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Paediatric Hypertension in Africa: A Systematic Review and Meta-Analysis

Simone H Crouch1, Larske M Soepnel1,2, Andrea Kolkenbeck-Ruh1

  • 1SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Eclinicalmedicine
|December 17, 2021
PubMed

Insights

Paediatric hypertension is increasing in Africa, with a pooled prevalence of 7.45%. Overweight and obese children show significantly higher rates, underscoring the impact of rising obesity on child health.

Area of Science:

  • Public Health
  • Cardiology
  • Pediatrics

Background:

  • Cardiovascular disease (CVD) and hypertension burdens are rising in low- and middle-income countries, affecting both adults and children.
  • Estimates of paediatric hypertension prevalence in Africa are scarce, necessitating updated data.
  • This study addresses the need for current prevalence data on hypertension in African children.

Purpose of the Study:

  • To conduct a systematic review and meta-analysis to determine updated prevalence estimates of paediatric hypertension in Africa.
  • To identify factors associated with hypertension in children, including weight status.
  • To compare current findings with previous estimates to track trends.

Main Methods:

  • Systematic literature search of PubMed and EBSCO (January 2017–November 2020).
  • Quality assessment of identified studies.
  • Meta-analysis using a random effects model (Freeman-Tukey arcsine transformation) for pooled prevalence estimation.

Main Results:

  • Analysis of 41 studies involving 52,918 participants (ages 3–19) from ten African countries.
  • Pooled prevalence of hypertension (BP ≥95th percentile) was 7.45%; elevated blood pressure (BP ≥90th to <95th percentile) was 11.38%.
  • Overweight/obese children had significantly higher hypertension prevalence (18.5%) compared to normal/underweight children (1.0%–4.8%).

Conclusions:

  • Paediatric hypertension prevalence in Africa shows a continued increasing trend compared to 2017 estimates.
  • Rising rates of overweight and obesity in children are a potential driver of increased hypertension.
  • Urgent public health interventions are needed to address paediatric hypertension and obesity in Africa.
Abstract

Keywords:
AfricaBMI, Body mass indexBP, Blood pressureBlood pressureCVD, Cardiovascular diseaseChild and adolescentGDP, Gross domestic productHypertensionLMIC, Low- and middle-income countiresNCD, Non-communicable diseasesPaediatricUN, United NationsWHO, World Health Organisation

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