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Awareness
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HICsa
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Patient-level: Young age [20,52,132], female sex [52,53], and high socioeconomic status [54,132]
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Patient-level: Male sex [55], low income [55,56], poor health literacy [57], minority group [58], and living in resource-limited areas [55]
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LMICsb
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Patient-level: Aged [53,59], female sex [10,16,59,138], high socioeconomic status [10,16,60], overweight and obesity [59-61], unhealthy lifestyle [59,60], and multimorbidity [61]
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Patient-level: Male sex [60], never married [10,60], Hispanic adults [58], and Asian adults [58]
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Screening
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HICs |
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LMICs |
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Patient-level: Low socioeconomic group [16,56], unhealthy lifestyle [66,139], and multimorbidity [65]; Not feeling at risk of hypertension [67]; Not aware of screening services [67]; Low ability to pay for health care [67]; Preference for traditional healers [67]; Perceiving hypertension as a normalized condition [67]
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Diagnosis
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HICs |
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Patient-level: Male sex [68,132], living alone [132], multimorbidity [69], unhealthy lifestyle [132], and living in resource-limited areas [70]
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LMICs |
Patient-level: Aged [60,66,71-73], overweight or obesity [63,66,71,74], and presence of other comorbidities [71]
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Patient-level: Characteristics of individuals: male sex [64,69,73], low socioeconomic group [72,75], and unhealthy lifestyle [63]; Lack of understanding regarding the importance of following a referral after a positive screening result [76]; Unaffordable health care services [67]; Fear of diagnosis, refusal to accept illness, and noncompliance with referrals [67]; Influence of culture and values, including gender norms [69]; Conflicting time with health facility opening hours [69] System-level: Shortage of physicians [75]; Shortage of health facilities [69,76]; Lack of diagnostic equipment and testing capabilities [26,76]
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Linkage to care
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HICs |
Patient-level: High socioeconomic status [77] and female sex [77]; Regular clinic visit (due to smoke) [65]; Involvement in other health programs [77] System-level: Presence of a national or local chronic disease management program [78]
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Patient-level: Male sex [16,68,77], no health insurance [79], and low education level [64,134]; Presence of other diseases that affect physical activity [134]; Language barriers [31] System-level: Heavy workload affecting patient care [31,77]; Inadequate collaboration among health care team members [31]; Providers’ frustration and aggressive attitudes toward patients [31]
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LMICs |
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Patient-level: Without health insurance [80]; Misconceptions about medications [85]; Cultural beliefs [85] System-level: Absence of guidelines for hypertension and diabetes management [38,44]; Insufficient essential resources and infrastructure [84]
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Treatment
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HICs |
Patient-level: Young age [20,26,52,72], female sex [10,52,62], White ethnicity [52], and high health literacy [80]; Medicare beneficiary [20] System-level: Presence of a chronic disease management program [44,78]; Home delivery of medication [86]; Good doctor-patient relationship [87,140]
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Patient-level: Male sex [68,80], no medical insurance [20,80], low education level [80], unhealthy lifestyle [88], multimorbidity [10,65,80], and language barriers [31]; Psychological fear of treatment [140] System-level: Health care mistreatment attributed to ethnic discrimination [89]; Heavy workload of health providers [34,90,140]; Lack of collaborative strategies among health care teams [140]
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LMICs |
Patient-level: High education [55,73], high income [16,55,56,60], and overweight and obesity [59,60,91]; Well-designed education and educational materials [84] System-level: Physician density [75]; Doctors’ interpersonal behaviors and technical competence [92]; Well-trained health workforce [84]
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Patient-level: Individual characteristics: never married [60], occupation [66], poor socioeconomic status [15,66,83], poor comprehension [83], unhealthy lifestyle [66], and living in resource-limited areas [16,53,55,64,70]; Misconceptions, lack of confidence, and fear about medications [85,141]; High treatment costs and low ability to pay for medication or transport [26,67]; Poor understanding of asymptomatic conditions requiring treatment [67]; Low risk awareness of nontreatment consequences [67]; Wrong understanding of the disease and its therapy [93]; Lack of social support from peers, family, and the community [93]; High time cost of seeking care [93] System-level: Poor monitoring and lack of a patient follow-up protocol [69,94]; Ineffective medication and physician inertia [69,94]; Ambiguous and inappropriate clinical guidelines in under-resourced areas [93]; Shortage of human resources and equipment for blood pressure monitoring [93]; Limited knowledge and understanding among health care workers [76]; Lack of essential clinical facilities and adequate training of health care workers [76,84]; Absence of organized diabetes services within health care facilities [83]; Rarely receiving feedback on patient management from higher-level facilities [83]
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Medication adherence
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HICs |
Patient-level: Female sex [80,95], high income [56,95], and high level of hypertension and diabetes knowledge [95,96]; Less negative general beliefs about medications and few concerns about medications [95]
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Patient-level: Lower socioeconomic group [95]; Not confident about community pharmacists [141]; Fear about medications [85]; Cultural beliefs influencing management [31]; Multimorbidity [80]; Lack of knowledge leading to misconceptions about disease management [141] System-level: Low primary care visits [80]; Ethnic discrimination in health care settings [89]; Heavy workload [31,90]; Lack of a teamwork approach [31]; Insufficient availability of essential medicines [38]; Ambiguous and inappropriate clinical guidelines [93]
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LMICs |
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Patient-level: High cost of medication [69]; Personal and cultural beliefs [69]; Wrong understanding of a disease and its therapy among patients [93]; Lack of support from peers, family, providers, and the community [93]
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Control
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HICs |
Patient-level: Young age [52], female sex [95], high income [74], and being of White ethnicity [52,58]; High level of hypertension and diabetes knowledge [95]; Partner involvement in care [82]; Better self-perceived health status [95]; Healthy lifestyle practices: regular exercise and weight management [97] System-level: Trust between physicians and patients [98]
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Patient-level: Characteristics of individuals: male sex [56], ethnic minority [20], and low health literacy [96]; Lack of access to medical care and medications [50]; Using nonoptimal doses of antihypertensive medications [65]; Experiencing adverse events associated with medications [65]
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LMICs |
Patient-level: High income [15,54,60,74], older age [19,72], marriage [10,54], fewer complications [65], and health insurance [19,39]; Healthy lifestyle: adopting dietary modifications or engaging in regular exercise [54,99]; Receiving long prescribed medications for hypertension and diabetes [71]; Belief in treatment efficacy and having family support [67]; Timely monitoring of blood pressure and blood glucose [19] System-level: Adequate medications [84]; High physician density [75]
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Patient-level: Age ≥75 years [74], male sex [15,55,59,68,100], overweight [59,66,100], low income [55,60,67], specific occupations [66], and low education level [55,68]; Coexisting chronic conditions [68,97]; Living in rural or resource-limited areas [55,60]; Unhealthy lifestyle: smoking and alcohol consumption [66,97,100]; Lack of family/social support [57]; Limited awareness of the lifelong nature of the condition [67]; Complexity of the intervention [68]; Insufficient patient education about the importance of clinical management [67]; Poor communication of treatment monitoring results [67] System-level: Long waiting times at clinics [67]; Negative staff attitudes toward patients [67]; Weak monitoring schedules [67]; Lack of medical resources [84]
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