Non-pharmacological interventions for the prevention of hypertension in low-income and middle-income countries: protocol for a systematic review and meta-analysis

Saif‐Ur‐Rahman, K. M.; Mk, Hasan; Hossain, Md. Shabab; Shafique, Sohana; Khalequzzaman, -; Haseen, Fariha; Rahman, Aminur; Anwar, Iqbal; Islam, Syed Shariful

doi:10.1136/bmjopen-2017-020724

Cited by 4 publications

(3 citation statements)

References 20 publications

(16 reference statements)

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“… 31 Screening for hypertension and its risk factors earlier, combined with lifestyle-based interventions effectively avoid future complications. 32 33 …”

Section: Discussionmentioning

confidence: 99%

Missed opportunities in hypertension risk factors screening in Indonesia: a mixed-methods evaluation of integrated health post (POSBINDU) implementation

et al. 2022

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ObjectivesTo assess the implementation and contextual barriers of POSBINDU, a community-based activity focusing on screening of non-communicable diseases (NCDs), mainly hypertension and diabetes, in Indonesia.DesignThis was a concurrent mixed-methods study, with a cross-sectional analysis of secondary data and focus group discussions (FGDs) on stakeholder of POSBINDU.SettingThe study was conducted in seven districts in three provinces in Indonesia, with approximately 50% of the primary healthcare (PHC) were selected as areas for data collection (n PHC=100).ParticipantsFrom 475 POSBINDU sites, we collected secondary data from 54 224 participants. For the qualitative approach, 21 FGDs and 2 in-depth interviews were held among a total of 223 informants.Primary outcomes and measuresProportion of POSBINDU visitors getting the hypertension screening and risk factors’ assessment, and barriers of POSBINDU implementation.ResultsOut of the 114 581 POSBINDU visits by 54 224 participants, most (80%) were women and adults over 50 years old (50%) showing a suboptimal coverage of men and younger adults. Approximately 95.1% of visitors got their blood pressure measured during their first visit; 35.3% of whom had elevated blood pressure. Less than 25% of the visitors reported to be interviewed for NCDs risk factors during their first visit, less than 80% had anthropometric measurements and less than 15% had blood cholesterol examinations. We revealed lack of resources and limited time to perform the complexities of activities and reporting as main barrier for effective hypertension screening in Indonesia.ConclusionsThis study showed missed opportunities in hypertension risk factors screening in Indonesia. The barriers include a lack of access and implementation barriers (capability, resources and protocols).

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“… 31 Screening for hypertension and its risk factors earlier, combined with lifestyle-based interventions effectively avoid future complications. 32 33 …”

Section: Discussionmentioning

confidence: 99%

Missed opportunities in hypertension risk factors screening in Indonesia: a mixed-methods evaluation of integrated health post (POSBINDU) implementation

et al. 2022

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“…This systematic review has been carried out following the methodology of Cochrane systematic reviews [19] and addressed the requirements stated in preferred reporting items for systematic reviews and meta-analysis protocols guidelines [20, 21]. Details methodology including the development of search strategy, dual-screening process, dual-data extraction, dual appraisal of included articles for quality assessment, narrative synthesis, and meta-analysis has been described in the published protocol [22]. A comprehensive search strategy was developed using the key words such as Exercise, “Physical activity”, “Weight loss”, “Sodium restriction”, “Dietary potassium”, “Calcium supplementation”, “Fish oil supplementation”, Lifestyle, Hypertension, “Blood pressure” to search different electronic bibliographic database including Embase, MEDLINE through Pubmed, Web of Science, Clinical Trials.…”

Section: Methodsmentioning

confidence: 99%

Nonpharmacological interventions for the prevention of hypertension in low- and middle-income countries: a systematic review and meta-analysis

