Background
Methods
Data sources and search strategy
Study selection and data extraction
Data synthesis
Quality appraisal of studies
Results
Description of selected studies
Primary Reference | Country | Study year | Type of participants | % Participation rate of eligible sample | % Female | % urban | % aged 70+ years | Mean age ± sd | % currently married | % no education | Number whose hypertension status assessed | % males with hypertension | % females with hypertension | % total subjects with hypertension | Overall risk of study bias |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Abegunde 2013 [24] | Nigeria | adults aged ≥60 years | 98.4 | 61.1 | 50.2 | 57.9 | 72.2 ± 9.5 (urban), 70.8 ± 8.1 (rural) | 63.0 | 93.8 | 600 | 36.5 | Low | |||
Dewhurst 2013 [25] | Tanzania | 2010 | Rural cohort aged ≥70 years (DSS) | 93.5 | 56.3 | 0.0 | 100.0 | 2223 | 62.2 | 75.8 | 69.9 | Low | |||
Guerchet 2012A [17] | CAR | 2009 | adults aged ≥65 years | 96.3 | 58.1 | 100.0 | 59.9 | 72.6 ± 6.1 | 41.6 | 461 | 47.2 | 62.7 | 56.2 | Low | |
Guerchet 2012B [17] | Congo | 2009 | adults aged ≥65 years | 96.3 | 61.9 | 100.0 | 72.0 | 74.4 ± 6.7 | 38.1 | 515 | 66.3 | 76.2 | 72.4 | Low | |
Hammami 2011 [26] | Tunisia | 2009 | Elderly aged ≥65 years | 100 | 66.2 | 86.3 | 62.0 | 72.3 ± 7.4 | 60.0 | 76.9 | 598 | 45.0 | 55.6 | 52.0 | Low |
Hien 2014 [27] | Burkina Faso | 2012 | Elderly aged ≥60 years | 100 | 44.7 | 100.0 | 39.3 | 69 ± 7 | 58.7 | 54.1 | 389 | 79.1 | 86.2 | 82.3 | Low |
Iribhogbe 2013 [28] | Nigeria | 2012 | church attendants aged ≥50 years | 100.0 | 50.0 | 23.5 | 67.55 ± 16.61 | 200 | 58.0 | 35.0 | 46.5 | High | |||
Koopman 2012 [29] | Ghana | 2010 | registered inhabitants ≥50 years | 85.4 | 48.1 | 35.3 | 924 | 25.6 | 22.5 | 24.1 | Low | ||||
Macia 2012 [30] | Senegal | 2009 | adults aged ≥50 years | NR | 47.4 | 100.0 | 19.2 | 74.4 | 45.6 | 500 | 63.9 | 67.1 | 65.4 | Moderate | |
Mathenge 2010 [31] | Kenya | 2008 | adults aged ≥50 years | 87.7 | 52.3 | 32.7 | 26.4 | 33.1 | 4396 | 50.1 | Low | ||||
Minicuci 2014 [22] | Ghana | 2008 | adults aged ≥50 years | 95.9 | 50.3 | 40.6 | 32.5 | 59.8 | 54.0 | 4724 | 51.5 | 50.7 | 51.1 | Low | |
Mkhize 2011 [32] | South Africa | 2008 | elderly persons aged ≥60 years | 83.0 | 270 | 82.6 | 91.5 | 90.0 | Low | ||||||
Mugisha 2013 [33] | Uganda | 2013 | rural adults aged ≥50 years | 72.3 | 58.2 | 0.0 | 27.7 | median 62 | 48.5 | 28.0 | 1449 | 36.5 | 38.3 | 37.5 | Moderate |
Nuertey 2017 [34] | Ghana | 2014 | registered members of the national pensioners association | 93.0 | 31.4 | 28.5 | 73.0 | 12.1 | 4439 | 47.8 | High | ||||
Osman 2017 [35] | Ghana | 2016 | free-living adults aged ≥65 years | 100.0 | 66.3 | 46.0 | 51.0 | 400 | 57.8 | 52.5 | 54.3 | High | |||
Peltzer 2013 [23] | South Africa | 2008 | adults aged ≥50 years | 60 | 57.3 | 66.7 | 23.8 | 53.3 | 25.4 | 3672 | 74.4 | 79.6 | 77.4 | Moderate | |
Pilleron 2017A [36] | CAR | 2012 | adults aged ≥65 years | 94.7 | 62.2 | 51.5 | 60.4 | 72.7 ± 6.4 | 34.3 | 967 | 53.7 | Low | |||
Pilleron 2017B [36] | Congo | 2012 | adults aged ≥65 years | 94.7 | 60.9 | 48.7 | 66.8 | 73.5 ± 6.7 | 38.8 | 1023 | 68.0 | Low | |||
