Please use this identifier to cite or link to this item: http://dx.doi.org/10.25673/85768
Title: Non-pharmacological interventions to achieve blood pressure control in African patients : a systematic review
Author(s): Cernota, Monique
Kroeber, Eric Sven
Demeke, Tamiru
Frese, Thomas
Getachew, Sefonias
Kantelhardt, Eva Johanna
Ngeh Ngeh, Etienne
Unverzagt, Susanne
Issue Date: 2022
Type: Article
Language: English
Abstract: 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.
URI: https://opendata.uni-halle.de//handle/1981185920/87720
http://dx.doi.org/10.25673/85768
Open Access: Open access publication
License: (CC BY-NC 4.0) Creative Commons Attribution NonCommercial 4.0(CC BY-NC 4.0) Creative Commons Attribution NonCommercial 4.0
Sponsor/Funder: Publikationsfonds MLU
Journal Title: BMJ open
Publisher: BMJ Publishing Group
Publisher Place: London
Volume: 12
Issue: 2
Original Publication: 10.1136/bmjopen-2020-048079
Appears in Collections:Open Access Publikationen der MLU

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