Dataset Information

Trends in prevalence of hypertension in Brazil: a systematic review with meta-analysis.

ABSTRACT:

Background

The prevalence of hypertension in emerging nations was scarcely described to date. In Brazil, many population-based surveys evaluated the prevalence in cities throughout the country. However, there is no population-based nationwide study of prevalence of hypertension. In this study, we estimated the prevalence of hypertension for the country and analyzed the trends for the last three decades.

Methods

Cross-sectional and cohort studies conducted from 1980 to 2010 were independently identified by two reviewers, without language restriction, in the PubMed, Embase, LILACS, and Scielo electronic databases. Unpublished studies were identified in the Brazilian electronic database of theses and in annals of Cardiology congresses and meetings. In total, 40 studies were selected, comprising 122,018 individuals.

Results

Summary estimates of prevalence by the former WHO criteria (BP?160/95 mmHg) in the 1980's and 1990's were 23.6% (95% CI 17.3-31.4%) and 19.6% (16.4-23.3%) respectively. The prevalence of hypertension by the JNC criteria (BP?140/90 mmHg) in the 1980's, 1990's and 2000's were 36.1% (95% CI 28.7-44.2%), 32.9% (29.9-36.0%), and 28.7% (26.2-31.4%), respectively (P<0.001). In the 2000's, the pooled prevalence estimates of self-reported hypertension on telephone inquiries was 20.6% (19.0-22.4%), and of self-reported hypertension in home surveys was 25.2% (23.3-27.2%).

Conclusions

The prevalence of hypertension in Brazil seems to have diminished 6% in the last three decades, but it still is approximately 30%. Nationwide surveys by self-reporting by telephone interviews underestimate the real prevalence. Rates of blood pressure control decreased in the same period, corresponding currently to only one quarter of individuals with hypertension.

SUBMITTER: Picon RV

PROVIDER: S-EPMC3485225 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

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Publications

Trends in prevalence of hypertension in Brazil: a systematic review with meta-analysis.

Picon Rafael V RV Fuchs Flávio D FD Moreira Leila B LB Riegel Glaube G Fuchs Sandra C SC

PloS one 20121031 10

<h4>Background</h4>The prevalence of hypertension in emerging nations was scarcely described to date. In Brazil, many population-based surveys evaluated the prevalence in cities throughout the country. However, there is no population-based nationwide study of prevalence of hypertension. In this study, we estimated the prevalence of hypertension for the country and analyzed the trends for the last three decades.<h4>Methods</h4>Cross-sectional and cohort studies conducted from 1980 to 2010 were in ...[more]

PMID: 23118964

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Project description:Despite the recent increasing worldwide attention towards pulmonary hypertension (PH), its epidemiology remains poorly described in Africa. Accordingly, we performed a systematic review and meta-analysis of PH prevalence, incidence and etiologies in Africa.We searched PubMed, EMBASE, African Journals Online, and Africa Index Medicus. Published observational studies until September 20, 2017, including adult participants residing in Africa were considered. Two review authors independently selected studies, assessed included studies for methodological quality, and extracted data. A random-effects model was used for meta-analysis. Heterogeneity was evaluated by the ? 2 test on Cochrane's Q statistic which is quantified by I2 values. Using Newcastle-Ottawa Scale, we considered a score of 0-4, 5-7, and 8-10 as indicative of high, moderate, and low risk of bias in included studies, respectively.Of 1611 entries, 25 studies were retained. Twelve (48%), seven (28%), and six (24%) papers had respectively a low, moderate and high risk of bias. The prevalence of PH widely varied across different populations: 9.8% (95% confidence interval: 3.2-19.3; I2?=?99.4%; 6 studies) in 11,163 people presenting with cardiac complaints; 10.6% (4.3-19.1; I2?=?90.3%; 4 studies) in 937 HIV-infected people; 32.9% (17.6-50.4; I2?=?97.2%; 3 studies) in 2077 patients with heart failure; 23.2% (15.2-32.2; I2?=?59.4%; 3 studies) in 248 patients on hemodialysis; 12.9% (11.8-14.0; I2?=?79.7%; 2 studies) in 3750 patients with rheumatic heart disease; 36.9% (29.7-44.3; I2?=?79.7; 2 studies) in 79 patients with sickle cell disease; 62.7% (49.0-74.7; 1 study) in 51 patients with chronic obstructive pulmonary disease; 25.4% (16.3-37.3; 1 study) in 63 patients with systemic lupus erythematous; 68.7% (62.8-74.1; 1 study) in 259 patients with cardiac surgery; and 7.4% (4.6-11.9; 1 study) in 202 patients with systemic sclerosis. No study reported PH incidence. From one international study (n?=?209), PH etiologies were: left heart disease (68.9%), pulmonary arterial hypertension (15.8%), lung disease and/or hypoxia (12.0%), chronic thromboembolic PH (1.9%) and unclear/multifactorial PH (15.8%).The prevalence of PH is relatively high in some populations in Africa, perhaps mainly driven by left heart diseases, highlighting the need for context-specific interventions.

Project description:BACKGROUND: Cardiovascular diseases are the leading cause of death in the world and are responsible for a high number of disability-adjusted life years. Elevated blood pressure is an independent, linear and continuous risk factor for cardiovascular disease and has also been reported in the young population. Brazil is a country of continental dimensions, and is very heterogeneous with respect to socioeconomic and cultural aspects. Brazilian studies on the subject of hypertension in adolescence are not nationally representative, and this provides a rationale for the conduction of a meta-analysis to assess the magnitude of the problem in the country. METHODS: Hypertension studies in adolescents published from 1990 to September 2010 were searched in six electronic databases. Forest plots of the prevalence of hypertension were built for the overall population and by gender. Heterogeneity was assessed using I2 statistics. Meta-regression models were adjusted in order to identify possible sources of heterogeneity. RESULTS: Of 3,631 articles initially identified, 17 were considered eligible for systematic review. The pooled prevalence of hypertension, estimated through random effects models, was 8.12% (95% CI 6.24-10.52) for the total population. Overall, prevalence was higher in males, 8.75% (95% CI 5.81-12.96) than females, 6.31%, (95% CI 4.41-8.96). Several variables were investigated in the heterogeneity analysis: region of the study, sample size, age and method of blood pressure measurement. The only variables that partially and inconsistently explained the observed heterogeneity (I2?=?95.3%) were the region of the country where the study was conducted and sample. CONCLUSIONS: There was a large variation in hypertension prevalence and in the methods used for its evaluation throughout studies with Brazilian adolescents, indicating the need for standardized procedures and validated methods for hypertension measurement. Despite the large observed heterogeneity, and the small number of studies in some regions of Brazil, the pooled prevalence found in both males and females shows that systemic arterial hypertension should be monitored in the population aged 10-20 years and that specific measures are required to prevent and control the disease, as well as its risk factors. Studies that compare regional heterogeneities may contribute to the knowledge of factors associated with increased blood pressure among adolescents.

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Dataset Information

Trends in prevalence of hypertension in Brazil: a systematic review with meta-analysis.

Background

Methods

Results

Conclusions

Publications

Trends in prevalence of hypertension in Brazil: a systematic review with meta-analysis.

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