Awareness of hypertension and its impact on blood pressure control among elderly nigerians: report from the Ibadan study of aging

Psychophysiological Impact of Touching Landscape Grass among Older Adults

Few studies have investigated plants' healing effects, particularly through touch-based therapy, on older adults. As hypertension rates continue to climb worldwide, touch-based therapy for hypertension prevention has become a significant priority in public health initiatives. This study investigated the impact of tactile interaction with real grass (a landscape activity) versus artificial grass on older adults' physical and cognitive abilities. Employing a within-subject design, we assessed the physiological and emotional effects of touching real grass versus artificial glass for 10 min. Study participants included 50 Chinese individuals, with an average age of 85.64 ± 3.72 years. Measurements included blood pressure, electroencephalogram, State-Trait Anxiety Inventory, and standard deviation (SD). Analyzing the SD data revealed that participants experienced a heightened sense of relaxation and calmness after touching real grass, compared to artificial grass. Furthermore, the participants' brainwave patterns-measured in mean power units-exhibited an upward trend while interacting with real grass, whereas they exhibited a downward trend during the interaction with artificial grass. Moreover, the mean systolic blood pressure significantly decreased following interaction with real grass. These findings suggest that engaging with real grass through touch potentially alleviates mental stress, in contrast to the effects of artificial grass.

Prevalence, risks factors, and control of hypertension in Guinean older adults in 2021: a cross-sectional survey

BACKGROUND

The incidence of arterial hypertension increases with the aging of the population, but its magnitude remains insufficiently assessed. The aim of this study was to investigate the prevalence of hypertension and associated factors in elderly people in Guinea.

METHODS

Data were obtained from a cross-sectional general population survey, conducted among people aged ≥ 60 years. A stratified enumeration area random sample survey was conducted in the four natural regions of Guinea from February to April 2021. This study included an interview on sociodemographic data, and a clinical examination. Hypertension was defined as systolic blood pressure ≥ 140mmHg and/or diastolic blood pressure ≥ 90mmHg or previous diagnosis of hypertension (with or without antihypertensive medication). Hypertension control was defined as blood pressure below 140/90 mmHg during treatment. Age-standardized prevalence was calculated, and logistic regression was used to examine factors associated with hypertension.

RESULTS

A total of 1698 adults (1079 men, mean age: 71.6 ± 9.4 years) had at least two blood pressure measurements. The standardized prevalence of hypertension was 61.4% [95% CI: 61.3-61.6], ranging from 52% in Middle Guinea to 67% in Upper Guinea, and was higher in women (65.2%: 65.0-65.4) than in men (59.1%:58.9-59.3). Among those with hypertension, 46.7% were unaware of their condition before the survey and 49.6% were on treatment and only 18.5% had controlled hypertension. Whatever the residence (rural or urban), increasing age, being unmarried, working as a trader or functionary, jobless, living in upper Guinea, low monthly income, intake of extra salt, known diabetic, overweight, and obesity increased the risk of hypertension. In urban area, female sex (AOR: 1.14: 1.12-1.17), living in lower Guinea (AOR: 3.08: 2.97-3.20), being Maninka (AOR: 1.26: 1.21-1.31), being Nguerze (AOR: 1.71: 1.63-1.81) increased the risk of hypertension, but living in forest Guinea (AOR: 0.88: 0.83-0.93), being Soussou (AOR: 0.88: 0.85-0.92) decreased the risk. In rural area, living in forest Guinea (AOR: 2.14: 2.03-2.26), being Soussou (AOR: 1.14: 1.12-1.17) increased the risk of hypertension, but female sex (AOR: 0.96: 0.94-0.98), living in lower Guinea (AOR: 0.87: 0.85-0.89), being Maninka (AOR: 0.94: 0.92-0.97), being Nguerze (AOR: 0.50: 0.47-0.52) decreased the risk.

CONCLUSION

Hypertension is a major problem in the elderly population in Guinea, and the level of treatment and control in elderly with known hypertension is inadequate. The place of hypertension among cardiovascular diseases and the identification of associated factors underlines the need to develop innovative approaches to control this major risk factor.

Undiagnosed hypertension and its determinants among hypertensive patients in rural districts of northwest Ethiopia: a mediation analysis

BACKGROUND

Early detection of hypertension is associated with improved blood pressure control and a reduced risk of cardiovascular diseases. However, in rural areas of Ethiopia, evidence is scarce where access to healthcare services is low. This study aimed to estimate the proportion of undiagnosed hypertension and identify its determinants and mediators among patients with hypertension in rural northwest Ethiopia.