Raji 2017 [37] | Nigeria | 2007 | elderly cohort aged ≥65 years | 76.8 | 55.1 | 37.4 | 79.0 | 76.9 ± 8.4 | 55.7 | 44.8 | 1469 | 62.0 | 70.7 | 66.8 | Moderate |
Scholten 2011 [38] | Uganda | 2010 | adults aged ≥50 years | > 99% | 61.2 | 34.9 | 32.4 | 24.0 | 510 | 30.3 | 34.6 | 32.9 | Low | ||
Tianyi 2017 [39] | Cameroon | 2013 | rural adults aged ≥50 years | 68.9 | 0.0 | 24.2 | 62.7 ± 9 | 89.4 | 82.0 | 501 | 60.9 | 55.7 | 57.3 | Low |
Description of sample characteristics
Risk factors for hypertension
No. | Reference | Country | 50–59 | 60–69 | 70–79 | 80 + | 50–59 | 60–69 | 70–79 | 80 + | 50–59 | 60–69 | 70–79 | 80 + | 50–64 | 65–74 | 75+ | 65–69 | 70–74 | 75–79 | 80 + | 65–74 | 75–84 | 85+ |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
M | M | M | M | F | F | F | F | T | T | T | T | T | T | T | T | T | T | T | T | T | T | |||
1 | Dewhurst 2013 [25] | Tanzania | 60.6 | 65.9 | 75.0 | 77.3 | 68.6 | 72.5 | ||||||||||||||||
2 | Hammami 2011 [26] | Tunisia | 51.5 | 54.9 | 45.8 | |||||||||||||||||||
3 | Minicuci 2014 [22] | 50.0 | 54.2 | 49.9 | ||||||||||||||||||||
4 | Osman 2017 [35] | Ghana | 52.0 | 54.5 | 63.5 | 52.0 | 54.5 | 63.5 | ||||||||||||||||
5 | Phaswana-Mafuya 2013 [42] | South Africa | 74.9 | 80.6 | 78.4 | |||||||||||||||||||
6 | Pilleron 2017a [36] | CAR | 50.1 | 53.2 | 52.7 | 63.6 | ||||||||||||||||||
7 | Pilleron 2017b [36] | Congo | 62.9 | 72.7 | 67.8 | 70.6 | ||||||||||||||||||
8 | Raji 2017 [37] | Nigeria | 66.2 | 68.9 | 60.1 | 68.1 | ||||||||||||||||||
9 | Tianyi 2017 [39] | Cameroon | 59.5 | 68.6 | 52.3 | 54.5 | 53.8 | 62.0 | 48.9 | 30.0 | 54.9 | 62.2 | 50.5 | 50.0 |
No. | Country | Reference | Significant harmful (higher HTN) variables in crude analysis | Significant protective (lower HTN) variables in crude analysis | NS variables in crude analysis | Harmful Determinants of (higher) HTN | Determinants of lower HTN | NS variables in multivariate model |
---|---|---|---|---|---|---|---|---|
1 | Nigeria | Abegunde 2013 [24] | Female gender, decreasing monthly income, increasing BMI | alcohol intake | ||||
2 | Ghana | Boateng 2017 [21] | For systolic stage 1 or 2 HTN: increasing BMI category, alcohol intake, higher wealth index, female sex | traditional religion, | Place of residence, depression or ethnicity for stage 1 or 2 SHTN; religion not significantly associated with stage 1 SHTN. | |||
3 | Ghana | Boateng 2017 [21] | For diastolic stage 1 or 2 HTN: increasing BMI category, higher wealth index | traditional religion, other religion | Place of residence, depression or ethnicity for stage 1 or 2 DHTN; religion except traditional or other religion not significantly associated with stage of DHTN. | |||
4 | Tanzania | Dewhurst 2013 [25] | BMI (continuous variable), female sex, older age group ≥85 years, Chagga tribal origin, upland village dwelling | Presence of (moderate or severe) disability (by Barthel Index Score); age groups 75–79 and 80–84 years | ||||
5 | Tunisia | Hammami 2011 [26] | Females, Older age group, dependency, self-reported diabetes, overweight, abdominal obesity | Education, urban-rural residence, depression, marital status, physical activity | Diabetes, BMI, Dependency (disability) | age, sex, marital status, region, educational level, physical activity, depression | ||