Saif‐Ur‐Rahman

Islam

et al. 2019

J Hum Hypertens

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Hypertension is the single biggest cause of various cardiovascular complications and at the same time one of the most preventable phenomena. Low- and middle-income countries (LMICs) are facing increasing prevalence of hypertension which is imposing a huge burden on morbidity, premature mortality, and catastrophic health expenditure. This systematic review searched for the nonpharmacological interventions for prevention of hypertension among normotensive people in LMICs considering the period 1990–2016. This review has been conducted following standard methodology of Cochrane review involving two independent reviewers in screening, quality appraisal, and data extraction. Narrative synthesis of included articles was demonstrated using tables and meta-analysis was conducted to pool the estimates of studies which fulfilled the criteria. Total seven trials were included in the review with 6046 participants from eight LMICs. Two cluster randomized trials were pooled and there was a statistically significant effect (Systolic Blood Pressure: mean difference −2.35 [95% CI: −4.31 to −0.38], Diastolic Blood Pressure: mean difference −2.11 [95% CI: −3.20 to −1.02]) of home based health education in reducing blood pressure. Three individual studies reported reduction of blood pressure as a result of restricted dietary sodium intake. None of the studies was appraised as low risk of bias due to poor methodological quality. Non-pharmacological interventions can play important role in preventing the development of hypertension among normotensive people. Further trials with longer follow-up period and robust methods are recommended for getting stronger evidence on these interventions.

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“…However, diabetic people, pregnant women (for excluding gestational diabetes), and the population living outside of LMICs will be excluded. -Intervention: Studies that are describing or assessing the impact of available non-pharmacological (e.g., changes in lifestyle, dietary restriction, physical activity, exercise, psychological support, diabetes mellitus self-management approaches) approaches/ intervention [19,20] to prevent type 2 diabetes in LMICs will be included in this review. -Comparators: Comparators will be the comparison groups which is either the control arm or no intervention group or placebo group (if any).…”

Section: Inclusion Criteriamentioning

confidence: 99%

Non-pharmacological interventions for the prevention of type 2 diabetes mellitus in low and middle-income countries: protocol for a systematic review and meta-analysis of randomized controlled trials

et al. 2020

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Introduction The disease burden caused by type 2 diabetes mellitus is a prime public health concern. The prevalence and rate of deaths from diabetes mellitus in low- and middle-income countries (LMICs) are higher than the high-income countries. Increased physical activity and a balanced diet are essential and successful measures to prevent the onset of diabetes mellitus. This systematic review aims to explore the available non-pharmacological approaches for the prevention of type 2 diabetes mellitus in LMICs. Methods and analysis Six online databases will be explored to get related randomized controlled trials (RCTs) published in English from inception to September 2020, and two coders will independently screen, identify studies, extract data, and assess the risk of bias in each article. The searched articles will be included by applying specific inclusion and exclusion criteria. Joanna Briggs Institute’s tool for RCTs will be used for appraising the trials critically. Narrative synthesis and pooled effect of the interventions will be demonstrated. A meta-analysis will be conducted using the random-effects model if assumptions are fulfilled. Discussion This review is an attempt to explore the available non-pharmacological approaches for the prevention of type 2 diabetes mellitus in LMICs. Findings from the review will highlight effective non-pharmacological measures for the prevention of type 2 diabetes mellitus to guide policy for future strategies. Systematic review registration The review protocol has been registered (CRD42020191507).

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Non-pharmacological interventions for the prevention of hypertension in low-income and middle-income countries: protocol for a systematic review and meta-analysis

Cited by 4 publications

References 20 publications

Missed opportunities in hypertension risk factors screening in Indonesia: a mixed-methods evaluation of integrated health post (POSBINDU) implementation

Missed opportunities in hypertension risk factors screening in Indonesia: a mixed-methods evaluation of integrated health post (POSBINDU) implementation

Nonpharmacological interventions for the prevention of hypertension in low- and middle-income countries: a systematic review and meta-analysis

Non-pharmacological interventions for the prevention of type 2 diabetes mellitus in low and middle-income countries: protocol for a systematic review and meta-analysis of randomized controlled trials

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