METHODS

A community-based cross-sectional study was conducted from September to November 2020. A three-stage sampling technique was used to select a total of 2436 study participants. Blood pressure was measured using an aneroid sphygmomanometer two times, 30 min apart. A validated tool was used to assess participants' beliefs and knowledge of hypertension. The proportion, determinants, and mediators of undiagnosed hypertension were determined among patients with hypertension. The regression-based approach used to calculate the direct and indirect effects of determinants of undiagnosed hypertension. Joint significance testing was used to determine the significance of the indirect effect.

RESULTS

The proportion of undiagnosed hypertension was 84.0% (95% CI: 81.4-86.7%). Participants aged 25-34 years (AOR = 6.03; 95% CI: 2.11, 17.29), who drank alcohol (AOR = 2.40; 95% CI: 1.37, 4.20), were overweight (AOR = 0.41; 95% CI: 0.18, 0.98), had a family history of hypertension (AOR = 0.32; 95% CI: 0.20, 0.53), and had comorbidities (AOR = 0.28; 95% CI: 0.15, 0.54) were significantly associated with undiagnosed hypertension. The mediation analysis revealed that hypertension health information mediated 64.1% and 68.2% of the effect of family history of hypertension and comorbidities on undiagnosed hypertension, respectively. Perceived susceptibility to hypertensive disease mediated 33.3% of the total effect of age on undiagnosed hypertension. Health facility visits also mediated the effect of alcohol drinking (14.2%) and comorbidities (12.3%) on undiagnosed hypertension.

CONCLUSION

A higher proportion of hypertensive patients remain undiagnosed. Being young, drinking alcohol, being overweight, having a family history of hypertension, and having comorbidities were significant factors. Hypertension health information, knowledge of hypertensive symptoms, and perceived susceptibility to hypertension were identified as important mediators. Public health interventions aimed at providing adequate hypertension health information, particularly to young adults and drinkers, could improve knowledge and perceived susceptibility to hypertensive disease and reduce the burden of undiagnosed hypertension.

Awareness, Treatment, and Control of Hypertension among the Adult Population in Burkina Faso: Evidence from a Nationwide Population-Based Survey

Background

Hypertension is the leading cause of cardiovascular disease, particularly in low- and middle-income countries. Improved awareness of hypertension status can significantly increase early treatment, thereby reducing cardiovascular complications and premature death. This study aimed to report the prevalence of the awareness, treatment, and control of hypertension among the adult population in Burkina Faso.

Method

We performed a secondary analysis of the first national population-based survey on common risk factors of noncommunicable diseases in Burkina Faso. It was a national representative cross-sectional survey among adults aged 25–64 years. Awareness of hypertension was defined by blood pressure ≥140/90 mmHg or a prior diagnosis by a health worker or the use of any antihypertensive drugs. A modified Poisson regression model using a generalized estimating equation was used to identify factors associated with awareness of hypertension.

Result

A total of 4628 people with valid blood pressure measurements were considered. Of them, 828 had hypertension. Among people with hypertension, the prevalence of awareness was 17.5% (95% CI: 14.4%–21.1%), and 47.3% (95% CI: 37.6%–57.3%) of them had taken antihypertensive medications for their hypertension. One-third (35.5% (95% CI: 23.3%–49.9%)) of those who took medications had controlled hypertension. The prevalence of awareness was significantly higher among women (21.1% (95% CI: 16.4%–26.7%)) compared with men (13.8% (95% CI: 10.4%–17.9%)) (p = 0.019). The prevalence of awareness increased with increasing age and education level. Nearly one-third (29.3% (95% CI: 25.3%–33.6%)) of people with hypertension needed antihypertensive drug treatment.

Conclusion

There was a poor level of awareness, treatment, and control of hypertension among adults in Burkina Faso. Effective control strategies to increase the screening of hypertension in primary care and at the community level are necessary in Burkina Faso.

Unmet needs of the oldest old primary care patients with common somatic and psychiatric disorders-A psychometric evaluation

OBJECTIVES

Unmet needs are common in older patients and should be assessed via suitable instruments. The adapted German version of the Camberwell Assessment of Need for the Elderly (CANE) represents an often used tool to determine the needs in older individuals. Evidence on the psychometric properties of the CANE is still pending.

