Prevalence of Hypertension and its relationship with Smoking among Adults in Sub Saharan Africa countries: A Systematic review and Meta-analysis

Abstract

Background: Hypertension is one of the major public health challenges across the globe. Many smaller studies were done at local setting, but there is lack of pooled estimate data that shows national or multinational representative prevalence studies. This study is intended to summarize and pool the results of individual studies to provide comprehensive estimate on the prevalence of hypertension. Objective: To assess the pooled prevalence of hypertension and its relationship with smoking among adults in Sub Saharan Africa. Methods: Using database (MEDLINE/Pub Med, Google Scholar, HINARI, Cochrane Library and Science Direct) and manually articles were searched (from January 1/2008 to April 15/2019). Studies were selected if the meet inclusion criteria (prevalence of hypertension and or its association with smoking among adults in Sub Saharan Africa). Data were extracted using predefined data extraction template and analysis using Rev Man and JASP statistical software. Descriptive information were presented in a table, Heterogeneity test and publication bias analysis were presented using forest plots and funnel plot respectively. The Cochrane chi-square test was used to test heterogeneity across studies and I 2 test statistic was used to estimate the percentage of the variability in effect estimates that is due to heterogeneity, this estimate was computed by a random effects model. Results: Three thousands one hundreds forty five (3145) records were identified by search database using keywords and Medical Subject Heading of these, 27 studies meet the inclusion criteria. The pooled prevalence of hypertension was 24.8% CI: (24.4%, 25.1%). Subgroup analyses for urban and rural population estimated the prevalence of hypertension to be 26.5% CI: (26% - 27.1%) and 21.2% CI: (20.6% - 21.9%) respectively. Compared to nonsmokers, smokers were significantly develop hypertension by 1.26 CI (1.11, 1.44) with proportion of hypertension among smokers to nonsmokers were 27.9% CI: (26.6% - 29.2%) and 23% CI: (22.6% - 23.4%) respectively. Conclusion: In conclusion, one out of four adults in Sub Saharan Africa adults have Hypertension. Rising in proportion of people with hypertension in the population must trigger the policy makers and health care professionals as this can provide an evidence where primary prevention measures can bring about a substantial reduction in morbidity, mortality and consequences of hypertension in the future