Background
Methods
Search strategy and inclusion criteria
Data extraction
Definition of hypertension, awareness, treatment and control
Data analysis
Results
State of the evidence: hypertension awareness, treatment and control in the Arab world
The Cascade of hypertension care
Study | Sample size | Agea | Prevalenceb (%) | Among Hypertensives c | |||||
---|---|---|---|---|---|---|---|---|---|
Loss 1 (%) | Aware (%) | Loss 2 (%) | Treated (%) | Loss 3 (%) | Controlled (%) | ||||
HOUSEHOLD | |||||||||
Algeria | |||||||||
Hamidaa,F. et al. (2013) [46] | 722 | > = 40 | 50.0 | −57.5 | 42.5 | −1.7 | 40.8 | −32.5 | 8.3 |
Bahrain | |||||||||
Al-Mahroos, F. et al. (2000) e [43] | 2090 | 40–69 | 30 | −38.0 | 62.0 | −6.3 | 55.7 | −42.3 | 13.4 |
Jordan | |||||||||
Jaddou, H.Y. et al. (2011)f [40] | 4117 | > = 25 | 32.3 | −43.9 | 56.1 | −20.6 | 35.5g | −21.43 | 14.07g |
Kheirallah, K. A et al. (2015) h [41] | 517g | > = 25 | 44.3 | −63.8 | 36.2 | −3.0 | 33.2g | −23.2 | 10.0g |
KSA | |||||||||
Saeed, A.A. et al. (2011) f [45] | 4758 | 15–64 | 25.5 | −55.3 | 44.7 | −12.6 | 32.1g | −20.2 | 11.9 g |
El-Bcheraoui C. et al. (2014) f [44] | 10,735 | > = 15 | 15.2 | −57.8 | 42.2i | −5.4 | 36.8i | −20.2 | 16.6i |
Yusufali, A. M. et al. (2017) j [25] | 1545 | 35–70 | 30.0 | −39.0 | 61.0g | −2.0 | 59.0gf | −29.0 | 30.0g |
Morocco | |||||||||
Tazi, M.A. et al. (2009) f [28] | 1802 | > = 20 | 39.6 | −78.1 | 21.9 | −13.1 | 8.8 | −7.7 | 1.1 |
Palestine | |||||||||
Yusufali, A. M. et al. (2017) j [25] | 1545 | 35–70 | 37.0 | −40.0 | 60.0 | −2.0 | 58.0g | −35.0 | 23.0g |
Tunisia | |||||||||
Ben Romdhane, H.et al. (2005) [31] | 1837 | 40–69 | 44.3 | −58.1 | 41.9 | −10.9 | 31.0g | −26.9 | 4.1g |
Hammami, S. et al. (2011) [36] | 598 | > = 65 | 52.0 | −19.0 | 81.0 | −2.6 | 78.4 | −54.0 | 24.4g |
Ben Romdhane, H. et al. (2012) f [47] | 8007 | 35–74 | 30.6 | −61.2 | 38.8 | −5.9 | 32.9g | −25.0 | 7.9 |
UAE | |||||||||
Yusufali, A. M. et al. (2017) j [25] | 1545 | 35–70 | 52.0 | −48.0 | 52.0 | −2.0 | 50.0g | −37.0 | 13.0g |
Yemen | |||||||||
Modesti, P. A. et al. (2013) f [20] | 10,242 | 15–69 | 12.8 | −55.5 | 44.5 | −4.1 | 40.4 | −30.7 | 9.7g |
HEALTH CARE FACILITIES | |||||||||
Kuwait | |||||||||
Awad, A. I& Alsaleh, F. (2015) f [33] | 1610 | 20–79 | 20.0 | −41.9 | 58.1f | 0 | 58.1g | −19.3 | 38.8g |
Palestine (West Bank) | |||||||||
Khdour, M. R. et al. (2013) [48] | 2077 | 25–92 | 27.6 | −49.0 | 51.0 | −10.8 | 40.2 | −30.5 | 9.7 |
Sudan | |||||||||
Abdelsatir, S. et al. (2013) [38] | 389 | 41 ± 15 | 39.6 | −27.9 | 72.1 | −17.1 | 55.0g | −19.9 | 35.1 |
Tunisia | |||||||||
Laouani Kechrid,C.et al. (2004) [37] | 600 | > = 60 | 69.3 | −31.5 | 68.5 | −2.1 | 66.4 | −50.6 | 15.8 |
