Review Article

Current hypertension care practice in Sub-Saharan Africa and need for creating hypertension care ecosystem: An explanatory Review

Need for creating hypertension care ecosystem

Abstract

Background: A comprehensive ecosystem for hypertension care is needed, particularly in Sub-Saharan Africa (SSA), to address disproportionately increasing hypertension prevalence and poor blood pressure (BP) control. Therefore, this explanatory review was conducted to present the ecosystem for providing hypertension care in resource-limited settings from a sub-Saharan African perspective. Methods:  We searched articles written in the English language from January 2000 to January 2020 from the following databases: PubMed, Embase, Scopus, Web of Science, and Google Scholar with a systematic search query. Results: We identified 3,451 articles, abstracted 143 articles, read full text 101 articles, and included 97 articles in the final Review. Hypertension control in SSA is poor due to the interaction of a complex network of factors involving patients (lack of awareness, poor treatment adherence), the healthcare system (lack of early screening, lack of access to medicines, under treatment, poor research involvement), community (inequities), environment (air pollution), economy (poverty), poor political commitment, lack of strong policies and leadership support, and weak networking and collaboration. The Healthcare system in SSA needs strengthening concerning; health promotion and hypertension prevention, scale-up of cost-effective screening approaches, aggressive treatment of hypertension, and researching country-specific approaches for managing hypertension. Conclusion: Hypertension control in SSA needs a comprehensive ecosystem view involving all relevant stakeholders. Therefore, improving health promotion and disease prevention activities to improve patient and public awareness of hypertension prevention and control; restructuring hypertension care approach to environmentally appropriate and cost-efficient methods; introducing cost-effective FDC medications in the national drug lists to improve treatment adherence; designing strategies to address SDH health and reducing health inequities, strengthening implementation of HiAP with due consideration to determinants of hypertension control, and improving collaboration and networking of existing cardiovascular societies, an international society of hypertension and world hypertension league, and other funding agencies are critical success factors for improving hypertension control in SSA.

Region WSEA. Special Issue on Blood Pressure-take control. India2013 World Health Day.

Mills KT, Bundy JD, Kelly TN, Reed JE, Kearney PM, Reynolds K, et al. Global disparities of hypertension prevalence and control: a systematic analysis of population-based studies from 90 countries. Circulation. 2016;134(6):441-50.

Zhou B, Danaei G, Stevens GA, Bixby H, Taddei C, Carrillo-Larco RM, et al. Long-term and recent trends in hypertension awareness, treatment, and control in 12 high-income countries: an analysis of 123 nationally representative surveys. The Lancet. 2019;394(10199):639-51.

Volpe M, Savoia C. Natural History of Treated and Untreated Hypertension. In: Berbari AE, Mancia G, editors. Disorders of Blood Pressure Regulation: Phenotypes, Mechanisms, Therapeutic Options. Cham: Springer International Publishing; 2018. p. 33-44.

Elliott WJ. What factors contribute to the inadequate control of elevated blood pressure? The Journal of Clinical Hypertension. 2008;10:20-6.

Zühlke L, Sliwa K, Naidoo P, Ntsinjana H, Ntsekhe M, Hellig F, et al. Cardiovascular medicine and research in sub-Saharan Africa: challenges and opportunities. Nature Reviews Cardiology. 2019;16(11):642-4.

GLOBALLY IBIET. High blood pressure in sub-Saharan Africa: why prevention, detection, and control are urgent and important. The Journal of Clinical Hypertension. 2015;17(9):663.

Collaborators. GRF. Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 84 behavioral, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. . Lancet 2018;392:1923-94.

Campbell NR, Bovet P, Schutte AE, Lemogoum D, Nkwescheu AS. High blood pressure in sub‐Saharan Africa: why prevention, detection, and control are urgent and important. The Journal of Clinical Hypertension. 2015;17(9):663-7.

Samuel O Oti, Steven JM van de Vijver, Lange J. A community-based intervention for primary prevention of cardiovascular diseases in the slums of Nairobi: the SCALE UP study protocol for a prospective quasi-experimental community-based trial. . Trials 2013;14(409).