METHODS

A sample of 231 patients with common somatic and psychiatric diseases were interviewed about their needs including their caring relatives and general practitioners (GPs). Frequencies of unmet needs were evaluated across the different perspectives. Interrater agreement, convergent and discriminant validity were evaluated.

RESULTS

On average, psychiatric patients reported more unmet needs than somatic patients, particularly regarding to psychological distress and behavior. The interrater agreement was higher in the somatic subgroup than in the psychiatric subgroup, and higher between patients and relatives compared to patients and GPs. Evidence for construct validity was reported.

CONCLUSIONS

Patients with common somatic and psychiatric disorders report specific unmet needs that should be considered in healthcare. Moderate to good psychometric characteristics were found for the CANE. The use of valid instruments to record needs in health and nursing care can be useful and represents an important starting point for targeted interventions and effective treatment.

Knowledge, Attitude and Practice (KAP) of Malay Elderly on Salt Intake and Its Relationship With Blood Pressure

Hypertension is a worldwide problem and a major global health burden with high salt intake as one of the factors often related to it. Public exposure to a high salt diet has contributed to the increase in prevalence of hypertension among the Malaysian population. Improving the knowledge, attitudes and practices (KAP) related to salt intake is a key component of effective blood pressure control. Therefore, this study was aimed to determine the association of KAP of healthy salt intake toward blood pressure among the elderly residing in a semi urban area of Klang Valley Malaysia. A cross-sectional study using convenience sampling was conducted among Malay elderly, aged 60–81 years old residing in Bandar Baru Bangi. Subjects were required to answer the questionnaire via face to face interview regarding KAP of Salt Intake, together with sociodemographic and health profiles. Anthropometry parameters and blood pressure were measured. A total of 94 elderly [57.5% women with mean Body Mass Index (BMI) of 26. 46 ± 4.16, 42.5% men with mean BMI of 27.31 ± 5.19] have participated in the study. Results indicated that the overall KAP score was average (57.4%). However, majority showed a positive attitude toward reducing the salt intake. BMI was found to have significant correlation with blood pressure (r = 0.278, p < 0.05). Higher education level was significantly (p < 0.05) associated with good knowledge scores while younger subjects have a positive attitude toward healthy intake of salt (p < 0.05). Subjects with higher knowledge scores were also observed to have the more controlled blood pressure compared to those who scored less. Attitude and practices score showed no significance difference (p > 0.05) with blood pressure. Younger age, higher level of education and living partner or elderly was significantly (p < 0.05) associated with lower systolic and diastolic blood pressure. Overall, this study showed that knowledge toward healthy salt intake, BMI, education level, and living with others were significantly associated with the blood pressure among the elderly. Further education and intervention is required to improve knowledge on healthy salt intake among elderly as part of the prevention from hypertension.

Risk factors of heart failure among patients with hypertension attending a tertiary hospital in Ibadan, Nigeria: The RISK-HHF case-control study

Aim

Hypertension is the leading cause of heart failure (HF) in sub-Saharan Africa. Preventive public health approach to reduce the scourge of HF must seek to understand the risk factors of HF in at-risk populations. The aim of this study was to characterize the risk factors of HF among patients with hypertension attending a cardiology clinic.

Methods and results

One hundred and one (101) case-control age- and sex-matched pairs were recruited. The study population were adults with a clinical diagnosis of hypertensive HF (cases) and individuals with systemic hypertension without HF. They were interviewed and evaluated for cardiovascular risk factors. Associations between variables were tested with chi square test, Fisher’s exact test and independent sample t test as appropriate. Logistic regression modelling was used to determine the independent risk factors of hypertensive HF (HHF) in the study population while ‘punafcc’ package in stata12 was used to calculate the population attributable fraction (PAF) of the risk factors. Suboptimal medication adherence was the strongest adverse risk factor of HHF (medium adherence aOR: 3.53, 95%CI: 1.35–9.25; low adherence aOR: 9.44, 95%CI: 3.41–26.10) with a PAF of 67% followed by dipstick proteinuria (aOR: 4.22, 95%CI: 1.62–11.02; PAF: 34%) and alcohol consumption/day per 10grams (aOR: 1.23, 95%CI: 1.02–1.49; PAF: 22%). The protective risk factors of HHF were use of calcium channel blockers (aOR 0.25, 95%CI: 0.11–0.59; PAF: 59%), then daily fruits and vegetable consumption (aOR 0.41, 95%CI: 0.17–1.01; PAF: 46%), and eGFR (aOR 0.98, 95%CI: 0.96–0.99; PAF: 5.3%).

