Prevalence, awareness and control of hypertension in Malaysia 1980 – 2017: A Systematic Review and Meta-Analysis

Abstract

3Background: 4 Hypertension is a common public health problem worldwide and is a well-known risk factor 5 for increased risk of cardiovascular diseases, contributing to high morbidity and mortality. 6 However, there is no systematic review and meta-analysis that has been done in a multi-ethnic 7 population like Malaysia. This systematic review aims to determine the trend in prevalence, 8 awareness and control of hypertension in Malaysia. 9 10 Methods: 11 Systematic searches were conducted in PubMed, Scopus, Ovid, Cumulative Index to Nursing 12 and Allied Health Literature, Malaysian Medical Repository and Malaysia Citation Index 13 published between 1980 and 2017. All original articles in English were included. Studies 14 included were those on adults aged 18 years and above. Studies of prevalence in children and 15 adolescents and pregnancy related hypertension were excluded. Two authors independently 16reviewed the studies, carried out data extraction and performed quality assessment. 17Heterogeneity between studies and publication bias was assessed and effect size was pooled 18 3 1 2 Conclusion: 3 Three in 10 adults aged 18 years old and above have hypertension, whereas four in 10 adults 4 aged 30 years old and above have hypertension. Four out of 10 are aware of their hypertension 5 status and only one-third of them who were under treatment achieved control of their 6 hypertension. Concerted efforts by policymakers and healthcare professionals to improve the 7 awareness and control of hypertension should be of high priority. 8 9 Cumulative Index of Nursing and Allied Health Literature (Cinahl), MyCite [7] 2 and MyMedR [8]. The search strategy was based on terms related to: (prevalence) and 3 (awareness) and (control) and (hypertension or high blood pressure) and (Malaysia) and 4 combination of these using Boolean operators, adapted from previous reviews, and a 5 combination of expanded MeSH term and free-text searches were conducted. A combination 6 of expanded MeSH term and free-text searches were used as shown in Appendix 3. Cross 7 reference of all selected articles were scanned for additional studies. If more than one article 14 fulfilling the following criteria were included into the analysis: (1) Studies including the 15 general population who are 18 years old and above; 2) studies on prevalence of hypertension 16 diagnosed using digital automated or mercury sphygmomanometer 3) studies which were on 17 either prevalence, awareness, control of blood pressure or hypertension individually or any 18 combination of the three; (4) hypertension was defined as BP≥140/90 mmHg according to JNC 19 5; (5) studies on prevalence at BP screening campaigns 6) prevalence which was based either 20 on physician-diagnosed hypertension or on antihypertensive medications; (7) awareness was 21 defined as knowing one's own hypertension status or having been diagnosed as hypertension 22 previously; (8) control was defined as achieving target blood pressure of less than 140/90 23 mmHg; (9) studies in English only. 24 25...

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