WHO. Global Health Estimates 2016: Deaths by Cause, Age, Sex, by Country and by Region, 2000–2016. . 2018.

Ataklte F, Erqou S, Kaptoge S, Taye B, Echouffo-Tcheugui JB, Kengne AP. Burden of undiagnosed hypertension in sub-saharan Africa: a systematic review and meta-analysis. Hypertension. 2015;65(2):291-8.

Organization WH. Prevention of cardiovascular disease: guidelines for assessment and management of total cardiovascular risk: World Health Organization; 2007.

Organization WH. Hearts: technical package for cardiovascular disease management in primary health care. 2020.

Ndindjock R, Gedeon J, Mendis S, Paccaud F, Bovet P. Potential impact of single-risk-factor versus total risk management for the prevention of cardiovascular events in Seychelles. Bulletin of the World Health Organization. 2011;89:286-95.

Mendis S, Lindholm LH, Anderson SG, Alwan A, Koju R, Onwubere BJC, et al. Total cardiovascular risk approach to improve efficiency of cardiovascular prevention in resource constrain settings. Journal of clinical epidemiology. 2011;64(12):1451-62.

Kishore SP, Heller DJ, Vasan A. Beyond hypertension: integrated cardiovascular care as a path to comprehensive primary care. Bulletin of the World Health Organization. 2018;96(3):219.

Dudenbostel T, Siddiqui M, Gharpure N, Calhoun DA. Refractory versus resistant hypertension: Novel distinctive phenotypes. Journal of nature and science. 2017;3(9).

Bomfim GF, Cau SBA, Bruno AS, Fedoce AG, Carneiro FS. Hypertension: a new treatment for an old disease? Targeting the immune system. British Journal of Pharmacology. 2019;176(12):2028-48.

Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev.[Internet]. 2015; 4: 1.

Rapsomaniki E, Timmis A, George J, Pujades-Rodriguez M, Shah AD, Denaxas S, et al. Blood pressure and incidence of twelve cardiovascular diseases: lifetime risks, healthy life-years lost, and age-specific associations in 1· 25 million people. The Lancet. 2014;383(9932):1899-911.

Lamprea-Montealegre JA, Zelnick LR, Hall YN, Bansal N, de Boer IH. Prevalence of Hypertension and Cardiovascular Risk According to Blood Pressure Thresholds Used for Diagnosis. Hypertension. 2018;72(3):602-9.

Lewsey JD, Lawson KD, Ford I, Fox KAA, Ritchie LD, Tunstall-Pedoe H, et al. A cardiovascular disease policy model that predicts life expectancy taking into account socioeconomic deprivation. Heart. 2015;101(3):201.

Drawz PE, Alper AB, Anderson AH, Brecklin CS, Charleston J, Chen J, et al. Masked hypertension and elevated nighttime blood pressure in CKD: prevalence and association with target organ damage. Clinical Journal of the American Society of Nephrology. 2016;11(4):642-52.

Di Palo KE, Barone NJ. Hypertension and heart failure: prevention, targets, and treatment. Heart failure clinics. 2020;16(1):99-106.

Farsang C, Kiss I, Tykarski A, Narkiewicz K. Treatment of hypertension in patients with chronic obstructive pulmonary disease (COPD). European Society of Hypertension Scientific Newsletter. 2016;17:62.

Marathe PH, Gao HX, Close KL. American D iabetes A ssociation S tandards of M edical C are in D iabetes 2017. Journal of diabetes. 2017;9(4):320-4.

Agca R, Heslinga S, Rollefstad S, Heslinga M, McInnes I, Peters M, et al. EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update. Annals of the rheumatic diseases. 2017;76(1):17-28.

Patten SB, Williams JV, Lavorato DH, Campbell NR, Eliasziw M, Campbell TS. Major depression as a risk factor for high blood pressure: epidemiologic evidence from a national longitudinal study. Psychosomatic medicine. 2009;71(3):273-9.

Unger T, Borghi C, Charchar F, Khan NA, Poulter NR, Prabhakaran D, et al. 2020 International Society of Hypertension global hypertension practice guidelines. Hypertension. 2020;75(6):1334-57.