Yemen | |||||||||
Noman, O. et al. (2008) [42] | 994 | NA | 22.3i | −63.8 | 36.2i | −5.6 | 30.6i | −3.6 | 27.0i |
Multicountry study | |||||||||
Nejjari, C. et al. (2013) [39] | 28,500j | > = 18 | 45.4 | −54.8 | 71.0 | −6.2 | 64.8g | −34.5 | 30.3g |
Other (malls, plazas, centers)l | |||||||||
Lebanon | |||||||||
Matar, D. et al. (2015) [35] | 1697 | > = 21 | 36.9 | −47.0 | 53.0 | −4.1 | 48.9 | −21.9 | 27.0 |
Correlates of hypertension
Gender differences in awareness, treatment and control of hypertension in the Arab World
Country | Studyb | Agec | Male (%) | Female (%) | Ratio M/F | Significance |
---|---|---|---|---|---|---|
AWARENESS OF HYPERTENSION | ||||||
Awareness among hypertensive subjects (%) | ||||||
Egypt | Mohamed, M. R. et al. (2000) [55] | > = 18 | 62.9 | 49.5 | 1.27 | P = 0.002e |
Jordan | Jaddou, H. Y. et al. (2000) [49] | > = 25 | 79.4 | 83.6 | 0.95 | NS |
Jaddou, H. Y. et al. (2003) [50] | > = 25 | 50.0 | 55.6 | 0.90 | p = 0.02 | |
Jaddou, H. Y. et al. (2011) [40] | > = 25 | 54.7 | 56.7 | 0.96 | NS | |
> = 25 | 34.1 | 37.6 | 0.91 | NS | ||
KSA | Kalantan, K. A. et al. (2001) [56] | 35–85 | 28.5 | 19.0 | 1.50 | P = 0.049 |
Saeed, A.A. et al. (2011) d [45] | 15–64 | 37.3 | 53.3 | 0.70 | P < 0.001 | |
Amin, T. T. et al. (2014) [52] | 24–63 | 67.5 | 85.7 | 0.79 | P = 0.025e | |
El-Bcheraoui, C. et al. (2014)f, d [44] | > = 15 | 38.8f | 47.1f | 0.82 | Undiagnosed OR = 1.85[1.49–2.27]g, p < 0.05 | |
Mirza, A.A. et al. (2016) [51] | > = 30 | 49.7 | 62.8 | 0.79 | NS | |
Lebanon | Matar, D. et al. (2015) [35] | > = 21 | 50.4 | 57.9 | 0.87 | OR = 0.6 [0.4–0.9]g, p < 0.05 |
Morocco | > = 20 | 13.5 | 27.3 | 0.49 | P < 0.001e | |
Oman | Al-Riyami, A. et al. (2003) d [59] | > = 20 | NA | NA | NA | Significantly higher among females than males |
Barakat, H. et al. (2008) [53] | > = 20 | 14.9 | 21.4 | 0.70 | NSe | |
Abd El-Aty, MA. et al. (2015) f, d [27] | > = 18 | 13.7f | 39.1f | 0.35 | Unawareness OR = 2.5 [1.7–3.3]g, p < 0.001 | |
Palestine | Khdour, M. R. et al. (2013) [48] | > = 25 | 39.8 | 53.8 | 0.74 | p < 0.01e |
Tunisia | Ben Romdhane, H. et al. (2005) [31] | 40–69 | 30.2 | 48.3 | 0.63 | OR = 0.4 [0.3–0.5]g, p < 0.001 |
Ben Romdhane, H. et al. (2012) d [47] | 35–74 | 28.8 | 44.8 | 0.64 | OR = 0.5 [0.4–0.6]g, p < 0.001 | |
Yemen | Gunaid, A.A. et al. (2008) [54] | > = 35 | 25.0 | 38.0 | 0.66 | NSe |
Modesti, P. A. et al. (2013) d [20] | 15–69 | 40.7 | 47.6 | 0.86 | NSg | |
TREATMENT OF HYPERTENSION | ||||||
Treatment among hypertensive subjects (%) | ||||||
Algeria | Temmar, M. et al. (2007) [57] | 40–99 | 13.7 | 43.1 | 0.32 | p < 0.0001e |
Hamida,F.et al. (2013) [46] | > = 40 | 32.0 | 45.0 | 0.71 | P = 0.032e | |
