Diagnosis, Prevalence, Awareness, Treatment, Prevention, and Control of Hypertension in Cameroon: Protocol for a Systematic Review and Meta-Analysis of Clinic-Based and Community-Based Studies

Background Hypertension holds a unique place in population health and health care because it is the leading cause of cardiovascular disease and the most common noncommunicable condition seen in primary care worldwide. Without effective prevention and control, raised blood pressure significantly increases the risk of stroke, myocardial infarction, chronic kidney disease, heart failure, dementia, renal failure, and blindness. There is an urgent need for stakeholders—including individuals and families—across the health system, researchers, and decision makers to work collaboratively for improving prevention, screening and detection, diagnosis and evaluation, awareness, treatment and medication adherence, management, and control for people with or at high risk for hypertension. Meeting this need will help reduce the burden of hypertension-related disease, prevent complications, and reduce the need for hospitalization, costly interventions, and premature deaths. Objective This review aims to synthesize evidence on the epidemiological landscape and control of hypertension in Cameroon, and to identify elements that could potentially inform interventions to combat hypertension in this setting and elsewhere in sub-Saharan Africa. Methods The full search process will involve several steps, including selecting relevant databases, keywords, and Medical Subject Headings (MeSH); searching for relevant studies from the selected databases; searching OpenGrey and the Grey Literature Report for gray literature; hand searching in Google Scholar; and soliciting missed publications (if any) from relevant authors. We will select qualitative, quantitative, or mixed-methods studies with data on the epidemiology and control of hypertension in Cameroon. We will include published literature in French or English from electronic databases up to December 31, 2016, and involving adults aged 18 years or older. Both facility and population-based studies on hypertension will be included. Two reviewers of the team will independently search, screen, extract data, and assess the quality of selected studies using suitable tools. Selected studies will be analyzed by narrative synthesis, meta-analysis, or both, depending on the nature of the data retrieved in line with the review objectives. Results This review is part of an ongoing research program on disease prevention and control in the context of the dual burden of communicable and noncommunicable diseases in Africa. The first results are expected in 2017. Conclusions This review will provide a comprehensive assessment of the burden of hypertension and control measures that have been designed and implemented in Cameroon. Findings will form the knowledge base relevant to stakeholders across the health system and researchers who are involved in hypertension prevention and control in the community and clinic settings in Cameroon, as a yardstick for similar African countries. Trial Registration PROSPERO registration number: CRD42017054950; http://www.crd.york.ac.uk/PROSPERO/ display_record.asp?ID=CRD42017054950 (Archived by WebCite at http://www.webcitation.org/6qYSjt9Jc)

[1]  D. Lackland,et al.  Implementing standardized performance indicators to improve hypertension control at both the population and healthcare organization levels , 2017, Journal of clinical hypertension.

[2]  Ivy Shiue,et al.  Global Burden of Hypertension and Systolic Blood Pressure of at Least 110 to 115 mm Hg, 1990-2015 , 2017, JAMA.

[3]  Hynek Pikhart,et al.  Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19·1 million participants , 2017, The Lancet.

[4]  S. Yusuf,et al.  Social disparities explain differences in hypertension prevalence, detection and control in Colombia , 2016, Journal of hypertension.

[5]  C. Toniolo,et al.  Nutritional composition, bioactive compounds and volatile profile of cocoa beans from different regions of Cameroon , 2016, International journal of food sciences and nutrition.

[6]  R. Walker,et al.  Hypertension in Sub-Saharan Africa; prevalence, prescriptions, pitfalls and paradigms , 2016, Journal of Human Hypertension.

[7]  F. Cappuccio,et al.  Cardiovascular disease and hypertension in sub-Saharan Africa: burden, risk and interventions , 2016, Internal and Emergency Medicine.

[8]  M. Woodward,et al.  Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta-analysis , 2016, The Lancet.

[9]  W. Aronow,et al.  Hypertension in Sub-Saharan Africa: A Contextual View of Patterns of Disease, Best Management, and Systems Issues , 2016, Cardiology in review.