Sorato MM, Davari M, Kebriaeezadeh A. Health Care System Response to Cardiovascular Diseases, Trends from 2010-2018: Can Ethiopia Achieve 2025 Global voluntary targets for Non-communicable diseases from cardiovascular diseases perspective? Explanatory Review of available literatures. Research & Reviews: Journal of Medical and Health Sciences. 2019;9(1):1-13.

Organization. WH. Prevention of Cardiovascular Disease: Guidelines for assessment and management of cardiovascular risk2007.

al. SHe. ATS Documents Development and Implementation Committee. An official ATS statement: grading the quality of evidence and strength of recommendations in ATS guidelines and recommendations. . Am J Respir Crit Care Med 2006;174(5):605-14.

Organization. WH. Commission on Social Determinants of Health. Closing the gap in a generation: health equity through action on the social determinants of health. 2008.

practice. EGocdpic. The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts). . European Heart Journal.2016(37):2315-81.

Whelton PK CR, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith SC Jr, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams KA Sr, Williamson JD, Wright JT Jr. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension (Dallas, Tex : 1979). 2018;71:e13-e115.

Gareth Beevers GYHL, Eoin O'Brien. ABC of Hypertension. Sixth edition ed. Series A, editor2014.

Group. WCRCW. World Health Organization cardiovascular disease risk charts: revised models to estimate risk in 21 global regions. The Lancet Global health. 2019;7(10):e1332-e45.

Kuhlmann E, Groenewegen PP, Bond C, Burau V, Hunter DJ. Primary care workforce development in Europe: An overview of health system responses and stakeholder views. Health Policy. 2018;122(10):1055-62.

Organization WH. Health System Transformation: Making it Happen. Copenhagen: World Health Organization. 2016.

WHO. Tackling NCDs “Best buys” and other recommended interventions for the prevention and control of non-communicable diseases. 2017.

Organization. WH. Global action plan for the prevention and control of non-communicable diseases 2013–2020. 2013.

Suchard MA, Schuemie MJ, Krumholz HM, You SC, Chen R, Pratt N, et al. Comprehensive comparative effectiveness and safety of first-line antihypertensive drug classes: a systematic, multinational, large-scale analysis. Lancet. 2019;394(10211):1816-26.

Alma J. Adler DP, Pascal Bovet, Dhruv S. Kazi, Giuseppe Mancia, Vash Mungal-Singh, Neil Poulter. Reducing cardiovascular mortality through prevention and management of raised blood pressure. A world heart federation road map. Global Heart 2015;10(2):111-22.

Hood CM, Gennuso KP, Catlin BB. County health rankings: Relationships between determinant factors and health outcomes. American Journal of Preventive Medicine 2016;50(2):7.

Alma J. Adler DP, Pascal Bovet, Dhruv S. Kazi, Giuseppe Mancia, Vash Mungal-Singh, Neil Poulter. . Reducing cardiovascular mortality through prevention and management of raised blood pressure. A world heart federation road map. . Global Heart. 2017;10(2):111-22.

Pascal Geldsetzer J-G, Maja-EmiliaMarcus, CaraEbert, ProfZhaxybayZhumadilov, Chea SWesseh, LindiweTsabedze, AdilSupiyev, LelaSturua, Silver KBahendeka, ProfAbla MSibai, SarahQuesnel-Crooks, BolormaaNorov, Kibachio JMwangi, OmarMwalim, RoyWong-McClure, Mary TMayige, Joao SMartins, Lindsay MJaacks. The state of hypertension care in 44 low-income and middle-income countries: a cross-sectional study of nationally representative individual-level data from 1·1 million adults. Lancet. 2019;6736(19):30955-9.

health Wh. HEARTS: Technical package for cardiovascular disease management in primary health care. Geneva: World Health Organization. 2016.

Kilama WL. The 10/90 gap in sub-Saharan Africa: Resolving inequities in health research. Acta Tropica. 2009;112:S8-S15.

Brown C, Harrison D, Burns H, Ziglio E. Governance for health equity: WHO Regional Office for Europe; 2013.

