What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Hypertension (n=533167). Intervention: Sub-Saharan Africa residence. Primary outcome: Pooled hypertension prevalence (29.9%, 95% CI 27.8% - 32.1%).

What does this research mean for the field?

Approximately 29.9% of adults in Sub-Saharan Africa have hypertension, with significant disparities showing higher prevalence in urban settings, Southern Africa, and older age groups. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To estimate the pooled prevalence of hypertension across Sub-Saharan Africa and assess disparities across geographical regions, urban versus rural environments, and age groups.

September 14, 2026Discover Public HealthOpen Access

Hypertension prevalence and regional disparities in Sub-Saharan Africa based on a systematic review and meta-analysis

Q: What are the key findings of this study?

The pooled prevalence of hypertension among adults in Sub-Saharan Africa is estimated to be 29.9%, with substantial regional and urban-rural disparities.

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Key result

Hypertension affects ~30% of adults in Sub-Saharan Africa with substantial regional and urban-rural disparities.

29.9%
95% CI 27.8% - 32.1%
n=533,167

Key Points

To estimate the pooled prevalence of hypertension across Sub-Saharan Africa and assess disparities across geographical regions, urban versus rural environments, and age groups.
Systematic review and random-effects meta-analysis (logit transformation) of observational studies published between 2010 and 2025 across PubMed, Scopus, Web of Science, African Journals Online, and Google Scholar.
Included 45 studies comprising N = 533,167 participants aged ≥ 18 years across 26 countries, assessing study quality using the Newcastle-Ottawa Scale (71.1% high quality).
Hypertension was defined as systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, or current antihypertensive medication use.
Pooled hypertension prevalence was 29.9% (95% CI: 27.8%–32.1%), with arithmetic and geometric mean estimates of 30.5% and 30.1%, respectively, alongside high heterogeneity (I² = 98.8%, p < 0.001) and evidence of publication bias (Egger's test p = 0.042).
Prevalence was higher in urban areas (32.9%) than rural areas (26.3%), with Southern Africa exhibiting the highest regional rate (34.8%), followed by West Africa (31.2%), Central Africa (29.6%), and Eastern Africa (27.2%).
Hypertension rates rose sharply with advancing age, increasing from 10.6% in individuals aged 21–30 years to 66.4% in those aged 71–80 years.

Study Design

Type

Meta-Analysis (n=533,167)

Structured PICO

Population

533,167 adults aged 18 years and older from 26 Sub-Saharan African countries included in a meta-analysis of observational studies to estimate hypertension prevalence.

Outcome

Pooled prevalence of hypertension (systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg or antihypertensive medication use)

Main Result

Effect estimate: 29.9% (95% CI 27.8% - 32.1%)

Approximately one in three adults in Sub-Saharan Africa is estimated to have hypertension, highlighting a significant public health burden with substantial regional, urban-rural, and age-related disparities.

Limitations

Extreme heterogeneity (I² = 98.8%) reflecting true variation across diverse populations and methods
Most included studies were cross-sectional, precluding causal inference about temporal trends
Geographic gaps remain with sparse data from Francophone West Africa, Central Africa, and conflict-affected nations
Evidence of publication bias (Egger's p = 0.042)
Predominant use of the 140/90 mmHg definition likely underestimates the true burden compared to newer thresholds
Trim-and-fill analysis was not performed
Grey literature was not systematically searched
Restriction to English-language publications may have introduced language bias
Absence of prospective protocol registration (e.g., PROSPERO)
Extreme heterogeneity (I² = 98.8%)
Publication bias suggested by Egger's test

Implication

Highlights substantial hypertension burden requiring enhanced screening in Sub-Saharan Africa; extends inconsistent prior estimates with a region-wide meta-analysis.

Abstract

Hypertension is a leading cause of cardiovascular disease and premature death in Sub-Saharan Africa (SSA), but region-wide prevalence estimates remain inconsistent due to fragmented evidence. To estimate the pooled prevalence of hypertension in SSA and examine regional, urban-rural, and age-related disparities. We searched PubMed, Scopus, Web of Science, African Journals Online, and Google Scholar for observational studies published between 2010 and 2025 reporting hypertension prevalence (systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg or antihypertensive medication use) among adults (≥ 18 years) in SSA. Two independent reviewers screened records, extracted data, and assessed quality using the Newcastle-Ottawa Scale. Random-effects meta-analysis using logit transformation was performed to pool prevalence. Heterogeneity was assessed using I², and publication bias was evaluated with funnel plots and Egger’s test. Subgroup analyses were conducted by region, urban/rural setting, age, and sex. Of 3,250 records, 45 studies (533,167 participants, 26 countries) met inclusion criteria for meta-analysis. The pooled hypertension prevalence was 29.9% (95% CI: 27.8% – 32.1%) using logit transformation, with similar estimates from arithmetic (30.5%) and geometric (30.1%) means. Prevalence was higher in urban (32.9%) than rural (26.3%) settings. Southern Africa had the highest prevalence (34.8%), followed by West Africa (31.2%), Central Africa (29.6%), and Eastern Africa (27.2%). Prevalence increased steeply with age, from 10.6% (21–30 years) to 66.4% (71–80 years). Heterogeneity was extreme (I² = 98.8%, p < 0.001). Egger’s test suggested publication bias ( p = 0.042). The majority of studies (71.1%) were high quality. Approximately one in three adults in Sub-Saharan Africa is estimated to have hypertension, with substantial regional and urban-rural disparities. The steep age gradient signals a potential window for early screening and prevention.

Discussion

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Cite This Study

Eling et al. (2026) conducted a meta-analysis in Hypertension (n=533,167). Sub-Saharan Africa residence was evaluated on Pooled hypertension prevalence (29.9%, 95% CI 27.8% - 32.1%). The pooled prevalence of hypertension among adults in Sub-Saharan Africa is estimated to be 29.9%, with substantial regional and urban-rural disparities.

synapsesocial.com/papers/6aa7afef79e9260bc85aacfc https://doi.org/10.1186/s12982-026-02966-z

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Implication

Highlights substantial hypertension burden requiring enhanced screening in Sub-Saharan Africa; extends inconsistent prior estimates with a region-wide meta-analysis.

Hypertension prevalence and regional disparities in Sub-Saharan Africa based on a systematic review and meta-analysis

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Hypertension prevalence and regional disparities in Sub-Saharan Africa based on a systematic review and meta-analysis

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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