Abstract
BackgroundThe burden of hypertension is high in Africa, and due to rapid population growth and ageing, the exact burden on the continent is still far from being known. We aimed to estimate the prevalence and awareness rates of hypertension in Africa based on the cut off “≥140/90 mm Hg”.MethodsWe conducted a systematic search of Medline, EMBASE and Global Health. Search date was set from January 1980 to December 2013. We included population-based studies on hypertension, conducted among people aged ≥15 years and providing numerical estimates on the prevalence of hypertension in Africa. Overall pooled prevalence of hypertension in mixed, rural and urban settings in Africa were estimated from reported crude prevalence rates. A meta-regression epidemiological modelling, using United Nations population demographics for the years 1990, 2000, 2010 and 2030, was applied to determine the prevalence rates and number of cases of hypertension in Africa separately for these four years.ResultsOur search returned 7680 publications, 92 of which met the selection criteria. The overall pooled prevalence of hypertension in Africa was 19.7% in 1990, 27.4% in 2000 and 30.8% in 2010, each with a pooled awareness rate (expressed as percentage of hypertensive cases) of 16.9%, 29.2% and 33.7%, respectively. From the modelling, over 54.6 million cases of hypertension were estimated in 1990, 92.3 million cases in 2000, 130.2 million cases in 2010, and a projected increase to 216.8 million cases of hypertension by 2030; each with an age-adjusted prevalence of 19.1% (13.9, 25.5), 24.3% (23.3, 31.6), 25.9% (23.5, 34.0), and 25.3% (24.3, 39.7), respectively.ConclusionOur findings suggest the prevalence of hypertension is increasing in Africa, and many hypertensive individuals are not aware of their condition. We hope this research will prompt appropriate policy response towards improving the awareness, control and overall management of hypertension in Africa.
Highlights
Hypertension and other cardiovascular diseases rank among the leading causes of disabilities and deaths from non-communicable diseases (NCDs) in Africa [1,2], with rising prevalence and death rates observed more in young and active adults [3]
The African Union (AU) reported that hypertension is one of the greatest health challenges after HIV/AIDS in the continent [4]. This is a priority globally as conclusions from the 2011 United Nations high level meeting on NCDs focus on a reduction of hypertension and other NCDs, especially in Africa, where the burden is rising at a faster rate compared to other parts of the world [5]
On screening titles for relevance, 4936 articles were excluded, giving a total of 291 full texts that were assessed. 82 articles did not report hypertension prevalence or population denominators from which prevalence rates can be calculated, 75 articles did not specify study designs and/or clarify case definitions of hypertension, and 42 articles were based on blood pressures base-line of 160/90 mm Hg
Summary
Hypertension and other cardiovascular diseases rank among the leading causes of disabilities and deaths from non-communicable diseases (NCDs) in Africa [1,2], with rising prevalence and death rates observed more in young and active adults [3]. The African Union (AU) reported that hypertension is one of the greatest health challenges after HIV/AIDS in the continent [4]. This is a priority globally as conclusions from the 2011 United Nations high level meeting on NCDs focus on a reduction of hypertension and other NCDs, especially in Africa, where the burden is rising at a faster rate compared to other parts of the world [5]. We aimed to estimate the prevalence and awareness rates of hypertension in Africa based on the cut off ‘‘$140/90 mm Hg’’
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