Labonté R, Schrecker T. Globalization and social determinants of health: Promoting health equity in global governance (part 3 of 3). Globalization and health. 2007;3(1):7.

Fielding JE, Kumanyika S, Manderscheid RW. A perspective on the development of the Healthy People 2020 framework for improving US population health. Public Health Reviews. 2013;35(1):3.

Health Do, Human Services W, DC., People H, Office USGP. Healthy people 2010: Understanding and improving health: US Department of Health and Human Services; 2000.

Artiga S, Hinton E. Beyond health care: the role of social determinants in promoting health and health equity. Health. 2019;20(10):1-13.

Remington PL, Catlin BB, Gennuso KP. The county health rankings: rationale and methods. Population health metrics. 2015;13(1):11.

Adebayo B. Nigeria overtakes India in extreme poverty ranking. CNN, June. 2018;26.

Kharas H, Hamel K, Hofer M. The start of a new poverty narrative. Brookings Institution. 2018.

Action. HP. Key facts: poverty and poor health. 2018.

Anyangwe SC, Mtonga C, Chirwa B. Health inequities, environmental insecurity and the attainment of the millennium development goals in sub-Saharan Africa: the case study of Zambia. International journal of environmental research and public health. 2006;3(3):217-27.

Peters DH, Garg A, Bloom G, Walker DG, Brieger WR, Hafizur Rahman M. Poverty and access to health care in developing countries. Annals of the New York Academy of Sciences. 2008;1136(1):161-71.

O'Neill MS, McMichael AJ, Schwartz J, Wartenberg D. Poverty, Environment, and Health: The Role of Environmental Epidemiology and Environmental Epidemiologists. Epidemiology. 2007;18(6).

Awan MS, Malik N, Sarwar H, Waqas M. Impact of education on poverty reduction. 2011.

Chokshi DA. Income, Poverty, and Health Inequality. JAMA. 2018;319(13):1312-3.

McCurdy K, Gorman KS, Metallinos-Katsaras E. From Poverty to Food Insecurity and Child Overweight: A Family Stress Approach. Child Development Perspectives. 2010;4(2):144-51.

Mocumbi AO, Stewart S, Patel S, Al-Delaimy WK. Cardiovascular Effects of Indoor Air Pollution from Solid Fuel: Relevance to Sub-Saharan Africa. Current Environmental Health Reports. 2019;6(3):116-26.

Katoto PDMC, Byamungu L, Brand AS, Mokaya J, Strijdom H, Goswami N, et al. Ambient air pollution and health in Sub-Saharan Africa: Current evidence, perspectives and a call to action. Environmental Research. 2019;173:174-88.

Rother H-A, Sabel CE, Vardoulakis S. A collaborative framework highlighting climate-sensitive non-communicable diseases in urban sub-Saharan Africa. Africa and the Sustainable Development Goals: Springer; 2020. p. 267-78.

Agyepong IA, Sewankambo N, Binagwaho A, Coll-Seck AM, Corrah T, Ezeh A, et al. The path to longer and healthier lives for all Africans by 2030: the Lancet Commission on the future of health in sub-Saharan Africa. The Lancet. 2017;390(10114):2803-59.

Adesina JO. 18. Inequality in sub-Saharan Africa: dimensions and drivers. World Social Science Report. 2016:96.

Cissé B, Luchini S, Moatti JP. Progressivity and horizontal equity in health care finance and delivery: What about Africa? Health Policy. 2007;80(1):51-68.

Schutte AE. Urgency for South Africa to prioritise cardiovascular disease management. The Lancet Global Health. 2019;7(2):e177-e8.

Akazili J, Welaga P, Bawah A, Achana FS, Oduro A, Awoonor-Williams JK, et al. Is Ghana’s pro-poor health insurance scheme really for the poor? Evidence from Northern Ghana. BMC Health Services Research. 2014;14(1):637.

Ataguba JE, Akazili J, McIntyre D. Socioeconomic-related health inequality in South Africa: evidence from General Household Surveys. International journal for equity in health. 2011;10(1):48.

