Table 1.
Summary of the included studies and their relevant characteristics (n = 33).
| No | Author | Country and Income Class | Sample Included | Significant Findings |
|---|---|---|---|---|
| 1 | Animut, et al., 2018 [8] | Ethiopia (Low-income) |
395 hypertensive patients. | 50.4% had their BP controlled. Salt intake, overweight, and obesity were negatively associated with BP control. Physical activity, duration on antihypertensive drugs (2–4 or ≥5 yrs.), and high adherence were positively correlated with BP control. |
| 2 | Sibomana, et al., 2019 [9] | Rwanda (Low-income) |
112 patients from four district rural hospitals. | 29% had their BP controlled. 77% reported medication adherence associated with literacy and lack of adverse effects. 50% highlighted physicians’ nonadherence to clinical guidelines. |
| 3 | Paquissi, et al., 2016 [10] | Angola (Lower-middle-income) |
102 hypertensive patients. | 7.8% had their BP controlled, while 54.9% and 28.4% were aware and treated, respectively. Younger (<37 years) and male patients were more likely to be unaware of their disease. |
| 4 | Duboz, et al., 2014 [12] | Senegal (Lower-middle-income) |
165 hypertensive patients. | 5.4% had their BP controlled, while 27.8% and 17% were aware and treated, respectively. Older patients (≥50 years) were more likely to be aware of and treated for their HTN. |
| 5 | Zack, et al., 2016 [11] | Tanzania (Lower-middle-income) |
803 hypertensive patients. | 10% had their BP controlled, while 48% and 22% were aware and treated, respectively. Higher BP readings were reported in male, older, uneducated, unemployed, overweight, obese, and physically-inactive patients. |
| 6 | Menanga, et al., 2016 [13] | Cameroon (Lower-middle-income) |
440 hypertensive patients in an urban city. | 36.8% had their BP controlled. Optimal medication adherence and dietary lifestyle changes were significantly associated with BP control. |
| 7 | Okwuonu, et al., 2014 [14] | Nigeria (Lower-middle-income) |
252 adults with hypertension. | 32.9% had their BP controlled (affected by knowledge and lifestyle changes) Low medication adherence was reported in 68.7% of patients due to forgetfulness (61.2%), financial barriers (56.6%), a heavy pill burden (22.5%), and side effects (17.3%). |
| 8 | IIoh, et al., 2013 [15] |
Nigeria (Lower-middle-income) |
140 adults with primary HTN on treatment for at least six months. | 35% had their BP controlled, and 42.9% were adherent. Adherence, HTN duration (≥3 years), and receiving > one anti-HTN therapy were related to better blood pressure control. |
| 9 | Sarfo, et al., 2018 [16] | Ghana (Lower-middle-income) |
2870 hypertensive participants enrolled at five different hospitals. | 42.3% had their BP controlled. Uncontrolled BP was attributed to receiving therapy at a tertiary care level, longer HTN duration, poor adherence, and number of and access to anti-HTN treatments. |
| 10 | Harrison, et al., 2021 [17] | Ghana (Lower-middle-income) |
310 hypertensive participants | 41.8% had their BP controlled. Affordability (OR, 1.917; 95% CI: 1.013–3.630) and accessibility (OR, 1.642; 95% CI, 0.843–3.201) were more significantly linked to blood pressure control. |
| 11 | Gala, et al., 2020 [28] |
Botswana (Upper-middle-income) |
280 adult patients with HTN on medications. | 45% had their BP controlled. 34% had ≥ one medication error. Having ≥ one medication error was significantly associated with uncontrolled HTN compared with no errors. |
| 12 | Devkota, et al., 2016 [18] | Nepal (Lower-middle-income) |
191 hypertensive patients. | 24% had their BP controlled, while 61.8% and 78.8% were aware and treated, respectively. BP control was associated with combination therapy, medication adherence, follow-up care, and healthcare providers’ counselling |
| 13 | Dhungana, et al., 2022 [19] | Nepal (Lower-middle-income) |
2792 hypertensive patients. | Only 3.8% had their BP controlled. About 10.3% received antihypertensive treatment. 20% were aware of their hypertension. |
| 14 | Son, et al., 2012 [20] |
Vietnam (Lower-middle-income) |
2467 hypertensive patients. | Only 10.7% had their BP controlled. About 29.6% received antihypertensive treatment. 48.4% were aware of their hypertension. |
| 15 | De Souza, et al., 2014 [27] |
Brazil (Upper-middle-income) |
383 adult patients with HTN. | 33.7% had their BP controlled. Only 54.3% reported adherence to anti-HTN therapy. Diabetes mellitus (DM) was observed in 31% of participants, with only 15.7% having their BP controlled. |
| 16 | Lerner, et al., 2013 [30] | Peru (Upper-middle-income) |
205 hypertensive patients. | 4.9% had their BP controlled, while 48.3% and 40% were aware and treated, respectively. Women were more aware of their HTN than men. |
| 17 | Nassr, et al., 2019 [29] | Iraq (Upper-middle-income) |
300 adult patients with hypertension. | 38.7% had their BP controlled. Age < 60 years, male gender, and diabetes were predictors of uncontrolled BP. |