6 | Ghana | Lloyd-Sherlock 2014 [18] | older age group, female sex, increasing BMI, smoker | no education, alcohol consumption, rural residence | physical activity, wealth quintile, health insurance | |||
7 | South Africa | Lloyd-Sherlock 2014 [18] | older age group, female sex, increasing BMI | tertiary educational level, alcohol consumption | smoking, residence, wealth quintile, health insurance | |||
8 | Ghana | Lloyd-Sherlock 2017 [19] | older age group (65–69 years), female sex, richer quintiles | no education, rural residence | Nil | |||
9 | South Africa | Lloyd-Sherlock 2017 [19] | older age group (75+ years), female sex, richest quintile | Higher (tertiary) educational level | urban-rural residence | |||
10 | Senegal | Macia 2012 [30] | Older age, higher BMI | Sex, educational level, marital status, doctor visits in the previous years | Older age group; overweight (BMI ≥25 kg/m2) | Sex, educational level, marital status | ||
11 | Kenya | Mathenge 2010 [31] | Urban residence, Kikuyu tribe | Urban residence, Kikuyu tribe | Adjusted for age, sex, SES quartile, BMI, WHR, smoking status, alcohol use, diabetes (by measurement), cholesterol | |||
12 | Ghana | Minicuci 2014 [22] | Older age, marital status, ethnicity, residence, wealth quintile | sex | older age, urban residence, overweight/obesity | underweight BMI < 18.5; Upper East and Upper West regions | sex, educational level, administrative regions except Upper East and Upper West | |
13 | Ghana | Nuertey 2017 [34] | overweight/obesity | overweight/obesity | Model adjusted for sex, religion, region of residence, ethnicity, marital status, education, social class, use of eye glasses, diabetes, arthritis, previous surgeries, mean arterial pressure, smoking status, hearing loss, total cholesterol, triglycerides, low density lipoprotein, coronary risk ratio | |||
14 | South Africa | Peltzer 2013 [23] | Females, Older age (60–69-year group), coloured race; self-reported conditions (diabetes, stroke, arthritis), overall self-reported health status (moderate), being overweight (BMI ≥25 kg/m2); having had ≥5 outpatient visits in past 12 months; overweight, severe dependency | alcohol use in past month; underweight (BMI < 18.5 kg/m2) | marital status, educational level, wealth, urban-rural residence, physical activity, daily tobacco use, fruit and vegetable intake, social cohesion index | Coloured race, self-reported history of stroke, frequent outpatient visits in the past 12 months | alcohol use in past month | Age, sex, marital status, past medical history of diabetes, subject health status, activity limitation (dependency) |
15 | CAR, Congo | Pilleron 2017 [36] | Female sex, increasing age, living in Republic of Congo, urban residence, previous occupation as craftsman/storekeeper or being jobless, increasing BMI, high cholesterol, eating 3 or more meals daily | current smoker, high physical activity ≥150 min/wk | marital status, primary education, diabetes by measurement, alcohol intake | increasing age, living in Congo, previous occupation as craftsman/storekeeper or being jobless, increasing BMI, eating 3 or more meals daily | current or ex-smoker, high physical activity ≥150 min/wk | sex, rural-urban residence, primary education, cholesterol level, diabetes, alcohol consumption |