Okoi O, Bwawa T. How health inequality affect responses to the COVID-19 pandemic in Sub-Saharan Africa. World Development. 2020;135:105067.

De Allegri M, Sauerborn R, Kouyaté B, Flessa S. Community health insurance in sub-Saharan Africa: what operational difficulties hamper its successful development? Tropical Medicine & International Health. 2009;14(5):586-96.

Geneau R, Stuckler D, Stachenko S, McKee M, Ebrahim S, Basu S, et al. Raising the priority of preventing chronic diseases: a political process. The Lancet. 2010;376(9753):1689-98.

Nishtar S, Niinistö S, Sirisena M, Vázquez T, Skvortsova V, Rubinstein A, et al. Time to deliver: report of the WHO Independent High-Level Commission on NCDs. The Lancet. 2018;392(10143):245-52.

Organization WH. Time to deliver: report of the WHO independent high-level commission on noncommunicable diseases. 2018.

de-Graft Aikins A, Unwin N, Agyemang C, Allotey P, Campbell C, Arhinful D. Tackling Africa's chronic disease burden: from the local to the global. Globalization and Health. 2010;6(1):5.

Rabkin M, de Pinho H, Michaels-Strasser S, Naitore D, Rawat A, Topp SM. Strengthening the health workforce to support integration of HIV and noncommunicable disease services in sub-Saharan Africa. AIDS. 2018;32.

Geldsetzer P, Manne-Goehler J, Marcus M-E, Ebert C, Zhumadilov Z, Wesseh CS, et al. The state of hypertension care in 44 low-income and middle-income countries: a cross-sectional study of nationally representative individual-level data from 1· 1 million adults. The Lancet. 2019;394(10199):652-62.

Brown MT, Bussell JK. Medication Adherence: WHO Cares? Mayo Clinic Proceedings. 2011;86(4):304-14.

Oliveira-Filho AD, Barreto-Filho JA, Neves S, Lyra Junior DD. Association between the 8-item Morisky Medication Adherence Scale (MMAS-8) and blood pressure control. Arquivos brasileiros de cardiologia. 2012;99(1):649-58.

Pladevall M, Brotons C, Gabriel R, Arnau A, Suarez C, de la Figuera M, et al. Multicenter cluster-randomized trial of a multifactorial intervention to improve antihypertensive medication adherence and blood pressure control among patients at high cardiovascular risk (the COM99 study). Circulation. 2010;122(12):1183-91.

Lemstra M, Alsabbagh MW. Proportion and risk indicators of nonadherence to antihypertensive therapy: a meta-analysis. Patient Prefer Adherence. 2014;8:211-8.

Institute. EPH. Ethiopia steps report on risk factors for chronic non-communicable diseases and prevalence of selected NCDs. 2016.

Dadi AF, Desyibelew HD. Undernutrition and its associated factors among pregnant mothers in Gondar town, Northwest Ethiopia. PloS one. 2019;14(4):e0215305-e.

Birlew T, Alemseged F. Risk factors for hypertension among adults. An analysis of survey data on chronic non-communicable disease at Gilgel gibe field research center, south west Ethiopia. Science. 2015;3(2):281-90.

Organization WH. Noncommunicable diseases country profiles 2018. 2018.

Salam RA, Syed B, Syed S, Das JK, Zagre NM, Rayco-Solon P, et al. Maternal nutrition: how is Eastern and Southern Africa faring and what needs to be done? African health sciences. 2015;15(2):532-45.

Msyamboza KP, Ngwira B, Dzowela T, Mvula C, Kathyola D, Harries AD, et al. The burden of selected chronic non-communicable diseases and their risk factors in Malawi: nationwide STEPS survey. PloS one. 2011;6(5).

Mwenda V, Mwangi M, Nyanjau L, Gichu M, Kyobutungi C, Kibachio J. Dietary risk factors for non-communicable diseases in Kenya: findings of the STEPS survey, 2015. BMC public health. 2018;18(3):1218.

