Elevated blood pressure levels among 533,167 adults living in sub-Saharan Africa: a systematic review and meta-analysis

Aims Synthesising contemporary data from sub-Saharan African countries, we did a systematic review and meta-analysis of blood pressure (BP) levels and hypertension among adults living in the region. Methods We searched PubMed and other databases to identify studies published from 1/1/2010 to 31/12/2021. We used a random-effects model to estimate the pooled-prevalence of hypertension and mean systolic/diastolic BP overall and on a sex- and age-specific basis. Heterogeneity (I²) was assessed via the χ² test on Cochran’s Q statistic. Results We identified 170 high-quality studies (195 samples) comprising 533,167 adults living in 26 countries. The pooled prevalence of hypertension was 30.5% (95%CI 28.4%–32.6%). Overall mean systolic/diastolic BP was 128 (95%CI 127–129)/80 (95%CI 79–80) mmHg, with males recording higher mean BP levels (3.10 [95%CI 2.30–3.90]/0.69 [95%CI 0.10–1.29] mmHg) compared to females. Reflecting increasingly higher BP levels with age, the pooled estimates of hypertension prevalence initially rose three-fold (from 10.6% [95%CI 8.2%–13.0%] to 30.9% [95%CI 27.8%–34.0%]) in those aged 21–30 to 41–50 years, and then two-fold to 66.4% (95%CI 64.2%–68.7%) among those aged 71–80 years, respectively. Hypertension prevalence was lower in healthy weight (28.4% [95%CI 26.1%–30.6%]) compared to overweight (35.8% [95%CI 31.4%–40.1%]) adults. Regionally, prevalent hypertension was lowest in those living in Eastern Africa (27.2% [95%CI 24.8%–29.7%]). Conclusions Our findings suggest a steep age-related pattern of increasing BP levels in the region that will adversely affect millions of people within the 10–20 years without urgent intervention.