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      Blood pressure and burden of hypertension in Cameroon, a microcosm of Africa: a systematic review and meta-analysis of population-based studies

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      a , b , c , b , d , e , f , g , h , a , i , a , e , j , k , l , m , n , o , p , e , f , q , r , a , s , t , u , v , r , b , w , x
      Journal of Hypertension
      Lippincott Williams & Wilkins
      Africa, ageing, blood pressure, Cameroon, epidemiology, hypertension, low-income and middle-income countries, noncommunicable disease, review

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          Abstract

          Supplemental Digital Content is available in the text

          Objective:

          To estimate national and geography-based variations in blood pressure and burden of hypertension in Cameroon, generally called ‘miniature Africa’.

          Methods:

          PubMed, Medline, EMBASE, CINHAL, Web of Science, Popline, Scopus and BDSP were searched through November 2018, for hypertension studies among Cameroonians aged at least 18 years. Hypertension was measured as SBP at least 140 mmHg or DBP at least 90 mmHg. Random-effects meta-analysis was used.

          Results:

          Twenty studies involving 46 491 participants met inclusion criteria. Overall hypertension prevalence was 30.9% [95% confidence interval (CI) 27.0–34.8]: 29.6% (24.1–35.1) and 32.1% (27.2–37.1) in 1994–2010 and 2011–2018, respectively. Of hypertensive participants, only 24.4% (18.9–30.0) – 31.6% (21.0–42.3) and 20.8% (14.0–27.7) in 1994–2010 and 2011–2018, respectively – were aware of their status, 15.1% (10.6–19.6) were taking antihypertensive medications and 8.8% (5.7–11.9) – 10.4% (7.5–13.3) and 8.3% (4.4–12.3) in 1994–2010 and 2011–2018, respectively – were controlled. Hypertension prevalence varied by sex: 34.3% (30.0–38.6) for men and 31.3% (26.5–36.1) for women; ethnicity: from 3.3% (0.4–6.2) among Pygmies to 56.6% (49.4–63.8) among Bamileke; urbanity: 25.4% (17.1–33.7) for rural and 31.4% (27.3–35.5) for urban dwellers; agroecological zone: from 35.1% (28.9–41.3) in Tropical highlands to 28% (20.1–35.9) in Guinea-Savannah; and subnational region: from 36.3% (27.8–44.9) in the West to 17.1% (9.9–44.2) in the South.

          Conclusion:

          Cameroon's hypertension prevalence is high and increasing whereas awareness, treatment and control are low and declining. Emerging patterns call urgently for effective campaigns to raise hypertension awareness alongside strategies for hypertension prevention and BP control.

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          Most cited references70

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          Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.

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            Burden of undiagnosed hypertension in sub-saharan Africa: a systematic review and meta-analysis.

            The burden of hypertension in Sub-Saharan Africa has been increasing over the past few decades. However, a large proportion of the population with hypertension remains undiagnosed, untreated, or inadequately treated, contributing to the rising burden of cardiovascular disease in the region. We conducted a systematic review and meta-analysis to assess the recent burden of hypertension in Sub-Saharan Africa, based on studies published between 2000 and 2013. We pooled data from 33 surveys involving over 110 414 participants of mean age 40 years. Hypertension prevalence varied widely across the studies (range 15%-70%), partly because of differences in participant mean ages (31-76 years). The predicted prevalence of hypertension at mean participant ages of 30, 40, 50, and 60 years were 16%, 26%, 35%, and 44%, respectively, with a pooled prevalence of 30% (95% confidence interval, 27%-34%). Of those with hypertension, only between 7% and 56% (pooled prevalence: 27%; 95% confidence interval, 23%-31%) were aware of their hypertensive status before the surveys. Overall, 18% (95% confidence interval, 14%-22%) of individuals with hypertension were receiving treatment across the studies, and only 7% (95% confidence interval, 5%-8%) had controlled blood pressure. This review found a high prevalence of hypertension, as well as low percentage of hypertension awareness, treatment, and control in Sub-Saharan Africa, highlighting the need for implementation of timely and appropriate strategies for diagnosis, control, and prevention. © 2014 American Heart Association, Inc.
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              Monitoring and surveillance of chronic non-communicable diseases: progress and capacity in high-burden countries.

