Non-pharmacological interventions to achieve blood pressure control in African patients: a systematic review.

Autor:	Cernota M; Institute of General Practice and Family Medicine, Center of Health Sciences, Martin-Luther-Universität Halle-Wittenberg Medizinische Fakultät, Halle, Germany., Kroeber ES; Institute of General Practice and Family Medicine, Center of Health Sciences, Martin-Luther-Universität Halle-Wittenberg Medizinische Fakultät, Halle, Germany eric.kroeber@posteo.de., Demeke T; School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia., Frese T; Institute of General Practice and Family Medicine, Center of Health Sciences, Martin-Luther-Universität Halle-Wittenberg Medizinische Fakultät, Halle, Germany., Getachew S; School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia., Kantelhardt EJ; Institute for Medical Epidemiology, Biostatistics and Informatics, Center of Health Sciences, Martin-Luther-Universität Halle-Wittenberg Medizinische Fakultät, Halle, Germany., Ngeh EN; Physiotherapy Department, Regional Hospital Bamenda, Bamenda, Cameroon.; Research Organization for Health Education and Rehabilitation-Cameroon(ROHER-CAM), St. Louis University Bamenda, Bamenda, Cameroon.; African Regional Community, Guidelines International Network (G-I-N), Bamenda, Cameroon., Unverzagt S; Institute of General Practice and Family Medicine, Center of Health Sciences, Martin-Luther-Universität Halle-Wittenberg Medizinische Fakultät, Halle, Germany.; Department of Primary Care, Universität Leipzig Medizinische Fakultät, Leipzig, Germany.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2022 Feb 28; Vol. 12 (2), pp. e048079. Date of Electronic Publication: 2022 Feb 28.
DOI:	10.1136/bmjopen-2020-048079
Abstrakt:	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. Prospero Registration Number: CRD42018075062. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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