Prevalence of elevated blood pressure in children and adolescents in Africa: a systematic review and meta-analysis

Loading...
Thumbnail Image
File version

Version of Record (VoR)

Author(s)
Noubiap, Jean Jacques
Essouma, Mickael
Bigna, Jean Joel
Jingi, Ahmadou M
Aminde, Leopold N
Nansseu, Jobert Richie
Griffith University Author(s)
Primary Supervisor
Other Supervisors
Editor(s)
Date
2017
Size
File type(s)
Location
Abstract

BACKGROUND: Despite substantial attention paid to the threat of elevated blood pressure in children and adolescents in high-income countries and the epidemic of hypertension in African adult populations, data on the burden of elevated blood pressure in African children and adolescents have not yet been synthesised. We did a systematic review and meta-analysis to provide estimates of the prevalence of elevated blood pressure and assess associated factors among children and adolescents in Africa. METHODS: We searched Embase, PubMed, African Journals Online, and African Index Medicus to identify articles published from Jan 1, 1996, to Feb 2, 2017, and searched the reference list of retrieved articles. Each study was independently reviewed for methodological quality. We used a random-effects model to estimate the prevalence of elevated blood pressure across studies and heterogeneity (I2) was assessed via the χ2 test on Cochran's Q statistic. This review is registered with PROSPERO, number CRD42015019029. FINDINGS: We included 51 studies in qualitative synthesis and 25 in the meta-analysis reporting data of a pooled sample of 54 196 participants aged 2-19 years. Study quality was high with only four medium-quality studies and no low-quality studies. Prevalence of elevated blood pressure varied widely across studies (range 0·2-24·8%). The pooled prevalence of elevated blood pressure (systolic or diastolic blood pressure ≥95th percentile) was 5·5% (95% CI 4·2-6·9), whereas that of slightly elevated blood pressure (systolic or diastolic blood pressure ≥90th percentile and <95th percentile) was 12·7% (2·1-30·4). The prevalence of elevated blood pressure was largely associated with body-mass index (BMI), with a prevalence of elevated blood pressure six times higher in obese (30·8%, 95% CI 20·1-42·6) versus normal-weight children (5·5%, 3·1-8·4; p<0·0001). INTERPRETATION: This study suggests a high prevalence of elevated blood pressure among children and adolescents in Africa, with overweight and obesity being an important risk factor. Efforts to address this burden of elevated blood pressure in children and adolescents should mainly focus on primary prevention at the community level, by promoting healthy lifestyles and avoiding other cardiovascular risk factors, especially overweight and obesity. This study also stresses the need for more elaborate studies using uniform and reliable diagnostic methods to reliably map the burden of elevated blood pressure in children and adolescents in Africa. FUNDING: None.

Journal Title

The Lancet Public Health

Conference Title
Book Title
Edition
Volume

2

Issue

8

Thesis Type
Degree Program
School
Publisher link
Patent number
Funder(s)
Grant identifier(s)
Rights Statement
Rights Statement

© The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Item Access Status
Note
Access the data
Related item(s)
Subject

Health services and systems

Public health

Science & Technology

Life Sciences & Biomedicine

Public, Environmental & Occupational Health

CARDIOVASCULAR RISK-FACTORS

LEFT-VENTRICULAR HYPERTROPHY

Persistent link to this record
Citation

Noubiap, JJ; Essouma, M; Bigna, JJ; Jingi, AM; Aminde, LN; Nansseu, JR, Prevalence of elevated blood pressure in children and adolescents in Africa: a systematic review and meta-analysis, The Lancet Public Health, 2017, 2 (8), pp. E375-E386

Collections