Olack B, Wabwire-Mangen F, Smeeth L, Montgomery JM, Kiwanuka N, Breiman RF. Risk factors of hypertension among adults aged 35–64 years living in an urban slum Nairobi, Kenya. BMC public health. 2015;15(1):1251.

surveillance WSndrf. NON COMMUNICABLE DISEASES RISK FACTORS STEPS SURVEY KENYA, FACT SHEET. 2015.

Silva-Matos C, Beran D. Non-communicable diseases in Mozambique: risk factors, burden, response and outcomes to date. Globalization and health. 2012;8(1):37.

Nahimana M-R, Nyandwi A, Muhimpundu MA, Olu O, Condo JU, Rusanganwa A, et al. A population-based national estimate of the prevalence and risk factors associated with hypertension in Rwanda: implications for prevention and control. BMC public health. 2018;18(1):2.

Bovet P, Viswanathan B, Louange M, Gedeon J. National Survey of Noncommunicable Diseases in Seychelles, 2013-2014 (Seychelles Heart Study IV): methods and main findings. Ministry of Health, Republic of Seychelles; 2015.

Mayige M, Kagaruki G. Tanzania STEPS survey report. Dar es Salaam: National Institute of Medical Research. 2013.

Wesonga R, Guwatudde D, Bahendeka SK, Mutungi G, Nabugoomu F, Muwonge J. Burden of cumulative risk factors associated with non-communicable diseases among adults in Uganda: evidence from a national baseline survey. International journal for equity in health. 2016;15(1):195.

Musinguzi G, Nuwaha F. Prevalence, awareness and control of hypertension in Uganda. PloS one. 2013;8(4):e62236-e.

Mukanu MM, Zulu JM, Mweemba C, Mutale W. Responding to non-communicable diseases in Zambia: a policy analysis. Health research policy and systems. 2017;15(1):34.

Mukanu MM. Government’s Health Policy Response to Non-Communicable Diseases in Zambia: The University of Zambia; 2016.

Hakim J, Mujuru N, Rusakaniko S, Gomor Z. National Survey Zimbabwe Non-Communicable Disease Risk Factors-(ZiNCoDs) Preliminary Report Using The WHO STEPwise Approach to Surveillance of Non-Communicable Diseases (STEPS). Harare, Zimbabwe: Ministry of Health & Child Welfare and The University of Zimbabwe; 2005.

Mutowo MP, Mangwiro JC, Lorgelly PK, Owen AJ, Renzaho A. Hypertension in Zimbabwe: a meta-analysis to quantify its burden and policy implications. World Journal of Meta-Analysis. 2015;3(1):54-60.

Ataklte F, Erqou S, Kaptoge S, Taye B, Echouffo-Tcheugui JB, Kengne AP. Burden of Undiagnosed Hypertension in Sub-Saharan Africa. A Systematic Review and Meta-Analysis. 2014.

Ataklte F, Erqou S, Kaptoge S, Taye B, Echouffo-Tcheugui JB, Kengne AP. Burden of undiagnosed hypertension in sub-saharan Africa: a systematic review and meta-analysis. Hypertension (Dallas, Tex : 1979). 2015;65(2):291-8.

Carson AP, Howard G, Burke GL, Shea S, Levitan EB, Muntner P. Ethnic differences in hypertension incidence among middle-aged and older adults: the multi-ethnic study of atherosclerosis. Hypertension. 2011;57(6):1101-7.

Howard G, Lackland DT, Kleindorfer DO, Kissela BM, Moy CS, Judd SE, et al. Racial differences in the impact of elevated systolic blood pressure on stroke risk. JAMA internal medicine. 2013;173(1):46-51.

van Rijn-Bikker PC, Mairuhu G, van Montfrans GA, Sijbrands EJG, Zwinderman AH, Guchelaar H-J, et al. Genetic Factors Are Relevant and Independent Determinants of Antihypertensive Drug Effects in a Multiracial Population. American journal of hypertension. 2009;22(12):1295-302.

Brewster LM, Seedat YK. Why do hypertensive patients of African ancestry respond better to calciumblockers and diuretics than to ACE inhibitors and β-adrenergic blockers? Asystematic review. BMC medicine. 2013;11(1):141.