16 | Nigeria | Raji 2017 [37] | female sex, unmarried, urban residence, never smoked, never drank alcohol, overweight/obesity | older age, educational level, socioeconomic class, self-reported diabetes, history of transient ischaemic attack, diagnosis of lifetime depression | high educational level, urban or semi-urban residence, overweight/obesity | female sex, currently unmarried | older age, high SES, current smoking, current alcohol consumption, absence of self-reported diabetes | |
17 | Uganda | Scholten 2011 [38] | Older age, urban residence | HIV infection (on or not on ART) | sex, marital status, education | |||
18 | Cameroon | Tianyi 2017 [39] | overweight/obesity | occupational level (≥medium) | age, sex, marital status, illiteracy, occupational level | overweight/obesity | age, sex, marital status, illiteracy, occupational level | |
19 | Ghana | Tyrovolas 2015 [20] | higher BMI categories, self-reported diabetes, self-reported stroke, higher fruit intake | underweight BMI < 18.5 | Alcohol consumption, smoking, physical activity, vegetable intake, education, wealth. Adjusted for age, sex and marital status. | |||
20 | South Africa | Tyrovolas 2015 [20] | higher BMI categories, alcohol intake, ex-smoker, low physical activity, self-reported stroke, higher vegetable intake | heavy alcohol user, low level physical activity, secondary level of education | Self-reported diabetes, fruit intake, wealth. Adjusted for age, sex and marital status. |
No. | Country | Reference | Age | Sex | Residence | Education | Wealth | Occupation |
---|---|---|---|---|---|---|---|---|
1 | Nigeria | Abegunde 2013 [24] | Compared with males: Females OR = 1.551; (1.01–2.39; P = 0.046) | Decreasing monthly income: OR = 0.798; 95%CI = 0.677–0.940; P = 0.007 | ||||
2 | Ghana | Boateng 2017 [21] | Compared with males: Female sex RR 1.33 (1.04, 1.69) p ≤ 0.05 (Stage 1 SHTN); RR = 1.66 (1.28, 2.15) p ≤ 0.001 (Stage 2 SHTN). | Compared with urban residents: rural RR = 0.86 (0.65, 1.13), NS (Stage 1 SHTN); RR = 0.79 (0.59, 1.05), NS (Stage 2 SHTN). | Compared with the poorest adults: the next poor quintile group 2, RR 1.47 (1.02, 2.09) p ≤ 0.05 (Stage 1 SHTN); all other quintile groups NS for stage 1 or stage 2 SHTN | |||
3 | Ghana | Boateng 2017 [21] | Compared with males: Female sex RR 0.91 (0.69, 1.19) NS (Stage 1 DHTN); RR = 0.79 (0.61, 1.01) NS (Stage 2 DHTN). | Compared with urban residents: rural RR = 0.91 (0.69, 1.19), NS (Stage 1 DHTN); RR = 0.79 (0.61, 1.02), NS (Stage 2 DHTN). | Compared with the poorest adults: the next poor quintile group 2, RR 1.47 (1.03, 2.13) p ≤ 0.05 (Stage 1 DHTN); all other quintile groups NS for stage 1 or stage 2 DHTN | |||
4 | Tanzania | Dewhurst 2013 [25] | Compared with 70–74-year age group: ≥85y OR = 1.53 (1.13–2.08); 75–79 years OR 1.13 (0.89–1.44); 80–84 years OR 1.18 (0.88–1.58) | Compared with males: female, OR 1.80 (1.48–2.20) | Compared with lowland village dwelling: upland dwelling, OR = 1.52 (1.21–1.92) | |||
5 | Tunisia | Hammami 2011 [26] | NS | NS | NS | NS | ||
