Objectives This systematic review aims to evaluate the
evidence of non-pharmacological
strategies to improve
blood pressure (BP) control in patients with hypertension
from African countries.
Design We performed a systematic review and searched
Medline, Central, CINAHL and study registers until June
2020 for randomised studies on interventions to decrease
BP of patients with hypertension in African countries.
We assessed the study quality using the Cochrane risk
of bias tool and narratively synthesised studies on non-pharmacological
hypertension interventions.
Setting We included studies conducted in African
countries.
Participants Adult African patients with a hypertension
diagnosis.
Interventions Studies on non-pharmacological
interventions aiming to improve BP control and treatment
adherence.
Outcomes Main outcomes were BP and treatment
adherence.
Results We identified 5564 references, included 23 with
altogether 18 153 participants from six African countries.
The studies investigated educational strategies to improve
adherence (11 studies) and treatment by healthcare
professionals (5 studies), individualised treatment
strategies (2 studies), strategies on lifestyle including
physical activity (4 studies) and modified nutrition (1
study). Nearly all studies on educational strategies stated
improved adherence, but only three studies showed a
clinically relevant improvement of BP control. All studies
on individualised strategies and lifestyle changes resulted
in clinically relevant effects on BP. Due to the type of
interventions studied, risk of bias in domain blinding of
staff/participants was frequent (83%). Though incomplete
outcome data in 61% of the studies are critical, the
general study quality was reasonable.
Conclusions The identified studies offer diverse
low-cost
interventions including educative and task-shifting
strategies, individualised treatment and lifestyle
modifications to improve BP control. Especially trialled
physical activity interventions show clinically relevant BP
changes. All strategies were trialled in African countries
and may be used for recommendations in evidence-based
guidelines on hypertension in African settings.
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:83016 |
| Date | 23 January 2023 |
| Creators | Cernota, Monique, Kroeber, Eric Sven, Demeke, Tamiru, Frese, Thomas, Getachew, Sefonias, Kantelhardt, Eva Johanna, Ngeh, Etienne Ngeh, Unverzagt, Susanne |
| Publisher | BMJ Publishing Group |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, doc-type:article, info:eu-repo/semantics/article, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 2044-6055 |
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