Key result
The overall pooled prevalence of resistant hypertension in Africa was 12.1% (95% CI 8.0% to 17.7%), with associated risk factors including non-compliance, aging, male sex, and dyslipidemia.
Why the study?
What is the prevalence and what are the risk factors for resistant hypertension in Africa?
Meta-Analysis (n=4,068)
Yes
What is the prevalence and what are the risk factors for resistant hypertension in Africa?
The pooled prevalence of resistant hypertension in Africa is estimated at 12.1%, though data is severely limited by a lack of epidemiological studies.
Highlights substantial resistant hypertension burden in Africa; leaves open need for standardized definitions and prospective studies.
OBJECTIVE: The hypertension epidemic in Africa collectively with very low rates of blood pressure control may predict an incremented prevalence of resistant hypertension (RH) across the continent. The aim of this study was to determine the prevalence of RH and associated risk factors in Africa. DATA SOURCES: We conducted a comprehensive search of electronic databases (PubMed, EMBASE, Africa Wide Information and Africa Index Medicus) completed by manual search of articles, regardless of language or publication date. METHODS: We included studies which have reported the prevalence and/or risk factors for RH in Africa from inception to 19 May 2016. Forest plots were drawn to visualise the combined prevalence of RH and extent of statistical heterogeneity between studies. RESULTS: Out of 259 retrieved studies, only 5 from Cameroon, Nigeria, Burkina Faso, Lesotho and Algeria with a total population of 4 068 patients were finally included in this review. There was no study from the Eastern part of Africa. Though the definition of RH was not similar across studies, its prevalence was respectively 11.7%, 4.9%, 14.6%, 14.3% and 19.0%, with an overall pooled prevalence of 12.1% (95% CI 8.0% to 17.7%). Potential risk factors were: non-compliance to treatment, ageing, male sex, dyslipidaemia, metabolic syndrome, previous cardiovascular events, physical inactivity and stress, but not excessive salt intake, alcohol and coffee ingestions. Moreover, diabetes, smoking, obesity and renal insufficiency yielded discrepant results. CONCLUSIONS: There is a huge dearth of research on the epidemiology of RH in Africa. Thereby, an extensive study of RH prevalence and risk factors is still largely warranted to curtail the high and continuously increasing burden of hypertension across Africa.
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Nansseu et al. (2016) conducted a meta-analysis in Resistant hypertension (n=4,068). Risk factors for resistant hypertension was evaluated on Overall pooled prevalence of resistant hypertension (Prevalence 12.1%, 95% CI 8.0% to 17.7%). The overall pooled prevalence of resistant hypertension in Africa was 12.1% (95% CI 8.0% to 17.7%), with associated risk factors including non-compliance, aging, male sex, and dyslipidemia.
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