撒哈拉以南非洲青少年中的高血压：一项系统综述。

Hypertension among adolescents in sub-Saharan Africa: a systematic review.

作者信息

Nsanya Mussa K, Abramson Rachel, Kisigo Godfrey A, Hickner Andy, Nyanza Elias C, Peck Robert N, Kapiga Saidi H

机构信息

Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania.

Weill Cornell Medicine - Cornell University, New York, NY, United States.

出版信息

Front Cardiovasc Med. 2023 Dec 7;10:1251817. doi: 10.3389/fcvm.2023.1251817. eCollection 2023.

DOI:10.3389/fcvm.2023.1251817

PMID:38155990

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10754047/

Abstract

INTRODUCTION

Hypertension (HTN) among adolescents is common in high-income countries, and leads to increased premature cardiovascular diseases (CVD). In sub-Saharan Africa (SSA), the prevalence of HTN among adolescents, associated risk factors and CVD complications are not well-described. Such data is needed for planning public health programs to prevent premature CVD in SSA.

METHODS

We systematically searched 5 databases (MEDLINE, Embase, Google Scholar, Web of Science, and African Index Medicus) from their establishment to December 2021. Key search terms were: adolescent, arterial hypertension, and names of the 48 countries in SSA. We used Covidence® to manage the search results. The review was registered in the Open Science Framework (OSF) https://osf.io/p5sbt/.

RESULTS

We identified 4,008 articles out of which we screened 3,088 abstracts, and reviewed 583 full-text articles. We finally included 92 articles that were published between 1968 to December 2021. The majority were cross-sectional studies (80%) and conducted in school settings (78%). The risk of bias was low for 59 studies (64.1%), moderate for 29 studies (31.5%), and high for 4 studies (4.3%). Overall, the prevalence of HTN varied widely from 0.18% to 34.0% with a median (IQR) of 5.5% (3.1%, 11.1%). It was relatively higher in studies using automated blood pressure (BP) devices, and in studies defining HTN using thresholds based on percentile BP distribution for one's height, age, and sex. In addition, the prevalence of HTN was significantly higher in studies from Southern Africa region of SSA and positively correlated with the year of publication. Across studies, traditional risk factors such as age, sex, body mass index, and physical inactivity, were commonly found to be associated with HTN. In contrast, non-traditional risk factors related to poverty and tropical diseases were rarely assessed. Only three studies investigated the CVD complications related to HTN in the study population.

CONCLUSION

The prevalence of HTN among adolescents in SSA is high indicating that this is a major health problem. Data on non-traditional risk factors and complications are scarce. Longitudinal studies are needed to clearly define the rates, causes, and complications of HTN.

SYSTEMATIC REVIEW REGISTRATION

https://osf.io/p5sbt/, identifier (10.17605/OSF.IO/P5SBT).

摘要

引言

青少年高血压在高收入国家很常见，并会导致过早发生心血管疾病（CVD）的风险增加。在撒哈拉以南非洲（SSA），青少年高血压的患病率、相关风险因素及CVD并发症尚未得到充分描述。规划公共卫生项目以预防SSA地区过早发生的CVD需要此类数据。

方法

我们系统检索了5个数据库（MEDLINE、Embase、谷歌学术、科学网和非洲医学索引）自建库至2021年12月的文献。关键检索词为：青少年、动脉高血压以及SSA地区48个国家的名称。我们使用Covidence®管理检索结果。该综述已在开放科学框架（OSF）https://osf.io/p5sbt/上注册。

结果

我们共识别出4008篇文章，从中筛选了3088篇摘要，并审阅了583篇全文。最终纳入了92篇于1968年至2021年12月期间发表的文章。大多数为横断面研究（80%），且在学校环境中开展（78%）。59项研究（64.1%）的偏倚风险较低，29项研究（31.5%）的偏倚风险为中等，4项研究（4.3%）的偏倚风险较高。总体而言，高血压患病率差异很大，从0.18%至34.0%不等，中位数（IQR）为5.5%（3.1%，11.1%）。在使用自动血压测量设备的研究中，以及在根据身高、年龄和性别的血压百分位数分布阈值定义高血压的研究中，患病率相对较高。此外，SSA地区南部非洲的研究中高血压患病率显著更高，且与发表年份呈正相关。在各项研究中，年龄、性别、体重指数和身体活动不足等传统风险因素通常被发现与高血压有关。相比之下，与贫困和热带疾病相关的非传统风险因素很少被评估。只有三项研究调查了研究人群中与高血压相关的CVD并发症。