SynthesisBMC medicine2020
Pharmacotherapy for hypertension in Sub-Saharan Africa: a systematic review and network meta-analysis.
Synthesis in BMC medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 3 syntheses or guidelines pooled it, 23 citations in OpenAlex.
- Effectiveness and safety of chronic diuretic use in older adults: an umbrella review of recently published systematic reviews and meta-analyses of randomized-controlled trials.European geriatric medicine · 2025Pooled it
- Non-pharmacological interventions to achieve blood pressure control in African patients: a systematic review.BMJ open · 2022Pooled it
- Hypertension treatment in sub-Saharan Africa: a systematic review.Cardiovascular journal of AfricaPooled it
- Exploring the knowledge and practice of calcium channel blocker overdose management among South African Emergency Medicine doctors.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2026Article
- Are Angiotensin-Converting Enzyme Inhibitors Effective in the Treatment of Hypertension in Black Patients?CJC open · 2026Review
- Temporal analysis of non-communicable diseases and NCD-HIV/AIDS comorbidity in Malawi: A 4-year retrospective study 2020-2022.Tropical medicine & international health : TM & IH · 2025Article
- Genetic Variation in Hydrochlorothiazide Response-Related Genes Among Hypertensive Individuals in Soweto, South Africa.Clinical and translational science · 2025Article
- Antihypertensive Medication Category Prescriptions and Blood Pressure Control in African Surinamese and Ghanaian Migrants with Hypertension in Amsterdam, The Netherlands: The HELIUS Study.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2025Article
- Genetic Variation inJournal of personalized medicine · 2024Article
- Update of the clinical guideline for hypertension diagnosis and treatment in Iran.Clinical hypertension · 2024Article
- Examining the referral of patients with elevated blood pressure to health resources in an under-resourced community in South Africa.BMC public health · 2024Article
- Effectiveness of community-based interventions for prevention and control of hypertension in sub-Saharan Africa: A systematic review.PLOS global public health · 2024Article
- Blood pressure-lowering medication prescribing, its adherence to guidelines and relationship with blood pressure control at a family medicine department.Health science reports · 2023Article
- Integrated multi-month dispensing of antihypertensive and antiretroviral therapy to sustain hypertension and HIV control.Journal of human hypertension · 2023Article
- In-hospital outcomes of patients with a hypertensive emergency at a medical center, Ethiopia: A prospective observational study.Health science reports · 2022Article
- Pathophysiologically based antihypertensive pharmacotherapeutics rationality, efficacy and safety in Sub Saharan African Nations - A review.International journal of cardiology. Cardiovascular risk and prevention · 2021Review
- Preclinical Evaluation of the Antihypertensive Effect of an Aqueous Extract ofJournal of experimental pharmacology · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundThe highest burden of hypertension is found in Sub-Saharan Africa (SSA) with a threefold greater mortality from stroke and other associated diseases. Ethnicity is known to influence the response to antihypertensives, especially in black populations living in North America and Europe. We sought to outline the impact of all commonly used pharmacological agents on both blood pressure reduction and cardiovascular morbidity and mortality in SSA.
methodsWe used similar criteria to previous large meta-analyses of blood pressure agents but restricted results to populations in SSA. Quality of evidence was assessed using a risk of bias tool. Network meta-analysis with random effects was used to compare the effects across interventions and meta-regression to explore participant heterogeneity.
resultsThirty-two studies of 2860 participants were identified. Most were small studies from single, urban centres. Compared with placebo, any pharmacotherapy lowered SBP/DBP by 8.51/8.04 mmHg, and calcium channel blockers (CCBs) were the most efficacious first-line agent with 18.46/11.6 mmHg reduction. Fewer studies assessing combination therapy were available, but there was a trend towards superiority for CCBs plus ACE inhibitors or diuretics compared to other combinations. No studies examined the effect of antihypertensive therapy on morbidity or mortality outcomes.
conclusionEvidence broadly supports current guidelines and provides a clear rationale for promoting CCBs as first-line agents and early initiation of combination therapy. However, there is a clear requirement for more evidence to provide a nuanced understanding of stroke and other cardiovascular disease prevention amongst diverse populations on the continent.
trial registrationPROSPERO, CRD42019122490. This review was registered in January 2019.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.