KSA | El-Bcheraoui, C. et al. (2014) f, d [44] | > = 15 | 33.0f | 42.2f | 0.78 | NA |
Lebanon | Matar, D. et al. (2015) [35] | > = 20 | 46.1 | 54.0 | 0.85 | NS |
Palestine | Khdour, M. R. et al. (2013) [48] | > = 25 | 36.1 | 43.3 | 0.83 | p = 0.02 |
Yemen | Modesti, P. A. et al. (2013) d [20] | 15–69 | 36.5 | 43.6 | 0.84 | NSg |
Treatment among aware hypertensive subjects (%) | ||||||
Jordan | Jaddou, H. Y. et al. (2011) [40] | > = 25 | 67.0 | 61.9 | 1.08 | P = 0.01 |
KSA | Saeed, A.A. et al. (2011) d [45] | 15–64 | 74.2 | 69.2 | 1.07 | NS |
Morocco | Tazi, M.A. et al. (2009) d [28] | > = 20 | 26.3 | 44.9 | 0.59 | P = 0.042e |
Tunisia | Ben Romdhane, H et al. (2005) [31] | 40–69 | 72.5 | 74.6 | 0.97 | NS |
Ben Romdhane, H. et al. (2012)d [47] | 35–74 | 85.3 | 84.6 | 1.01 | NS | |
CONTROL OF HYPERTENSION | ||||||
Control among hypertensive subjects (%) | ||||||
KSA | El-Bcheraoui, C. et al. (2014) f, d [44] | > = 15 | 13.9f | 20.5f | 0.68 | NA |
Control among aware hypertensive subjects (%) | ||||||
KSA | Siddiqui, S. et al. (2001) [60] | > = 18 | 37.7 | 23.8 | 1.58 | NSe |
Mirza, A.A. et al. (2016) [51] | > = 30 | 37.2 | 39.5 | 0.94 | NS | |
Jordan | Jaddou, H.Y. et al. (2000) [49] | > = 25 | 25.9 | 34.8 | 0.74 | NS |
Khader, A.et al. (2014) [61] | > = 0/18 | 80.0 | 85.0 | 0.94 | OR = 1.4[1.2–1.4], p < 0.001 | |
Oman | Abd El-Aty, MA. et al. (2015) f, d [27] | > = 18 | 26.9f | 38.3f | 0.70 | Uncontrolled OR = 3.3[1.4–5.0]g, p < 0.001 |
Sudan | Babiker, F. A. et al. (2013) [62] | > = 20 | 39.0 | 85.0 | 0.46 | p < 0.001 |
Algeria, Morocco Tunisia | Nejjari, C.et al. (2013) [39] | > = 18 | 34.0 | 36.6 | 0.93 | p = 0.01 |
Control among treated hypertensive subjects (%) | ||||||
Algeria | Temmar, M. et al. (2007) [57] | 40–99 | 13.9 | 28.0 | 0.50 | NSe |
Hamida,F. et al. (2013) [46] | > = 40 | 17.1 | 21.3 | 0.80 | NSe | |
Jordan | Jaddou, H. Y. et al. (2011) [40] | > = 25 | 42.9 | 38.2 | 1.12 | NS |
Kheirallah, K.A. et al. (2015) [41] | > = 25 | 23.3 | 24.5 | 0.95 | NS | |
KSA | Saeed, A.A. et al. (2011) d [45] | 15–64 | 32.0 | 41.1 | 0.77 | NS |
Lebanon | Matar, D.et al. (2015) [35] | > = 21 | 48.9 | 62.3 | 0.78 | p = 0.021 |
Morocco | > = 20 | 20.0 | 11.3 | 1.77 | NSe | |
Palestine | Khdour, M. R. et al. (2013) [48] | > = 25 | 29.3 | 35.9 | 0.82 | p = 0.01 |
Tunisia | Ben Romdhane, H. et al. (2005) [31] | 40–69 | 16.8 | 12.0 | 1.40 | NS |
Masmoudi, J. et al. (2010) [58] | 61.8 ± 11.9 | 46.3 | 27.1 | 1.71 | p = 0.047 | |
Ben Romdhane, H. et al. (2012) d [47] | 35–74 | 27.5 | 22.8 | 1.21 | NS | |
Yemen | Modesti, P. A. et al. (2013) d [20] | 15–69 | 17.2 | 28.8 | 0.60 | OR = 0.5 [0.3–0.9]g, p < 0.05 |