14
- Issue :
- 7
- Database :
- Complementary Index
- Journal :
- PLoS ONE
- Publication Type :
- Academic Journal
- Accession number :
- 137620279
- Full Text :
- https://doi.org/10.1371/journal.pone.0219623