Population-level hypertension control rate in India: A systematic review and meta-analysis of community based non-interventional studies, 2001-2020

Abstract

Background: Hypertension is a significant contributor to mortality in India. This systematic review and meta-analysis aimed to understand the overall hypertension control rate in India, differences across sex and regions, and changes over time. Methods: Community-based, non-interventional studies published between 2001 and 2020 were searched in PubMed, Embase, and Web of Science. Modified New Castle-Ottawa scales was used to assess the risk of bias. We conducted a random-effects meta-analysis to provide summary estimates by including 29 studies that had a minimum sample size of 100 each. We also conducted subgroup analysis and meta-regression to explore changes in control rates over years and to explain the heterogeneity. Results: The systematic review included 170,631 hypertensive patients. The overall control rate was 33.2% (95% CI-27.9,38.6) with substantial heterogeneity, I2=99.1 % (95% CI-98.9,99.2; p <0.001). Subgroup analysis showed that hypertension control rates did not improve over the years (35.8% in 2011-2020 versus 29.6% in 2001-2010, p=0.23) and did not vary between males and females (34.2% for females and 28.2% for males, p=0.23). Control rates were significantly higher in the south region compared to other regions. Meta-regression model with sex, region, study period, and an interaction term for region and period of the study explained 76.5% of heterogeneity. Very few studies analyzed relevant factors that are associated with adequate control. Conclusion: Hypertension is adequately controlled only among one-third of patients in India. India needs more studies at community levels to understand the health system and socioeconomic factors that determine uncontrolled hypertension in India. PROSPERO registration: CRD42021267973

Predictors of non-adherence to antihypertensive medications: A cross-sectional study from a regional hospital in Afghanistan

“…In this study, we found that 71.2% of the patients had poor control of their BP. This finding is consistent with previous studies conducted in Afghanistan [ 4 , 10 ] and other developing countries [ 7 – 9 ]. There are several examples in the literature that non-adherence to AHMs also plays a significant role in the suboptimal control of hypertension [ 9 – 11 ].…”

“…The rate of blood pressure (BP) control differs between countries. In resource-poor countries such as India, Ethiopia, and Uganda, the level of controlled BP among treated patients was 17.5% [ 7 ], 47.9% [ 8 ], and 18% [ 9 ], respectively. In Afghanistan (with its healthcare system still recovering from years of conflict), the national prevalence of uncontrolled hypertension is ~80%, warranting immediate attention [ 4 , 10 ].…”

High Prevalence of Uncontrolled Hypertension Among Afghan Hypertensive Patients: A Multicenter Cross-Sectional Study

“…In this study, physically inactive patients suffered from uncontrolled hypertension, supporting the previously published findings that physically inactive patients with hypertension are more likely to have uncontrolled hypertension. 17 , 28 Furthermore, our results showed that high BMI (overweight/ obesity) also played a significant role in uncontrolled hypertension. These findings highlight the need to promote physical activity in the Afghan population to enhance the prevention and management of hypertension.…”

“…For instance, a recent systematic review and meta-analysis of community based non-interventional studies from India found that the pooled prevalence of uncontrolled hyperextension was as high as 82.5% and had significantly poor control rates in the eastern region. 17 Findings from several other LMICs reported uncontrolled hypertension in 82.5% of the study participants in Uganda, 28 and 52.1% in Ethiopia. 14 Variation in the prevalence of uncontrolled hypertension reported in pertinent literatures can be attributed to variation in socioeconomic status, geographic locations, research methodology, dietary habits of study participants, and other non-explored factors.…”

Designing, Validation, and Feasibility Analysis of Integrated Approach of Heartfulness Meditation and Yoga Protocol (IAHFNM & YP) for Hypertensive Participants

“…(Whelton et al, 2022) Among various modi able direct and indirect risk factors, a sedentary lifestyle resulting from emerging globalization and modernization has been identi ed as one of the primary causes of chronic diseases. (Koya et al, 2023;Patil et al, 2023) Evidence has also shown the association of psychological factors, such as negative affect, suppressed hostility, and emotional defensiveness, with elevated blood pressure and increased risk of hypertension. and effective tools for stress reduction and health management strategies.…”