              The burden of chronic, non-communicable diseases in low-income and middle-income countries is increasing. We outline a framework for monitoring of such diseases and review the mortality burden and the capacity of countries to respond to them. We show data from WHO data sources and published work for prevalence of tobacco use, overweight, and cause-specific mortality in 23 low-income and middle-income countries with a high burden of non-communicable disease. Data for national capacity for chronic disease prevention and control were generated from a global assessment that was done in WHO member states in 2009-10. Although reliable data for cause-specific mortality are scarce, non-communicable diseases were estimated to be responsible for 23·4 million (or 64% of the total) deaths in the 23 countries that we analysed, with 47% occurring in people who were younger than 70 years. Tobacco use and overweight are common in most of the countries and populations we examined, but coverage of cost-effective interventions to reduce these risk factors is low. Capacity for prevention and control of non-communicable diseases, including monitoring and surveillance operations nationally, is inadequate. A surveillance framework, including a minimum set of indicators covering exposures and outcomes, is essential for policy development and assessment and for monitoring of trends in disease. Technical, human, and fiscal resource constraints are major impediments to the establishment of effective prevention and control programmes. Despite increasing awareness and commitment to address chronic disease, concrete actions by global partners to plan and implement cost-effective interventions are inadequate. Copyright © 2010 Elsevier Ltd. All rights reserved.
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                Author and article information

                Journal
                J Hypertens
                J. Hypertens
                JHYPE
                Journal of Hypertension
                Lippincott Williams & Wilkins
                0263-6352
                1473-5598
                November 2019
                03 June 2019
                : 37
                : 11
                : 2190-2199
                Affiliations
                [a ]Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montreal, Canada
                [b ]Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences
                [c ]Laboratory of Molecular Medicine and Metabolism, The Biotechnology Centre, University of Yaoundé I
                [d ]Technical Adviser, Ministry of Public Health, Yaoundé, Cameroon
                [e ]Montreal Heart Institute
                [f ]Deparment of Cardiology, Faculty of Medicine, Université de Montréal, Montreal, Canada
                [g ]Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
                [h ]Faculty of Pharmacy, Université de Montréal, Montreal, Canada
                [i ]Department of Allied Health, Northern Kentucky University, Highland Heights, Kentucky, USA
                [j ]Department of Psychology, Université de Montréal
                [k ]Faculty of Dentistry
                [l ]Department of Neurology
                [m ]Department of Neurosurgery
                [n ]Department of Medicine, Faculty of Medicine, McGill University, Montréal
                [o ]Department of Ophthalmology, Faculty of Medicine
                [p ]Department of Environmental Health, School of Public Health
                [q ]Department of Obstetrics and Gynecology, Faculty of Medicine
                [r ]School of Nursing, Université de Montréal, Montreal
                [s ]Deparment of Cardiology, Faculty of Medicine, Université de Sherbrooke, Sherbrooke, Canada
                [t ]Faculty of Health Sciences, University of Bamenda, Bamenda, Cameroon
                [u ]Department of Chemistry, Université de Montréal, Montreal, Canada
                [v ]Department of Radiology and Radiation Oncology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
                [w ]PRONUSTIC Research Laboratory
                [x ]Department of Health Administration, Evaluation and Policy, School of Public Health, Université de Montréal, Montreal, Canada
                Author notes
                Correspondence to Professor Barthelemy Kuate Defo, MPM, PHD, Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, C.P. 6128 Succursale Centre-Ville, Montreal , Canada H3C 3J7. Tel: +1 514 343 7611; fax: +1 514 343 2309; e-mail: barthelemy.kuate.defo@ 123456umontreal.ca
                Article
                JH-D-19-00164
                10.1097/HJH.0000000000002165
                6784854
                31166251
                744e5669-e7df-41d0-9714-380bfa6a1bba
                Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0

                History
                : 14 February 2019
                : 10 April 2019
                : 08 May 2019
                Categories
                ORIGINAL PAPERS: Epidemiology
                Custom metadata
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                africa,ageing,blood pressure,cameroon,epidemiology,hypertension,low-income and middle-income countries,noncommunicable disease,review

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