| 18 | Wang, et al., 2013 [21] | China (Upper-middle-income) |
556 hypertensive patients from a rural community. | 12.5% had their BP controlled among only 429 patients aware of being hypertensive. Optimal HTN control was hindered by inadequate knowledge (82.8%), treatment cost (39.4%), poor medication adherence (65%), and lack of counselling sessions (95.1%). |
| 19 | Li, et al., 2016 [22] | China (Upper-middle-income) |
31,694 adult respondents were diagnosed with HTN. | 29.5% had their BP controlled. Higher BP levels positively correlate with the number of risk factors in both genders. |
| 20 | Xu, et al., 2013 [23] | China (Upper-middle-income) |
3279 HTN and CHD patients. | 18% had their BP controlled. Non-dihydropyridine CCB was associated with a low BP control rate. Independent factors of poor BP control include being overweight, stable angina pectoris, and a family history of diabetes. |
| 21 | Chen, et al., 2020 [24] | China (Upper-middle-income) |
89,925 hypertensive patients. | 25.4% had their BP controlled. Lower odds of uncontrolled BP were reported in women, those with diabetes, and CHD. Older patients, current smokers, and monotherapy users had higher odds of uncontrolled BP. |
| 22 | Lei wu, et al., 2015 [25] | China (Upper-middle-income) |
1409 elderly (≥60 years) with hypertension. | 30.3% had their BP controlled, while 74.5% and 63.7% were aware and treated, respectively. BP control was significantly associated with higher education levels, family history of HTN, and CVD comorbidity. |
| 23 | Xia, et al., 2021 [26] | China (Upper-middle-income) |
1046 hypertensive patients. | 48.3% and 37.6% had their BP controlled in public vs. private clinics. Higher treatment (87.5% vs. 66.8%), higher adherence (91.5% vs. 82.5%), and lower depression levels (8.5% vs. 18.2%) in public vs. private clinics. |
| 24 | Santosa, et al., 2020 [32] | Sweden and China (High-income “Sweden”) |
Sweden (n = 25,511) and China (n = 25,356). |
47.6% of males and 58.7% of females had their BP controlled in Sweden vs. 33.2% and 37.6% in China. Awareness was higher among patients in Sweden (63.7%” males” and 69.1% “females”) compared to China (50.2%” males” and 44.3% “females”). Higher odds of BP control in Sweden were reported for those with normal weight, controlled lipid profiles, and men with diabetes. |
| 25 | Ting li, et al., 2016 [33] | Hong Kong (High-income) |
2445 hypertensive patients. | 51.3% had their BP controlled, 53.4% had good adherence, and 47.4% had multiple comorbidities. Poor BP control was more likely among those with multiple comorbidities (Diabetes was the most prevalent). |
| 26 | Liew, et al., 2019 [40] | Singapore (High-income) |
10 215 participants from a multi-ethnic cohort. | 37.6% had their BP controlled. Older age was associated with uncontrolled HTN. Younger age, male gender, and lower educational level were associated with untreated HTN. |
| 27 | Ham, et al., 2011 [36] | South Korea (High-income) |
690 adult patients with HTN on medications. | 54.3% had their BP controlled. Higher control rates were observed at a younger age, for those with ≥one comorbidity, and ≥4 days physically active. Being overweight, heavy alcohol consumption, and mild to severe stress reduced BP control. |
| 28 | Khayyat, et al., 2017 [34] | Saudi Arabia (High-income) |
204 hypertensive patients. | 69.6% had their BP controlled. Higher odds were observed with high medication adherence and normal-weight individuals. 46% were adherent. Higher odds were observed among males, older individuals (>65 yrs), and patients with diabetes. |
| 29 | Sandoval, et al., 2012 [35] | Chile (High-income) |
1194 hypertensive patients. | 59.7% had their BP controlled. Women and non-diabetics had better BP control than men and diabetics |
| 30 | Zhang, et al., 2019 [31] | Australia (High-income) |
1750 CKD patients with HTN. | 36.3% had their BP controlled. Those with CVD had lower odds of uncontrolled BP. Participants ≥65 years old and those with severe albuminuria or proteinuria were at higher odds of uncontrolled BP. |
| 31 | Murphy, et al., 2016 [39] | Ireland (High-income) |
3579 hypertensive adults aged over 50 years. | 54.5% and 58.9% were aware and treated (affected by financial barriers). Among those treated, 51.6% had their BP controlled. Higher odds of BP control were observed among those with previous CVD history and those living in rural areas compared with a country area. |
| 32 | Tiffe, et al., 2019 [37] | Germany (High-income) |
293 adult patients with HTN on medications. | 50.2% had their BP controlled. Women who reported higher levels of concern had a higher chance of controlling HTN. |
| 33 | Cordero, et al., 2011 [38] | Spain (High-income) |
10743 patients with HTN. | 55.4% had their BP controlled. BP control rate was similar in those with and without CVD. Higher rates of poor BP control were reported for males, active smokers, obese individuals, and diabetics. |