The burden and high prevalence of hypertension in Pakistani adolescents: a meta-analysis of the published studies

Abstract

BackgroundHypertension has been recognized as a global health concern for developing countries and is scarcely described in many of these countries. In Pakistan, few population-based surveys evaluated the prevalence of hypertension and there is no current nationally representative study (the latest nationwide survey was conducted more than two decades ago). Objective: The goal of the current study was to estimate the pooled prevalence of hypertension in Pakistani population using meta-analysis approach.MethodsWe searched the published literature using PubMed, Google and Scopus supplemented by a manual search of bibliographies of retrieved articles for population studies providing estimates on the prevalence of hypertension between 1990 and 2017. Studies were included if they defined hypertension as ≥140/90 mmHg and conducted in adults (≥15 years). From the extracted results, the heterogeneity index of the studies was determined using Chi-squared I2 tests and on the basis of heterogeneity, a fixed or random effect model was used to estimates the pooled prevalence of hypertension. Meta-regression was performed to determine those factor of generating heterogeneity.ResultsOf a total of 1240 articles, 18 studies comprising 42,618 participants met the eligibility criteria. The overall pooled prevalence of hypertension was 26.34% (25.93%, 26.75%). Subgroup analysis showed higher urban prevalence 26.61% (21.80%, 31.42%) than the rural dwellers 21.03% (10.18%, 31.87%). The prevalence by decade in 1990s was 19.55% (18.07%, 21.05%), in 2000s 23.95% (16.60%, 31.30%) and in 2010s 29.95% (24.13%, 35.77%). Similarly, the pooled prevalence was 24.99% (19.70%, 30.28%) in males and 24.76% (16.76%, 32.76%) in females. We recorded high burden of hypertension among the adult Pakistanis when compared to the data published in local and international journals 23.32% (18.9%, 27.74%) and 27.44% (20.97%, 33.91%). We also found differences in the prevalence of hypertension among small, medium and large studies.ConclusionComparing data from previous studies in Pakistan, we found a higher prevalence in urban areas and among males. The prevalence over time is likely to increase faster, further our results underscore the importance of good quality long-term studies that will help to understand hypertension better and implement effective prevention and management programs.

Prevalence of hypertension and its determinants in Ethiopia: A systematic review and meta-analysis

“…This systematic review and meta-analysis revealed that the pooled prevalence of hypertension in Ethiopia was 21.81% (95% CI: 19.20–24.42), which was consistent with a study conducted in rural communities of Sub-Saharan Africa (22%), Kenya (22.8%), and a meta-analysis from Vietnam (21.1%) [ 62 – 64 ]. However, the finding of this meta-analysis was lower than the previous meta-analysis reports in LMICs (32.3%), among adults in Africa (57.0%), a meta-analysis study on undiagnosed hypertension in Sub-Saharan Africa (30%), Nigeria (28.9%), India (29.8%), Pakistan (26.34%), and a study in Nepal (25.1%) [ 65 – 71 ]. The prevalence of hypertension in this review was higher than a study conducted a previous systematic review in Ethiopia and a study conducted in Ghana [ 13 , 72 ].…”

Association between attendance at outpatient follow-up appointments and blood pressure control among patients with hypertension

“…Better disease knowledge and awareness about potential complications among university graduates may explain higher likelihood to attend treatment follow-up visits. [38] 190 [62] Secondary care hospital 203 123 [61] 80 [39] Primary healthcare centre 151 33 [22] 118 (78) Overall 662 274 [41] 388 [59] Entitlement to free medical care…”

<p>Non-Adherence to Prescribed Antihypertensives in Primary, Secondary and Tertiary Healthcare Settings in Islamabad, Pakistan: A Cross-Sectional Study</p>

“…Similarly, the pooled prevalence was 24.9% (19.70-30.28%) in males and 24.7% (16.76-32.76%) in females. 8 Poor adherence is a critical barrier to treatment success [9][10][11] leading to worsening of disease, increased hospitalization rate and longer hospital stays. The estimated overall global prevalence of non-adherence to antihypertensive therapy is around 30%.…”