Bakris GL, Fonseca V, Katholi RE, McGill JB, Messerli FH, Phillips RA, et al. Metabolic effects of carvedilol vs metoprolol in patients with type 2 diabetes mellitus and hypertension: a randomized controlled trial. Jama. 2004;292(18):2227-36.

Brewster LM, Van Montfrans GA, Kleijnen J. Systematic review: antihypertensive drug therapy in black patients. Annals of Internal Medicine. 2004;141(8):614-27.

Brewster LM, van Montfrans GA, Seedat YK. Antihypertensive Drug Therapy in Patients of African and South Asian Ethnicity: A Systematic Review. Ethnic Diversities, Hypertension and Global Cardiovascular Risk: Springer; 2018. p. 243-69.

Yoruk A, Boulos PK, Bisognano JD. The State of Hypertension in Sub-Saharan Africa: Review and Commentary. American Journal of Hypertension. 2017;31(4):387-8.

Lees-Marshment J. The ministry of public input: Integrating citizen views into political leadership: Springer; 2015.

Hendriks CM, Lees-Marshment J. Political leaders and public engagement: The hidden world of informal elite–citizen interaction. Political Studies. 2019;67(3):597-617.

Samb B, Desai N, Nishtar S, Mendis S, Bekedam H, Wright A, et al. Prevention and management of chronic disease: a litmus test for health-systems strengthening in low-income and middle-income countries. The Lancet. 2010;376(9754):1785-97.

Corinne V. Evans, Brittany U. Burda, Karen L. Margolis, Elizabeth O’Connor, Ning Smith, Elizabeth Webber, et al. Screening for High Blood Pressure in Adults: A Systematic Evidence Review for the U.S. Preventive Services Task Force. Evidence Synthesis. In: Quality AfHRa, editor. US: AHRQ Publication; 2014.

Kaczorowski J, Chambers LW, Dolovich L, Paterson JM, Karwalajtys T, Gierman T, et al. Improving cardiovascular health at population level: 39 community cluster randomised trial of Cardiovascular Health Awareness Program (CHAP). BMJ (Clinical research ed). 2011;342:d442-d.

Sorato MM, Davari M, Nikfar S. Cost-Effectiveness of Comprehensive Screening of General Population for Hypertension: Can it Save Money and Life? Systematic Review of Pharmacoeconomic Studies. EC Diabetes and Metabolic Research. 2020;4:13-25.

Campbell NRC, Lemogoum D. Hypertension in sub-Saharan Africa: a massive and increasing health disaster awaiting solution. Cardiovasc J Afr. 2015;26(4):152-4.

Sampson UKA, Amuyunzu-Nyamongo M, Mensah GA. Health Promotion and Cardiovascular Disease Prevention in Sub-Saharan Africa. Progress in Cardiovascular Diseases. 2013;56(3):344-55.

Organization WH. Health in all policies: Helsinki statement. Framework for country action. 2014.

Greer SL, Falkenbach M, Siciliani L, McKee M, Wismar M, Figueras J. From health in all policies to health for all policies. The Lancet Public Health. 2022;7(8):e718-e20.

Mauti J, Gautier L, De Neve J-W, Beiersmann C, Tosun J, Jahn A. Kenya’s Health in All Policies strategy: a policy analysis using Kingdon’s multiple streams. Health Research Policy and Systems. 2019;17(1):15.

Davari M, Sorato MM, Nikfar S. Cost-effectiveness of Comprehensive screening of general population for hypertension: Can it save money and Life? Systematic review of Pharmacoeconomic Studies. 2020.

Banerjee A, Khandelwal S, Nambiar L, Saxena M, Peck V, Moniruzzaman M, et al. Health system barriers and facilitators to medication adherence for the secondary prevention of cardiovascular disease: a systematic review. Open Heart. 2016;3(2):e000438.

Khatib R, Schwalm J-D, Yusuf S, Haynes RB, McKee M, Khan M, et al. Patient and healthcare provider barriers to hypertension awareness, treatment and follow up: a systematic review and meta-analysis of qualitative and quantitative studies. PloS one. 2014;9(1):e84238.

