Key result
The pooled prevalence of hypertension among people diagnosed with diabetes in Africa was 58.1% (95% CI 52.0% - 63.2%), with the highest regional prevalence in Central Africa at 77.6%.
Why the study?
Hypertension and diabetes comorbidity increases healthcare expenditure and coronary heart disease risk, prompting estimation of hypertension prevalence among people with diabetes in African countries.
Meta-Analysis
Yes
There is a high prevalence of hypertension (58.1%) among people with diabetes in Africa, highlighting the critical need for integrated primary care to prevent cardiovascular disease.
High pooled prevalence (58%) signals substantial comorbidity burden for African diabetes care; extends regional data but prospective studies needed before guiding policy.
Hypertension and diabetes comorbidity can increase healthcare expenditure and the risk of coronary heart disease. We conducted a systematic review and meta-analysis to estimate the prevalence of hypertension among people with diabetes in African countries. We searched EMBASE, PubMed and HINARI databases from inception to March 2023. Cross-sectional studies reporting the prevalence of hypertension among people with diabetes and published in English in Africa were eligible for inclusion. The cross-sectional study design component of the mixed method appraisal tool was used to assess the quality of the included studies. We quantified the overall and regional prevalence of hypertension among people with diabetes using random-effects meta-analysis. We assessed heterogeneity and publication bias using I2 statistics and funnel plots. Out of 3815 articles retrieved from the various databases, 41 met the inclusion criteria with sample sizes ranging from 80 to 116726. The mean age was 58 years (± 11) and 56% were women. The pooled prevalence of hypertension in people diagnosed with diabetes was 58.1% [95% CI: 52.0% - 63.2%]. By region, Central Africa had the highest hypertension prevalence; 77.6% [95% CI: 53.0% - 91.4%], Southern Africa 69.1% [95% CI: 59.8% - 77.1%;], North Africa 63.4% [95% CI: 37.1% - 69.1%;], West Africa 51.5% [95% CI: 41.8% - 61.1%] and East Africa 53.0% [95% CI: 45.8% - 59.1%]. Increasing age, being overweight/obese, being employed, longer duration of diabetes, urban residence, and male sex were reported to be associated with a higher likelihood of developing hypertension. The high prevalence of hypertension among people with diabetes in Africa highlights the critical need for an integrated differentiated service delivery to improve and strengthen primary care and prevent cardiovascular disease. Findings from this meta-analysis may inform the delivery of interventions to prevent premature cardiovascular disease deaths among persons in the region.
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Hinneh et al. (2023) conducted a meta-analysis in Diabetes. Diabetes was evaluated on Prevalence of hypertension (95% CI 52.0% - 63.2%). The pooled prevalence of hypertension among people diagnosed with diabetes in Africa was 58.1% (95% CI 52.0% - 63.2%), with the highest regional prevalence in Central Africa at 77.6%.
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