ArticleBMC cardiovascular disorders2021
Reasons for poor blood pressure control in Eastern Sub-Saharan Africa: looking into 4P's (primary care, professional, patient, and public health policy) for improving blood pressure control: a scoping review.
Article in BMC cardiovascular disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
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Who cites it
30 citing papers in PubMed, 50 citations in OpenAlex.
- Trial
- Cost-effectiveness of group medical visits and microfinance interventions versus usual care to manage hypertension in Kenya: a secondary modelling analysis of data from the Bridging Income Generation with Group Integrated Care (BIGPIC) trial.The Lancet. Global health · 2024Trial
- Facilitators of Blood Pressure Control Among Treated Patients in Public Clinics in Botswana.Public health challenges · 2026Article
- Prevalence and Determinants of Uncontrolled Hypertension Among Treated Adults in a Rural Primary Health Care Facility in South Africa: A Cross-Sectional Study.Epidemiologia (Basel, Switzerland) · 2026Article
- Assessing the burden and inequality in the unmet need for hypertension and type 2 diabetes care using a care cascade framework in Tanzania, Lesotho, and South Africa.Primary health care research & development · 2026Article
- Barriers and Facilitators to the implementation and scale-up of a mHealth integrated care program for diabetes and hypertension in Ghana: a qualitative study of the Akoma Pa program.BMC health services research · 2026Article
- Adherence to medication and gender are associated with uncontrolled hypertension: findings of a cross-sectional study in East-Central Uganda.The Pan African medical journal · 2026Article
- Assessment of Blood Pressure Control Status Among Hypertensive Patients Attending Rwandan District Hospital NCD Clinics: A Retrospective Follow-Up Study.Journal of epidemiology and global health · 2025Article
- Access to hypertension services and health-seeking experiences in rural Coastal Kenya: A qualitative study.PLOS global public health · 2025Article
- Article
- Hypertension guideline implementation and blood pressure control in Matlosana, South Africa.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2024Article
- High rate of uncontrolled hypertension among adults receiving integrated HIV and hypertension care with aligned multi-month dispensing in Malawi: results from a cross-sectional survey and retrospective chart review.Journal of the International AIDS Society · 2024Article
- Material needs security and cardiovascular risk factors in rural South Africa.BMC public health · 2024Observational
- Undiagnosed and uncontrolled hypertension in rural African adults: a scoping review protocol of primary health care interventions.BMJ open · 2024Article
- Hypertension Related Co-Morbidities and Complications in Women of Sub-Saharan Africa: A Brief Review.Circulation research · 2024Review
- Article
- The prevalence and determinants of blood pressure control among hypertension patients in eastern Zimbabwe: A cross-sectional study.PloS one · 2024Article
- The impact of the Sri Lankan economic crisis on medication adherence: An online cross-sectional survey.Dialogues in health · 2023Article
- Decoding the mechanism of hypertension through multiomics profiling.Journal of human hypertension · 2023Review
- Quality of Care for Patients with Hypertension in selected Health Centres in Rwamagana District, Rwanda.Rwanda journal of medicine and health sciences · 2023Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimHypertension control in Sub-Saharan Africa (SSA) is the worst (less than one out of ten) when compared to the rest of the world. Therefore, this scoping review was conducted to identify and describe the possible reasons for poor blood pressure (BP) control based on 4Ps' (patient, professional, primary healthcare system, and public health policy) factors.
methodsPRISMA extension for scoping review protocol was used. We systematically searched articles written in the English language from January 2000 to May 2020 from the following databases: PubMed/Medline, Embase, Scopus, Web of Science, and Google scholar.
resultsSixty-eight articles were included in this scoping review. The mean prevalence of hypertension, BP control, and patient adherence to prescribed medicines were 20.95%, 11.5%, and 60%, respectively. Only Kenya, Malawi, and Zambia out of ten countries started annual screening of the high-risk population for hypertension. Reasons for nonadherence to prescribed medicines were lack of awareness, lack of access to medicines and health services, professional inertia to intensify drugs, lack of knowledge on evidence-based guidelines, insufficient government commitment, and specific health behaviors related laws. Lack of screening for high-risk patients, non-treatment adherence, weak political commitment, poverty, maternal and child malnutrition were reasons for the worst BP control.
conclusionIn conclusion, the rate of BP treatment, control, and medication adherence was low in Eastern SSA. Screening for high-risk populations was inadequate. Therefore, it is crucial to improve government commitment, patient awareness, and access to medicines, design country-specific annual screening programs, and empower clinicians to follow individualized treatment and conduct medication adherence research using more robust tools.
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