A semi-systematic review on hypertension and dyslipidemia care in Egypt—highlighting evidence gaps and recommendations for better patient outcomes

BACKGROUND: Both hypertension and dyslipidemia are considered as major modifiable risk factors of cardiovascular diseases (CVDs), and their prevalence in Egypt has increased in recent years. Evidence-based systematic evaluation of data on hypertension and dyslipidemia is critical for effective patient-centric management to reduce the overall risk of CVDs in Egypt. This semi-systematic review aimed to quantify and identify data gaps in the prevalence and distribution of patient journey touchpoints including awareness, screening, diagnosis, treatment, adherence, and control of hypertension and dyslipidemia to provide the basis for research prioritization, practice guidance, and health care reforms in Egypt. MAIN BODY: Structured search was conducted on MEDLINE and Embase to identify articles published in English between January 2010 and December 2019 that reported key patient journey touchpoints in hypertension and dyslipidemia management. Unstructured search was conducted on public or government websites with no date restriction. Data from all sources were extracted and presented descriptively. In total, 22 studies published between 1995 and 2020 on hypertension and dyslipidemia were included in the final analyses. The prevalence of hypertension in Egypt ranged from 12.1 to 59%. Studies reported awareness (37.5% and 43.9%), diagnosis (42% and 64.7%), treatment (24% and 54.1%), and adherence to antihypertensive medication (51.9%) to be low. Furthermore, the percentage of patients who had their blood pressure controlled ranged from 8 to 53.2%. The prevalence of dyslipidemia varied in the general population (range 19.2-36.8%) but was higher in patients with acute coronary syndrome (ACS) (50.9% and 52.5%) and coronary artery disease (58.7%). A national report indicated that 8.6% of the general population was screened for dyslipidemia; however, no data was available on the diagnosis and treatment rates. Among ACS patients, 73.9% were treated for dyslipidemia. Data indicated low levels of medication adherence (59%) among dyslipidemia patients, with overall low control rates ranging from 5.1 to 34.4% depending on CVD risk in populations including ACS patients. CONCLUSION: Data on patient journey touchpoints of hypertension and dyslipidemia are limited in Egypt, indicating the need for more systematic and high-quality evidence-based studies covering different aspects of patient-centric management for better management of CVD and its risk factors.