6 | Ghana | Lloyd-Sherlock 2014 [18] | 50–54 (ref.): 55–59 years, OR 1.12 (0.91–1.38); 60–64 years, OR 1.24(0.99–1.56); 65–69 years, OR 1.53 (1.21–1.95); 70–74 years, OR 1.32 (1.04–1.67); 75+ years, OR 1.28 (1.02–1.61) | Female, OR 1.16 (1.00–1.35) | Urban (ref.): rural OR 0.73 (0.63–0.85) | Primary (ref.): None, OR 0.82 (0.69–0.98); Secondary, OR 0.76 (0.53–1.10); Higher, OR 0.96 (0.78–1.18) | Poorest wealth quintile (ref.): Q2, OR 1.11 (0.90–1.38); Q3, OR 1.77 (0.95–1.45); Q4, OR 1.77 (0.94–1.47); Richest, OR 1.16 (0.91–1.48) | |
7 | South Africa | Lloyd-Sherlock 2014 [18] | 50–54 (ref.): 55–59 years, OR 1.31 (1.13–2.07); 60–64 years, OR 1.53 (0.99–1.56); 65–69 years, OR 1.50 (1.07–2.09); 70–74 years, OR 1.53 (1.02–2.29); 75+ years, OR 1.83 (1.25–2.68) | Female, OR 1.29 (1.05–1.59) | Urban (ref.): rural OR 1.04 (0.83–1.31) | Primary (ref.): None, OR 1.11 (0.85–1.43); Secondary, OR 0.77 (0.57–1.04); Higher, OR 0.67 (0.48–0.93) | Poorest wealth quintile (ref.): Q2, OR 0.87 (0.64–1.17); Q3, OR 1.03 (0.75–1.42); Q4, OR 1.26 (0.90–1.78); Richest, OR 1.26 (0.88–1.80) | |
8 | Ghana | Lloyd-Sherlock 2017 [19] | 50–54 (ref.): 55–59 years, OR 1.08 (0.85–1.38); 60–64 years, OR 1.19 (0.91–1.54); 65–69 years, OR 1.36 (1.04–1.78); 70–74 years, OR 1.20 (0.92–1.58); 75+ years, OR 1.09 (0.84–1.40) | Female, OR 1.31 (1.12–1.54) | Urban (ref.): rural OR 0.64 (0.52–0.79) | Primary (ref.): None, OR 0.80 (0.66–0.98); Secondary, OR 0.77 (0.51–1.16); Higher, OR 0.94 (0.74–1.19) | Poorest wealth quintile (ref.): Q2, OR 1.20 (0.99–1.46); Q3, OR 1.36 (1.06–1.74); Q4, OR 1.55 (1.19–2.01); Richest, OR 1.68 (1.28–2.21) | |
9 | South Africa | Lloyd-Sherlock 2017 [19] | 50–54 (ref.): 55–59 years, OR 1.36 (0.93–1.98); 60–64 years, OR 1.58 (0.99–2.54); 65–69 years, OR 1.52 (1.03–2.26); 70–74 years, OR 1.38 (0.79–2.41); 75+ years, OR 1.62 (1.09–2.40) | Female, OR 1.42 (1.09–1.85) | Urban (ref.): rural OR 1.42 (1.09–1.85) | Primary (ref.): None, OR 1.09 (0.81–1.48); Secondary, OR 0.86 (0.57–1.28); Higher, OR 0.59 (0.39–0.90) | Poorest wealth quintile (ref.): Q2, OR 1.00 (0.62–1.62); Q3, OR 1.24 (0.76–2.04); Q4, OR 1.43 (0.88–2.33); Richest, OR 1.80 (1.04–3.12) | |
10 | Senegal | Macia 2012 [30] | 50–59 year age group (ref.): 60-69y, OR = 1.94 (1.22–3.07), p < 0.01; ≥70y, OR = 2.54 (1.45–4.44), p < 0.01 | Males (ref.): Females OR 1.01 (0.66–1.56) | Schooling ≥9 years (ref.): None, OR 1.28 (0.73–2.23);1–8 years, OR 1.23 (0.71–2.14) | |||
11 | Kenya | Mathenge 2010 [31] | Age adjusted | Sex adjusted | Urban (ref.): rural OR 0.77 (0.67–0.91) | SES adjusted | SES adjusted | |
12 | Ghana | Minicuci 2014 [22] | 50–64 (ref.): 65–74 years, OR 1.28 (1.05–1.55); ≥75 years, OR 1.14 (0.90–1.45) | Males (ref.): Females OR 1.14 (0.94–1.38) | Urban (ref.): rural OR 0.77 (0.61–0.97) | None (ref.): Primary, OR 1.07 (0.89–1.30); Secondary, OR 0.90 (0.60–1.35); High school completed, OR 1.15 (0.90–1.46); Tertiary or higher, OR 0.67 (0.43–1.06) | ||
13 | Ghana | Nuertey 2017 [34] | Age adjusted | Sex adjusted | Region of residence adjusted | Education adjusted | Social class adjusted | |
14 | South Africa | Peltzer 2013 [23] | 50–59 (ref.): 60–69 years, OR 1.30 (0.94–1.79); ≥70 years, OR 1.19 (0.80–1.78) | Males (ref.): Females OR 1.18 (0.61–1.25) | ||||