[10]  O. Uthman,et al.  Prevalence of Hypertension in Low- and Middle-Income Countries , 2015, Medicine.

[11]  Dan J Stein,et al.  Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013 , 2015, BDJ.

[12]  M. Olsen,et al.  A global perspective on hypertension: a Lancet Commission , 2015, The Lancet.

[13]  S. Yusuf,et al.  Understanding the modifiable health systems barriers to hypertension management in Malaysia: a multi-method health systems appraisal approach , 2015, BMC Health Services Research.

[14]  N. Campbell,et al.  Hypertension in sub-Saharan Africa: a massive and increasing health disaster awaiting solution , 2015, Cardiovascular journal of Africa.

[15]  K. S. Bobo,et al.  Wildlife use and the role of taboos in the conservation of wildlife around the Nkwende Hills Forest Reserve; South-west Cameroon , 2015, Journal of Ethnobiology and Ethnomedicine.

[16]  G. Parati,et al.  Effects of blood pressure lowering on outcome incidence in hypertension: 3. Effects in patients at different levels of cardiovascular risk – overview and meta-analyses of randomized trials , 2014, Journal of hypertension.

[17]  Hilary K. Wall,et al.  Patients with undiagnosed hypertension: hiding in plain sight. , 2014, JAMA.

[18]  Tej K. Khalsa,et al.  Standards for the Uniform Reporting of Hypertension in Adults Using Population Survey Data: Recommendations From the World Hypertension League Expert Committee , 2014, Journal of clinical hypertension.

[19]  A. Thrift,et al.  Do the socioeconomic and hypertension gradients in rural populations of low- and middle-income countries differ by geographical region? A systematic review and meta-analysis. , 2014, International journal of epidemiology.

[20]  L. Fourcade,et al.  [Sociocultural and medical management of hypertension in sub-Saharan Africa]. , 2014, Medecine et sante tropicales.

[21]  Huguette Gaelle Ngassa Mbenda,et al.  Does malaria epidemiology project Cameroon as ‘Africa in miniature’? , 2014, Journal of Biosciences.

[22]  R. Townsend,et al.  Top 10 landmark studies in hypertension. , 2014, Journal of the American Society of Hypertension : JASH.

[23]  B. K. Defo Beyond the ‘transition’ frameworks: the cross-continuum of health, disease and mortality framework , 2014, Global health action.

[24]  B. K. Defo Demographic, epidemiological, and health transitions: are they relevant to population health patterns in Africa? , 2014, Global health action.

[25]  Martin McKee,et al.  Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries. , 2013, JAMA.

[26]  B. Rayner,et al.  Recent advances in hypertension in sub-Saharan Africa , 2013, Heart.

[27]  Stephen S. Lim,et al.  Prevalence, Awareness, Treatment, and Control of Hypertension in United States Counties, 2001–2009 , 2013, PloS one.

[28]  S. Manda,et al.  Geographic variation of hypertension in sub-saharan Africa: a case study of South Africa. , 2013, American journal of hypertension.

[29]  K. Lange,et al.  Genetics of early-onset obsessive–compulsive disorder , 2010, European Child & Adolescent Psychiatry.

[30]  B. Balkau,et al.  Ten-year change in blood pressure levels and prevalence of hypertension in urban and rural Cameroon , 2009, Journal of Epidemiology & Community Health.

[31]  D. Beevers,et al.  Hypertension in ethnic groups: epidemiological and clinical perspectives , 2009, Expert review of cardiovascular therapy.

[32]  N. Lunet,et al.  Differences in prevalence, awareness, treatment and control of hypertension between developing and developed countries , 2009, Journal of hypertension.

[33]  H. Yatsuya,et al.  Self-reported medical history was generally accurate among Japanese workplace population. , 2009, Journal of clinical epidemiology.

[34]  Li-sheng Liu,et al.  Treatment of hypertension in patients 80 years of age or older. , 2008, The New England journal of medicine.

[35]  G. Guyatt,et al.  GRADE: an emerging consensus on rating quality of evidence and strength of recommendations , 2008, BMJ : British Medical Journal.

