Abstract
BackgroundThe health of older persons has not been a major priority in many African countries. Hypertension is one of the common health problems of older persons. However, there is little information on the prevalence of hypertension in older adults in Africa. This is in spite of the fact that Africa has the highest age-standardized prevalence of hypertension in the world. We therefore present this protocol to conduct a systematic review and meta-analysis on the prevalence of hypertension and the level of its awareness among older persons living in Africa.MethodsMajor databases (EMBASE, MEDLINE, Academic Search Complete, CINAHL, PsycINFO) and unpublished literature will be searched to identify population-based studies on hypertension in adults aged 50 years and older living in Africa. Eligible articles are those which use the 140/90-mmHg cutoff to diagnose hypertension and were published from 1980 to present. We will exclude subjects in restricted environments such as patients and refugees. Articles will be independently evaluated by two reviewers to determine if they meet the inclusion criteria. They will also evaluate the quality of included studies using a validated tool by Hoy and colleagues for prevalence studies. The main outcome is the prevalence of hypertension while the explanatory variables include demographic, socio-economic, dietary, lifestyle and behavioural factors. Effect sizes in bivariate and multivariate analyses will be presented as odds or prevalence ratios. We will explore for heterogeneity of the standard errors across the studies, and if appropriate, we will perform a meta-analysis using a random-effects model to present a summary estimate of the prevalence of hypertension in this population.DiscussionThe estimates of the prevalence, the risk factors and the level of awareness of hypertension could help in galvanizing efforts at prioritizing the cardiovascular health of older persons in Africa.Systematic review registrationPROSPERO CRD42017056474
Highlights
The health of older persons has not been a major priority in many African countries
Hypertension is a major risk factor for cardiovascular diseases, accounting for 52.5% of all strokes in Africa compared with 38.8% in the industrialized region [1]
Older persons aged 50 + years are more likely than younger adults in urban and rural Africa to have hypertension or to report risk factors for chronic non-communicable diseases (NCDs) [22, 23]
Summary
Protocol and registration This protocol complies with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA-P) guidelines (Additional file 1) [52] It is registered on PROSPSERO international prospective register of systematic reviews (http://www.crd.york.ac.uk/PROSPERO), registration number CRD42017056474 [53]. Inclusion criteria The following criteria should be met by studies to be included in the analysis: 1. Types of studies: population-based cross-sectional studies and follow-up studies published from January 1980 to present which report prevalence or incidence of hypertension in older adults. 3. Population: apparently healthy adults aged 50 years and older living in Africa. 5. Setting/context: only studies of persons living in Africa will be included. Studies involving older adults in a restricted population such as those who are unwell, attending hospitals or are in institutions for chronic or mental illness b.
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