Mensa Sorato M, Davari M, Kebriaeezadeh A, Naderi N, Sarrafzadegan N, Shibru T, et al. Cost-effectiveness of Interventional therapies for management of Treatment-resistant hypertension: systematic review of pharmacoeconomic studies. Journal of Pharmaceutical Health Services Research.n/a(n/a).

Martin U. What to do about difficult hypertension? Postgraduate medical journal. 2018;94(Suppl 1):A2-A.

Sorato MM, Davari M, AbdollahiAsl A. Descriptive Evaluation of National and International Hypertension Treatment Guidelines: The Guideline Quality and Comprehensiveness to provide Care to Adult with Hypertension. Clinical Medical Reviews and Case Reports. 2020;7(5):307.

Benjamin IJ, Kreutz R, Olsen MH, Schutte AE, Lopez-Jaramillo P, Frieden TR, et al. Fixed-dose combination antihypertensive medications. The Lancet. 2019;394(10199):637-8.

Salam A, Kanukula R, Esam H, Bahiru E, Sharma A, Heller D, et al. An application to include blood pressure lowering drug fixed dose combinations to the model list of essential medicines lists for the treatment of essential hypertension in adults. 2019.

Kjeldsen SE, Narkiewicz K, Burnier M, Oparil S. The International Society of Hypertension Guidelines 2020 – a new drug treatment recommendation in the wrong direction? Blood pressure. 2020:1-3.

Ram CV. Antihypertensive efficacy of olmesartan medoxomil or valsartan in combination with amlodipine: a review of factorial-design studies. Current medical research and opinion. 2009;25(1):177-85.

DiPette DJ, Skeete J, Ridley E, Campbell NR, Lopez-Jaramillo P, Kishore SP, et al. Fixed-dose combination pharmacologic therapy to improve hypertension control worldwide: Clinical perspective and policy implications. Journal of clinical hypertension (Greenwich, Conn). 2019;21(1):4.

Giaquinto AR, Grignolo A, Liberti L, Lim JC, Salmonson T, Sauer F, et al. Improving access to quality medicines in East Africa: An independent perspective on the East African Community Medicines Regulatory Harmonization initiative. PLoS medicine. 2020;17(8):e1003092.

Evans DCaDB. Improving health system efficiency as a means of moving towards universal coverage. World health report 2010 background paper, no. 28. 2010.

Shrank WH, Rogstad TL, Parekh N. Waste in the US Health Care System: Estimated Costs and Potential for Savings. Jama. 2019.

Word Health Organization. National Health Accounts [online database]. 2010.

Organization. WH. Monitoring the building blocks of health systems: a handbook of indicators and their measurement strategies. In: Organization WH, editor. Geneva, Switzerland2010.

WHO. World Health Organization, Regional Office for South-East Asia. Meeting Report: Reaching those who are left behind. For: Regional Consultation on Health, the SDGs and the role of Universal Health Coverage: next steps in South-East Asia Region. New Delhi. 2016.

Organization WH. World Health Statistics: Monitoring health for Sustainable development goals/SDGs. 2016.

Khetrapal S, Bhatia R. Impact of COVID-19 pandemic on health system & sustainable development goal 3. Indian Journal of Medical Research. 2020;151(5):395.

Association LG. Health in All Policies: a manual for local government. Local Government Association: London, UK. 2016.

Storm I, Aarts M-J, Harting J, Schuit AJ. Opportunities to reduce health inequalities by ‘Health in All Policies’ in the Netherlands: An explorative study on the national level. Health Policy. 2011;103(2):130-40.

Masseria C, Hernández-Quevedo C, Allin S. Health inequality: what does it mean and how can we measure it? Expert review of pharmacoeconomics & outcomes research. 2010;10(2):177-86.

Files
IssueVol 8 No 3 (2022) QRcode
SectionReview Article(s)
Keywords
Hypertension care ecosystem cardiovascular disease care continuum Social determinants of health Hypertension Sub-Saharan Africa An explanatory Review.

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Sorato M, Davari M, Kebriaeezadeh A. Current hypertension care practice in Sub-Saharan Africa and need for creating hypertension care ecosystem: An explanatory Review. JPPM. 2023;8(3):23-36.