The highly neglected burden of resistant hypertension in Africa: a systematic review and meta-analysis

Nansseu, Jobert Richie N., Noubiap, Jean Jacques N., Mengnjo, Michel K., Aminde, Leopold Ndemnge, Essouma, Mickael, Jingi, Ahmadou M. and Bigna, Jean Joel R. (2016) The highly neglected burden of resistant hypertension in Africa: a systematic review and meta-analysis. BMJ Open, 6 9: . doi:10.1136/bmjopen-2016-011452


Author Nansseu, Jobert Richie N.
Noubiap, Jean Jacques N.
Mengnjo, Michel K.
Aminde, Leopold Ndemnge
Essouma, Mickael
Jingi, Ahmadou M.
Bigna, Jean Joel R.
Title The highly neglected burden of resistant hypertension in Africa: a systematic review and meta-analysis
Journal name BMJ Open   Check publisher's open access policy
ISSN 2044-6055
Publication date 2016-09-01
Year available 2016
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1136/bmjopen-2016-011452
Open Access Status DOI
Volume 6
Issue 9
Total pages 9
Place of publication London, United Kingdom
Publisher BMJ Group
Collection year 2018
Language eng
Formatted abstract
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.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: HERDC Pre-Audit
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