Conclusions

The risk factors of HHF are amenable to lifestyle and dietary changes. Public health interventions and preventive cardiovascular care to improve medication adherence, promote fruit and vegetable consumption and reduce alcohol consumption among patients with hypertension are recommended. Renoprotection has utility in the prevention of HF among hypertensives.

Prevalence and determinants of hypertension unawareness among Egyptian adults: the 2015 EHIS

Hypertension (HTN) is a major cardiovascular risk factor that affects 1.3 billion people and accounts for 17.9 million deaths annually worldwide. Seventy-five percent of global deaths due to HTN occur in low- and middle-income countries where HTN prevalence is higher, and HTN control and population awareness are lower, than in high-income countries. Approximately 26% of Egyptian adults meet criteria for HTN, but the prevalence of HTN unawareness is unknown in this population. The purpose of this study was to assess prevalence and predictors of HTN unawareness among Egyptian adults. Using data from the 2015 Egyptian Health Issues Survey (EHIS), we identified 2869 participants 18-59 years of age whose blood pressure met criteria for HTN at the time of data collection. Our outcome of interest, hypertension unawareness, was indicated when a participant reported that they had not been diagnosed with HTN (despite meeting criteria). Descriptive statistics and multivariable logistic regression were performed to determine prevalence of, and risk factors for, HTN unawareness. Fifty-six percent of the sample were unaware of their HTN status. The odds of HTN unawareness were highest among participants 18-39 years old compared to those 40-59 years old (OR 1.91; 95% CI 1.48-2.47); males compared to females (OR 2.59; 95% CI 1.85-3.62); and never married compared to currently married participants (OR 1.96; 95% CI 1.19-3.24). Compared to those who had a college level education, the odds of HTN unawareness were highest among participants who had no education (OR 2.21; 95% CI 1.45-3.38). In addition, the odds of HTN unawareness were higher for participants who had a normal body mass index compared to those who were obese (OR 1.82; 95% CI 1.26-2.65); and those considered healthy compared to those who had at least one chronic illness (OR 4.53; 95% CI 3.29-6.24). Our findings indicate that more than half of Egyptian adults who meet criteria for HTN are unaware of their blood pressure status. Younger, healthier, and normal weight people-who are typically at lowest risk for HTN-appear mostly likely to be unaware of their HTN status. Less educated people are least likely to know their hypertensive status. This suggests the need for a targeted health education campaign and regular blood pressure screening in Egypt.

Opportunistic screening of cardiovascular disease risk factors in community pharmacies in Nigeria: a cross-sectional study

Background Early identification and treatment of cardiovascular disease (CVD) risk factors through screening are crucial in the primary prevention of CVD and reduction in healthcare-related costs. Use of Non-Physician Healthcare-workers including Community Pharmacists has been advocated as an effective and cost-efficient model of healthcare delivery. In Nigeria the use of community pharmacists for mass screening of CVD risk factors has not been explored. Objective We sought to investigate the possibility of mass CVD risk factor screening in community pharmacies by pharmacists. Setting Lagos, Nigeria. Methods Between October and December 2018 eight hundred and eighty-nine apparently healthy participants were screened for obesity, hypertension, diabetes and hypercholesterolaemia in ten community pharmacies. Diabetes and hypercholesterolaemia were screened for using point-of-care testing modalities. A structured questionnaire was used to obtain the socio-demographic data of the participants. Main outcome measures Prevalence of overweight/obesity, hypertension, diabetes, hypercholesterolaemia, smoking and alcohol intake. Results Mean age of the subjects was 56.8 ± 21.1 years. Majority (57.4%) were females. Prevalence of smoking and alcohol intake were 4.3% and 26.7% respectively. 59.7% and 71.5% of males and females were either overweight (BMI ≥ 25 kg/m²) or obese (BMI ≥ 30 kg/m²) respectively. Prevalence of hypertension was 28.2% in all subjects, 30.9% in males and 26.3% in females, p < 0.001. Using BP > 130/80 mmHg prevalence of hypertension was 55.1%. Diabetes was detected in 3% of the subjects while 45.3% had hypercholesterolaemia. In total, 64.1% of the subjects were diagnosed with CVD risk factors for the first time. Conclusion Opportunistic screening for CVD risk factors is possible in community pharmacies and has the ability to detect previously undiagnosed risk factors. This community pharmacy based model could serve as a cost-effective approach to primary prevention of CVD.

