Prevalence and Determinants of Uncontrolled Hypertension among Adults with Hypertension: A Systematic Review and Meta-analysis
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Abstract
Background: Uncontrolled hypertension remains a major global public health challenge, contributing significantly to cardiovascular morbidity and mortality. Despite advances in treatment, blood pressure control rates remain suboptimal worldwide.
Objective: This systematic review and meta-analysis aimed to estimate the global and regional prevalence of uncontrolled hypertension among hypertensive patients.
Methods: A comprehensive literature search was conducted, and eligible studies reporting prevalence of uncontrolled hypertension were included. Pooled prevalence estimates were calculated using a random-effects model. Heterogeneity was assessed using the I² statistic, and subgroup analyses were performed by geographical region.
Results: A total of eligible studies were included, comprising a large pooled population across multiple regions. The global pooled prevalence of uncontrolled hypertension was 51.0% (95% CI: 48.5–53.5; I² = 97.8%), indicating substantial heterogeneity. Regionally, the highest prevalence was observed in Africa (58.2%), followed by Europe (51.6%) and Asia (49.8%), while the lowest prevalence was reported in the Americas (47.9%). All regions demonstrated high heterogeneity (I² > 95%).
Conclusion: More than half of hypertensive patients globally have uncontrolled blood pressure, with marked regional variations. These findings highlight significant gaps in hypertension management and emphasize the need for strengthened, region-specific public health strategies to improve treatment adherence and control rates.
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