15 | CAR, Congo | Pilleron 2017 [36] | Age (continuous variable); OR = 1.02 (95% CI 1.01–1.04) | NS, OR = 0.98 (0.70–1.37); p = 0.924 | Urban (ref.): rural OR 0.92 (0.71–1.19), p value = 0.528. Living in Congo vs. CAR: OR 1.68 (1.31–2.16) p < 0.001 | Having primary education vs. not having it; OR = 1.09 (0.81–1.46); p = 0.566 | Compared with previous occupation as employee/government employee: craftsman/storekeeper OR 1.59 (1.10–2.31); Farmer/breeder/fisherman OR = 1.65 (1.13–2.41); Jobless OR = 1.83 (1.03–3.28). | |
16 | Nigeria | Raji 2017 [37] | Age > 69 years, OR 1.16 (0.78–1.72), p value = 0.443 | Males (ref.): Females OR 0.62 (0.48–0.79), p value = 0.001; NS | Urban/semi-urban (ref.): Rural OR 0.53 (0.72–0.98); p = 0.04 | Non-high education (ref.): High educational level OR 2.55 (1.02–6.38), p value = 0.045 | High SES, OR 1.50 (0.80–2.86), NS | |
17 | Uganda | Scholten 2011 [38] | 50–59 (ref.): 60–69 years, OR 1.13, NS; ≥70 years, OR 2.48; p = 0.01 | Males (ref.): Females OR 1.47; NS | Urban (ref.): Rural OR 0.57; p = 0.04 | Primary (ref.): None, OR 1.35, NS; Secondary or higher, OR 1.38; NS | ||
18 | Cameroon | Tianyi 2017 [39] | NS | NS | NS | Compared with low occupational level (unskilled workers): medium or high level occupational level: OR = 0.56 (0.23–1.32); P = 0.183 | ||
19 | Ghana | Tyrovolas 2015 [20] | Adjusted for age, sex and marital status | Adjusted for age, sex and marital status | Compared with ≤primary level: Secondary OR 1.11 (0.89–1.38), NS; ≥Tertiary, OR 0.66 (0.41–1.06), NS | Compared with middle wealth quintile: Poorest OR 0.83 (0.65–1.07), NS; Poorer, OR 1.02 (0.80–1.30); Richer, OR 1.10 (0.86–1.41); Richest, OR 1.15 (0.87–1.52) | ||
20 | South Africa | Tyrovolas 2015 [20] | Adjusted for age, sex and marital status | Adjusted for age, sex and marital status | Compared with ≤primary level: Secondary OR 0.66 (0.46–0.95), p < 0.05; ≥Tertiary, OR 0.66 (0.41–1.06), NS | Compared with middle wealth quintile: Poorest OR 0.85 (0.54–1.35), NS; Poorer, OR 0.78 (0.49–1.24); Richer, OR 0.87 (0.54–1.39); Richest, OR 1.14 (0.69–1.89) |
No. | Country | Reference | Physical activity | Obesity or adiposity | Alcohol | Diabetes | Other determinants |
---|---|---|---|---|---|---|---|
1 | Nigeria | Abegunde 2013 [24] | Compared with normal BMI: obese OR = 2.8 (1.52–5.29); p = 0.001 | ||||
2 | Ghana | Boateng 2017 [21] | Compared with BMI normal weight category: underweight RR = 0.65 (0.40, 0.81) p ≤ 0.01 (Stage 1 SHTN); RR = 0.57 (0.41, 0.81), p ≤ 0.001 (Stage 2 SHTN). Overweight RR = 1.73 (1.24, 2.40), p ≤ 0.001 (Stage 2 SHTN) Obese RR = 1.64 (1.07, 2.51) p ≤ 0.05 (Stage 1 SHTN); RR = 1.81 (1.19, 2.77), p ≤ 0.01 (Stage 2 SHTN) | Consumes alcohol compared with does not consume alcohol: RR 1.41 (1.08, 1.85) p ≤ 0.05 (Stage 1 SHTN); RR = 0.89 (0.68, 1.18) NS (Stage 2 SHTN). | Compared with subjects with no religion: Traditional religion, RR 0.38 (0.19, 0.75) p ≤ 0.01 (Stage 2 SHTN) | ||