Hypertension in Rural India: The Contribution of Socioeconomic Position

Background

Various indicators of socioeconomic position (SEP) may have opposing effects on the risk of hypertension in disadvantaged settings. For example, high income may reflect sedentary employment, whereas greater education may promote healthy lifestyle choices. We assessed whether education modifies the association between income and hypertension in 3 regions of South India at different stages of epidemiological transition.

Methods and Results

Using a cross‐sectional design, we randomly selected villages within each of rural Trivandrum, West Godavari, and Rishi Valley. Sampling was stratified by age group and sex. We measured blood pressure and anthropometry and administered a questionnaire to identify lifestyle factors and SEP, including education, literacy, and income. Logistic regression was used to assess associations between various components of SEP and hypertension, and interaction analyses were used to determine whether educational attainment modified the association between income and hypertension. Trivandrum, the region of highest SEP, had the greatest prevalence of hypertension, whereas Rishi Valley, the lowest SEP region, had the least. Overall, greater income was associated with greater risk of hypertension. In interaction analyses, there was no evidence that educational attainment modified the association between income and hypertension.

Conclusions

Education is widely considered to ameliorate the risk of hypertension in high‐income countries. Why this effect is absent in rural India merits investigation.

Reported Adherence to Antihypertensive Treatment and Outcome at Postmortem in Southwestern Nigerians

Background:

Systemic hypertension is referred to as a silent killer. Knowledge of disease and religious use of medication could mitigate against complications in hypertensives. This study evaluated outcome among decedent essential hypertensive patients in southwestern Nigeria in relation to their compliance with prescribed antihypertensive medication.

Materials and Methods:

This is a 10-year retrospective review of routine postmortem data. Archival postmortem records from January 1, 2008 to December 31, 2017 in the Department of Pathology, University College Hospital, Ibadan, Nigeria, were reviewed. Data extracted from the records included age, gender, knowledge of hypertension status, systolic and diastolic blood pressure at time of diagnosis, reported adherence to medications, complications of systemic hypertension, duration of survival from diagnosis to demise, cause of death, body length, and heart weight at autopsy. Descriptive, Students t-test, Chi-square test, Pearson correlation and Cox proportional-hazards model statistics was conducted using SPSS version 20 (IBM SPSS Statistics for windows, IBM Corp., Armonk, N.Y., USA).P < 0.05 was considered significant.

Results:

Eighty-one cases met the inclusion criteria, consisting of 60 males and 21 females with overall mean age of 55.65 ± 12.1 years. Seventy-five (91.7%) cases were known hypertensives prior to admission or demise while 6 (8.3%) were not known hypertensives. The duration of survival from diagnosis to death ranged from 1-month (0.08 years) to 31 years with overall mean duration of 5.2 years. Fifty-two (63.4%) of the 75 known hypertensive cases had documented medication compliance. Medication noncompliant cases had lower mean survival interval (5 vs. 8 years), died younger (53.5 ± 10.8 years vs. 54.8 ± 15.5 years), had higher mean blood pressures (systolic blood pressures: 197 ± 45.8 mmHg vs. 180 ± 55.4 mmHg; diastolic blood pressures: 117 ± 27.2 mmHg vs. 101 ± 32.8 mmHg) and heavier heart weights (476 ± 142 g vs. 390.8 ± 107.6 g). However, only the difference in heart weight was statistically significant (P < 0.036). Age and mean systolic blood pressures were correlated with interval from diagnosis to death (r = 0.5, P < 0.000; r = −0.4,P < 0.017, respectively). Death from complications of hypertension and all-cause mortality occurred with higher frequencies among medication noncompliant cases (40 vs. 12).

Conclusion:

Noncompliance with antihypertensive medication is associated with more cardiovascular and all-cause mortality among Southwestern Nigerians with essential hypertension.

The relationship between Life Style and mental health among medical students in Kermanshah

INTRODUCTION

Given the close relationship between life style and mental health and the importance of students as valuable human resources, the present study aimed at determining the relationship between life style and mental health among medical students in Kermanshah.

