Burden of Undiagnosed Hypertension in Sub-Saharan Africa

Ataklte, Feven; Erqou, Sebhat; Kaptoge, Stephen; Taye, Betiglu; Echouffo‐Tcheugui, Justin B.; Kengne, André Pascal

doi:10.1161/hypertensionaha.114.04394

Cited by 516 publications

(447 citation statements)

References 49 publications

Supporting

Mentioning

366

Contrasting

Unclassified

Order By: Relevance

“…HBP tends to become more common after ART initiation and may cause HTN [4]. Consistent with other African data [17], only half of patients were aware of having HBP, and similar to our study at rural outpatient clinics in Zambia [18], few patients took anti-hypertensive drugs. Challenges to HIV-NCD integration range from low patient and provider awareness, education, and training to structural and logistic barriers [7,19].…”

Section: Discussionsupporting

confidence: 91%

Awareness and management of elevated blood pressure among human immunodeficiency virus–infected adults receiving antiretroviral therapy in urban Zambia: a call to action

Bauer

Mwanza

Chilengi

et al. 2017

Global Health Action

View full text Add to dashboard Cite

The prevalence of high blood pressure (HBP) and hypertension (HTN), awareness of the diagnoses, and use of anti-hypertensive drugs were examined among human immunodeficiency virus (HIV)-infected individuals on antiretroviral therapy (ART) in Zambia’s capital Lusaka. Within a prospective cohort based at two public sector ART clinics, BP was measured at ART initiation and every 6 months thereafter as a routine clinic procedure. Predictors of HBP (systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg) during one year on ART were analyzed using logistic regression, and the proportion with HTN (2+ episodes of HBP >3 months apart) described. A phone survey was used to understand patient awareness of HBP, use of anti-hypertensive drugs, and history of cardiovascular events (CVE; myocardial infarction or stroke). Among 896 cohort participants, 887 (99.0%) had at least one BP measurement, 98 (10.9%) had HBP, and 57 (6.4%) had HTN. Increasing age (10-year increase in age: adjusted odds ratio [AOR] = 1.50; 95% confidence interval [CI] 1.20–1.93), male sex (AOR = 2.33, 95% CI 1.43–3.80), and overweight/obesity (AOR = 4.07; 95% CI 1.94–8.53) were associated with HBP. Among 66 patients with HBP, 35 (53.0%) reported awareness of the condition, and nine (25.7%) of these reported having had a CVE. Only 14 (21.2%) of those reached reported ever taking an anti-hypertensive drug, and one (1.5%) was currently on treatment. These data suggest that major improvements are needed in the management of HBP among HIV-infected individuals in settings such as Zambia.

show abstract

Section: Discussionsupporting

confidence: 91%

Awareness and management of elevated blood pressure among human immunodeficiency virus–infected adults receiving antiretroviral therapy in urban Zambia: a call to action

Bauer

Mwanza

Chilengi

et al. 2017

Global Health Action

View full text Add to dashboard Cite

show abstract

“…Yet, in sub-Saharan Africa (SSA) awareness of hypertension is low and access to quality care is poor [6]. Consequently, antihypertensive treatment coverage and hypertension control are both low [7,8]. The Pan-African Society of Cardiology presented a roadmap that aims to achieve 25% hypertension control by 2025 [9].…”

Section: Introductionmentioning

confidence: 99%

Low uptake of hypertension care after community hypertension screening events in Lagos, Nigeria

Nelissen

Okwor

Khalidson³

et al. 2018

Global Health Action

View full text Add to dashboard Cite

Background: In Lagos, Nigeria, approximately 33% of the population suffers from hypertension, yet antihypertensive treatment coverage is low. To improve access to care, a decentralized pharmacy-based hypertension care model was piloted. This study reports on the recruitment strategies used and is part of a larger study to evaluate the feasibility of the care model. Objective: To describe our experience executing three different strategies to recruit hypertensive patients in the program: community hypertension screenings, hospital and pharmacy referral. Methods: Individuals with elevated blood pressure and no history of cardiovascular disease were referred to the program’s recruitment days to see a medical doctor for hypertension diagnosis and enrollment. Individuals were referred from community screenings, tertiary hospital outpatient clinics, and pharmacies participating in the program. For the community screenings, we report the number needed to screen (NNS) to find one individual with elevated blood pressure, the NNS to enroll one individual in the program, and factors associated with enrollment in the program among participants referred. Results: We recruited 226 individuals (69%) in the program via the pharmacies, 97 (30%) via the community screenings, and 2 (<1%) via hospital referral. At the community screenings 3,204 individuals participated, 729 (23%) had elevated blood pressure and 618 (85%) were eligible for referral of whom 142 (23%) visited the recruitment days, and 97 (16%) enrolled. The NNS to find one individual with elevated blood pressure was 5, and the NNS to enroll one individual was 34. Enrollment in the program was associated with advancing age, blood pressure ≥160/100 and currently using antihypertensive medication. Conclusions: Despite the potential attractiveness of community screenings to identify and refer individuals with hypertension, enrollment in the program was low. For future programs we recommend pharmacy referral as individuals seem more inclined to access care through healthcare providers they are familiar with.

show abstract

“…4 Nonetheless, in sub-Saharan Africa, the prevalence of hypertension is rising steadily, 5,6 with a reported prevalence between 15% and 70% in different countries. 7 In Sudan, the situation is not different, as the burden of hypertension is also rising. [8][9][10] In 2012, the National Medical Information Centre/Federal Ministry of Health declared the registered number of hypertension cases to be about 9.9% of the total population.…”

Section: Introductionmentioning

confidence: 99%

High prevalence of hypertension among an ethnic group in Sudan: implications for prevention

et al. 2016

View full text Add to dashboard Cite

Objective Hypertension is an emerging non-communicable disease in developing countries. Due to its silent nature and serious complications, active screening is essential in order to prevent complications. For instance, premature mortality from cardiovascular diseases could be prevented by the effective control of hypertension. The aim of this study was to determine the prevalence of undiagnosed hypertension among Nuba ethnic group living in Atbara city, north Sudan and to identify the associated risk factors. Subject and methods All consenting 500 adults from Nuba tribe who live in El Wihda District, Atbara were included. Blood pressure (BP) and body mass index were measured. Standard interviewing procedures were used to record medical history, sociodemographic data, and lifestyle characteristics. Results Among the 500 participants, females were 364 (72.8%) and males were 136 (27.2%). The overall prevalence of undiagnosed hypertension was 49.4% (30.8% stage 1 hypertension and 18.6% stage 2 hypertension). In addition, 41% of the population was having prehypertension. The significant risk factors for high BP were: male sex, age above 45 years, overweight, illiteracy, and alcohol consumption. Conclusion Undiagnosed high BP is very common among Nuba ethnic group; therefore, active screening and early management are recommended to prevent complications. ARTICLE HISTORY

show abstract

Burden of Undiagnosed Hypertension in Sub-Saharan Africa

Cited by 516 publications

References 49 publications

Awareness and management of elevated blood pressure among human immunodeficiency virus–infected adults receiving antiretroviral therapy in urban Zambia: a call to action

Awareness and management of elevated blood pressure among human immunodeficiency virus–infected adults receiving antiretroviral therapy in urban Zambia: a call to action

Low uptake of hypertension care after community hypertension screening events in Lagos, Nigeria

High prevalence of hypertension among an ethnic group in Sudan: implications for prevention

Contact Info

Product

Resources

About