3 | Ghana | Boateng 2017 [21] | Compared with BMI normal weight category: underweight RR = 0.75 (0.54, 1.02) NS (Stage 1 DHTN); RR = 0.63 (0.47,0.85), NS (Stage 2 DHTN). Overweight RR = 1.51 (1.06, 2.15), p ≤ 0.05 (Stage 1 DHTN); 1.67 (1.21, 2.31), p ≤ 0.001 (Stage 2 DHTN) Obese RR = 1.79 (1.16, 2.77) p ≤ 0.01 (Stage 1 DHTN); RR = 1.77 (1.18, 2.63), p ≤ 0.01 (Stage 2 DHTN) | Consumes alcohol compared with does not consume alcohol: RR 0.94 (0.71, 1.23), NS (Stage 1 DHTN); RR = 0.91 (0.71, 1.16), NS (Stage 2 DHTN). | Compared with subjects with no religion: Other religion, RR 0.30 (0.11, 0.82) p ≤ 0.01 (Stage 1 DHTN); Traditional religion RR = 0.35 (0.19, 0.75) p ≤ 0.001 (Stage 2 DHTN) | ||
4 | Tanzania | Dewhurst 2013 [25] | Increasing BMI: OR 1.09 (1.06–1.12) | Compared with subjects of non-Chagga tribal origin: Chagga tribe, OR 1.65 (1.18–2.30) | |||
5 | Tunisia | Hammami 2011 [26] | BMI (continuous) OR 2.01 (1.5–2.5); P < 0.01 | Self-reported diabetes OR 2.06 (1.45–3.5), p < 0.001 | Disability OR 1.6 (0.9–2.7), p < 0.001 | ||
6 | Ghana | Lloyd-Sherlock 2014 [18] | High physical activity (ref.): Moderate, OR = 1.02 (0.83–1.25); Low, OR 1.09 (0.92–1.30) | Normal BMI (ref): Underweight, OR 0.65 (0.54–0.79); Overweight, OR 1.77 (1.48–2.12); Obese, OR 2.30 (1.76–3.00) | Life-time abstainers (ref.): non-heavy drinker, OR 0.80 (0.69–0.94); Infrequent heavy drinkers, OR 1.24 (0.66–2.33); Frequent heavy drinkers, OR 1.24 (0.66–2.33) | Never smoker (ref.): Less than daily / ever smoker, OR 1.24 (1.02–1.49); Daily, OR 0.83 (0.61–1.12). Has health insurance vs. Uninsured, OR 1.08 (0.94–1.25) | |
7 | South Africa | Lloyd-Sherlock 2014 [18] | High physical activity (ref.): Moderate, OR = 0.91 (0.66–1.26); Low, OR 0.77 (0.61–0.97) | Normal BMI (ref): Underweight, OR 0.96 (0.58–1.59); Overweight, OR 1.57 (1.29–2.06); Obese, OR 1.85 (1.43–2.39) | Life-time abstainers (ref.): non-heavy drinker, OR 0.66 (0.47–0.91); Infrequent heavy drinkers, OR 0.41 (0.25–0.67); Frequent heavy drinkers, OR 0.45 (0.17–1.15) | Never smoker (ref.): Less than daily / ever smoker, OR 1.05 (0.78–1.42); Daily, OR 1.07 (0.81–1.42). Has health insurance vs. Uninsured, OR 0.92 (0.71–1.20) | |
8 | Senegal | Macia 2012 [30] | Compared with BMI < 25: BMI ≥25, OR = 1.86 (1.24–2.79), p < 0.01 | Married (ref.): Not married, OR 0.81 (0.51–1.28) | |||
9 | Kenya | Mathenge 2010 [31] | BMI and WHR adjusted | Alcohol use adjusted | Diabetes (laboratory-confirmed) adjusted | Ethnicity Kalenjins (ref.): Kikuyus OR 1.4 (1.2–1.7) | |
10 | Ghana | Minicuci 2014 [22] | Normal weight (ref.): Overweight BM 25.0–29.9 kg/m2 OR = 1.72 (1.40–2.11); Obese BMI ≥30.0 kg/m2 OR 2.03 (1.53–2.71) Underweight (BMI < 18.5 kg/m2) OR 0.63 (0.50–0.80) | Administrative region. Greater Accra (ref.): Ashanti OR 1.14 (0.78–1.66); Brong Ahafo, OR 0.98 (0.66–1.45); Central, OR 1.03 (0.69–1.52); Eastern, OR 1.03 (0.73–1.45); Northern, OR 0.90 (0.54–1.49); Upper East, OR 0.37 (0.24–0.58); Upper West, OR 0.24 (0.12–0.46); Volta, OR 0.99 (0.65–1.48); Western, OR 0.81 (0.54–1.21) | |||
11 | Ghana | Nuertey 2017 [34] | Adjusted OR 1.8 (1.5–2.0) compares overweight/obese in hypertensives and non-hypertensives | Adjusted for self-reported diabetes | |||
12 | South Africa | Peltzer 2013 [23] | Normal weight (ref.): Overweight BMI ≥25 kg/m2 OR = 1.52 (1.15–2.01), p < 0.01 Underweight (BMI < 18.5 kg/m2) OR 0.77 (0.36–1.64 | Alcohol use over past one month, OR = 0.64 (0.49–0.84) | Self-reported diabetes, OR 1.30 (0.86–1.98) | Race black African (ref.): white OR 1.23 (0.66–2.30); Coloured OR 1.89 (1.04–3.44); Indian or Asian OR 0.82 (0.47–1.42) Self-reported stroke OR 4.48 (1.48–13.59), p < 0.01 Self-reported arthritis OR 1.13 (0.75–1.69) Outpatient visits in past 12 months; Nil (ref.):1–4 visits OR 1.14 (0.80–1.63); ≥ 5 visits vs. nil, OR = 1.93 (1.48–2.51) | |