METHODS

This is a descriptive-correlational study that was conducted in 2018. The study involved 200 medical students. The sampling method was convenience sampling. Demographic questionnaire, general health questionnaire, and life style questionnaire were used for data collection. The data were analyzed Pearson's correlation test and regression analysis. The significance level was considered 0.05.

RESULTS

The mean mental health score of the students was 25.43 ± 13.02 (2 points higher than the cutoff point of this test). The life style of 59.5 students was moderate. The results showed that all life style subscales had a negative significant relationship with the total mental health score and all its subscales (P < 0.05). Among the life style subscales, the highest relationship and predictive power to mental health were obtained for psychological health, social health, sport and fitness, and environmental health (R ² = 0.48, P < 0.001).

CONCLUSION

According to the results, the life style of most medical students in the final year of Kermanshah University of Medical Sciences was moderate. Further, the students had a better life style, and they had higher mental health. Therefore, considering the vital role of medical students in providing and promoting community health, the need for more detailed planning and interventions to improve their life style and mental health is essential.

Determinants of systemic hypertension in older adults in Africa: a systematic review

BACKGROUND

An estimated 55% of older adults in Africa have systemic hypertension, a major risk factor for stroke, heart failure and dementia in the region. The risk factors associated with hypertension in this population group in Africa have not been systematically evaluated. We, therefore, undertook a systematic review to identify these risk factors.

METHODS

We searched for population-based studies of adults aged ≥50 years living in Africa and reporting an estimate of hypertension and associated risk factors. We included articles published in any language between January 1980 and May 2018 using a comprehensive search strategy. We extracted data including the sample characteristics, prevalence of hypertension and risk factors with their effect sizes.

RESULTS

From an initial 10,719 records, we retained 63 eligible full text articles for review out of which we analyzed 23 studies made up of 19 primary and four multiple publications which had data on risk factors from bivariate or multivariable analysis. The primary studies, published from 2010 to 2018, involved a total of 30,500 participants in 12 different countries with mean ages ranging from 62.7 ± 9 years to 76.9 ± 8.4 years. Through narrative synthesis, we found consistent determinants of hypertension (overweight/obesity and history of stroke), less consistent but frequent determinants (including older age group, female sex and urban residence), inconsistent determinants (including education, wealth index, alcohol intake and physical activity) and nonsignificant covariates (marital status and having health insurance). Overall, the highest adjusted odds ratios were those associated with obesity and history of stroke.

CONCLUSION

The key determinants of systemic hypertension in older adults in Africa are older age group, overweight/obesity, history of stroke and female sex. Health programmes should promote weight reduction throughout the life course, including during the middle and older age of African adults.

Hypertension in older adults in Africa: A systematic review and meta-analysis

BACKGROUND

Hypertension is the leading driver of cardiovascular disease deaths in Africa. Its prevalence is highest in older populations. Yet, this group has received little attention in many African countries. We conducted a systematic review and meta-analysis (PROSPERO registration: CRD42017056474) to estimate the prevalence of hypertension in older adults living in Africa.

METHODS

We searched grey literature and major electronic databases including PubMed and Embase for population-based studies and published between 1 January 1980 to 28 May 2018 reporting the prevalence of hypertension for adults aged ≥50 years living in Africa. We employed a random effects model to estimate the pooled prevalence across included studies.

FINDINGS

We screened 10,719 articles and retrieved 103 full-text articles to evaluate for inclusion in the review. Thirty-four unique studies providing 37 data points on 43,025 individuals in 15 African countries were analyzed. The prevalence of hypertension ranged from 22.3% to 90.0% from the individual studies while the overall pooled prevalence was 57.0% (95% CI 52%-61%). The prevalence was not statistically significantly different by sex, residence, or African sub-region. In individual studies, older age and overweight/obesity were independently associated with hypertension. Twenty-nine (78%) data points were deemed to be of low- or moderate-risk of bias. Eliminating high-risk bias studies made little difference to the pooled estimate of hypertension. Sensitivity analyses, omitting one study at a time, identified three studies with significant but relatively small impact on the pooled estimate. We observed substantial heterogeneity (I2 = 98.9%) across the studies which was further explored by meta-regression analyses. Overall, the GRADE assessment suggested moderate quality evidence in the results.

CONCLUSION

The persistent high prevalence of hypertension among older adults in Africa, even in rural populations warrants more attention to the cardiovascular health of this group by public health authorities.