[36]  G. Salem,et al.  Hypertension, urbanization, social and spatial disparities: a cross-sectional population-based survey in a West African urban environment (Ouagadougou, Burkina Faso). , 2007, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[37]  J. Zicha,et al.  Developmental windows and environment as important factors in the expression of genetic information: a cardiovascular physiologist's view. , 2006, Clinical science.

[38]  Lisa Hartling,et al.  Single data extraction generated more errors than double data extraction in systematic reviews. , 2006, Journal of clinical epidemiology.

[39]  I. Hajjar,et al.  Hypertension: trends in prevalence, incidence, and control. , 2006, Annual review of public health.

[40]  P. Sorlie,et al.  The Burden of Adult Hypertension in the United States 1999 to 2000: A Rising Tide , 2004, Hypertension.

[41]  Douglas W Mahoney,et al.  Agreement between self-report questionnaires and medical record data was substantial for diabetes, hypertension, myocardial infarction and stroke but not for heart failure. , 2004, Journal of clinical epidemiology.

[42]  Erik von Elm,et al.  Different patterns of duplicate publication: an analysis of articles used in systematic reviews. , 2004, JAMA.

[43]  M. Porta Textbook of cancer epidemiology , 2003 .

[44]  Daniel W. Jones,et al.  The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. , 2003, JAMA.

[45]  J. Eriksson,et al.  Fetal origins of adult disease: strength of effects and biological basis. , 2002, International journal of epidemiology.

[46]  L. Hansson Hypertension management in 2002: where have we been? where might we be going? , 2002, American journal of hypertension.

[47]  S. Thompson,et al.  Quantifying heterogeneity in a meta‐analysis , 2002, Statistics in medicine.

[48]  Y. Ben-Shlomo,et al.  A life course approach to chronic disease epidemiology: conceptual models, empirical challenges and interdisciplinary perspectives. , 2002, International journal of epidemiology.

[49]  S. Yusuf,et al.  Global burden of cardiovascular diseases: Part II: variations in cardiovascular disease by specific ethnic groups and geographic regions and prevention strategies. , 2001, Circulation.

[50]  C. Navarro,et al.  Validation of self diagnosis of high blood pressure in a sample of the Spanish EPIC cohort: overall agreement and predictive values , 2000, Journal of epidemiology and community health.

[51]  N. Black,et al.  The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. , 1998, Journal of epidemiology and community health.

[52]  N. Poulter,et al.  Socio-economic status and blood pressure: an overview analysis , 1998, Journal of Human Hypertension.

[53]  Jan A Staessen,et al.  Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension , 1997, The Lancet.

[54]  M. Tramèr,et al.  Impact of covert duplicate publication on meta-analysis: a case study , 1997, BMJ.

[55]  M Susser,et al.  Choosing a future for epidemiology: II. From black box to Chinese boxes and eco-epidemiology. , 1996, American journal of public health.

[56]  B. K. Defo Areal and socioeconomic differentials in infant and child mortality in Cameroon. , 1996, Social science & medicine.

[57]  P Whelton,et al.  Prevalence of hypertension in the US adult population. Results from the Third National Health and Nutrition Examination Survey, 1988-1991. , 1995, Hypertension.

[58]  O Lewis,et al.  Stephen Hales and the measurement of blood pressure. , 1994, Journal of human hypertension.

[59]  M. C. Leske,et al.  Comparing self-reported and physician-reported medical history. , 1994, American journal of epidemiology.

[60]  R. Collins,et al.  Blood pressure, stroke, and coronary heart disease Part 2, short-term reductions in blood pressure: overview of randomised drug trials in their epidemiological context , 1990, The Lancet.

[61]  M. Crawford Nutritional Control of Heart Disease and Cancer: Are Different Diets Necessary* , 1985, Nutrition and health.

[62]  Ashutosh Kumar Singh,et al.  Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015 , 2016, Lancet.

[63]  L. Bortel,et al.  Management of hypertension at the community level in Sub-Saharan Africa (SSA): towards a rational use of available resources , 2011, Journal of Human Hypertension.

[64]  S. Syme,et al.  Environments, people, and health. , 1983, Annual review of public health.