13 | CAR, Congo | Pilleron 2017 [36] | high physical activity ≥150 min/wk. vs. < 150 min/wk.; OR = 0.75 (0.59–0.96); p = 0.023 | BMI (continuous variable); OR = 1.09 (1.06–1.12); p < 0.001 | Compared with abstainers: light OR = 0.99 (0.77–1.27); moderate to heavy OR = 0.89 (0.42–1.89); p = 0.953 | Diagnosed diabetes OR 0.85 (0.56–1.28), p = 0.408 | Compared with tobacco nonuser: ex-user OR = 0.65 (0.41–1.03); current smoker OR = 0.60 (0.38–0.95); other mode of intake OR = 0.81 (0.60–1.11) High cholesterol vs normal level: OR 1.33 (0.90–1.97) |
14 | Nigeria | Raji 2017 [37] | Overweight/obesity BMI ≥25 kg/m2 OR = 3.72 (1.47–9.40), p = 0.007 | Never drank alcohol (ref.): Drank alcohol OR 0.84 (0.66–1.09), NS | No history of self-reported diabetes (ref.): Self-reported diabetes OR 0.91 (0.50–1.75), p value = 0.389 | Cigarette smoking OR 0.97 (0.73–1.29), p value = 0.819 | |
15 | Uganda | Scholten 2011 [38] | Married (ref.): Not married, OR 0.92; NS HIV infection and treatment, No HIV (ref.): HIV on ART, OR 0.50, NS; HIV no ART, OR 0.23, p value = 0.01 | ||||
16 | Cameroon | Tianyi 2017 [39] | Overweight/obesity vs. Others, OR = 3.46 (2.38–5.03), p < 0.001 | ||||
17 | Ghana | Tyrovolas 2015 [20] | Compared with high level physical activity: Moderate, OR 0.96 (0.72–1.28), NS; Low, OR 1.12 (0.91–1.38), NS | Compared with normal BMI: underweight OR 0.70 (0.55–0.90), p < 0.01; overweight OR 1.90 (1.54–2.35), p < 0.001; BMI 30.0–34.9 category OR 2.14 (1.51–3.04), p < 0.001; BMI ≥ 35 OR 2.78 (1.65–4.69), p < 0.001 | Compared with never: Non-heavy OR 1.01 (0.86–1.19), NS; Heavy OR 1.07 (0.62–1.84), NS | Self-reported Yes vs No: OR 2.37 (1.51–3.74), p < 0.001 | History of stroke, Yes vs. No: OR 3.45 (1.70–7.01), p < 0.001. Fruit servings/day, 0–1 (ref): 2–4 servings OR 1.05 (0.86–1.28); ≥5 servings, OR 1.64 (1.13–2.39), p < 0.01 Vegetable servings/day, 0–1 (ref): 2–4 servings OR 1.04 (0.84–1.27); ≥5 servings, OR 0.68 (0.35–1.34) Compared with never smoker: Current smoker OR 0.78 (0.60–1.01); Ex-smoker, OR 1.22 (0.96–1.54) |
18 | South Africa | Tyrovolas 2015 [20] | Compared with high level physical activity: Moderate, OR 0.76 (0.50–1.17), NS; Low, OR 0.67 (0.47–0.96), p < 0.05 | Compared with normal BMI: underweight OR 0.84 (0.47–1.51); overweight OR 1.53 (1.07–2.19), p < 0.05; BMI 30.0–34.9, OR 1.65 (1.06–2.58), p < 0.05; BMI ≥ 35 OR 1.60 (1.04–2.44), p < 0.05 | Compared with never: Non-heavy OR 0.92 (0.62–1.35), NS; Heavy OR 0.43 (0.23–0.81), p < 0.01 | Self-reported Yes vs No: OR 1.61 (0.96–2.70) | History of stroke, Yes vs. No: OR 3.18 (1.36–7.43), p < 0.01 Fruit servings/day, 0–1 (ref): 2–4 servings OR 0.90 (0.65–1.24); ≥5 servings, OR 1.87 (0.63–5.54) Vegetable servings/day, 0–1 (ref): 2–4 servings OR 1.55 (1.11–2.18), p < 0.05; ≥5 servings, OR 1.20 (0.58–2.46) Compared with never smoker: Current smoker OR 1.25 (0.87–1.78); Ex-smoker, OR 1.70 (1.01–2.85), p < 0.05 |