BackgroundUncontrolled hypertension (HTN) is a major risk factor for cardiovascular and cerebrovascular disease. The prevalence of HTN in the Ethiopian adult population is almost 20%.This study aimed to determine the prevalence of uncontrolled HTN and its contributing factors among patients with HTN in Ethiopia undergoing treatment.MethodsElectronic bibliographic databases such as PubMed, Google Scholar, Hinari (Research4Life), Embase, and Scopus were searched for original records in the English language that assessed HTN control in Ethiopia and were available before 29 June 2023. The data were extracted using a format prepared in Microsoft Excel and exported to the software STATA 17.0 for analysis. The study protocol was registered at PROSPERO with the reference number CRD42023440121.ResultsA total of 26 studies with 9,046 patients with HTN were included in the systematic review and meta-analysis, of which 11 studies were used to assess factors contributing to uncontrolled blood pressure (BP) in patients in Ethiopia. The estimated prevalence of uncontrolled HTN in the population of Ethiopia is 51% [95% confidence interval (CI), 42%–60%]. The subgroup analysis, based on the assessment tools, region, and follow-up period, revealed that the prevalence of uncontrolled BP was highest following the guidelines of the American Heart Association/American College of Cardiology (AHA/ACC) (89%; 95% CI: 87%–91%) and in Addis Ababa (58%; 95% CI: 40%–76%), and the lowest proportion of uncontrolled BP was in the 3-month follow-up period (34%; 95% CI: 29%–39%). The presence of diabetes mellitus showed the highest impact (pooled odds ratio: 5.19; CI: 1.41–19.11) for uncontrolled HTN. The univariate meta-regression method confirmed that the sample size, year of publication, and subgroups were not sources of heterogeneity in the pooled estimates. Egger's regression test did not indicate the presence of publication bias.ConclusionMore than half of the hypertensive patients in Ethiopia have uncontrolled BP. Diabetes mellitus, advanced age, male sex, and the presence of comorbidities are among the factors contributing to uncontrolled HTN in Ethiopia. The concerned bodies working in this area should implement interventional strategies and recommendations that might be helpful in achieving optimal BP in hypertensive patients.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023440121, PROSPERO (CRD42023440121).

中文翻译：

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埃塞俄比亚不受控制的高血压患病率及其影响因素：系统评价和荟萃分析

研究背景不受控制的高血压（HTN）是心脑血管疾病的主要危险因素。埃塞俄比亚成年人中高血压的患病率几乎为 20%。本研究旨在确定埃塞俄比亚接受治疗的高血压患者中不受控制的高血压患病率及其影响因素。方法电子书目数据库，如 PubMed、Google Scholar、Hinari (Research4Life ）、Embase 和 Scopus 检索了评估埃塞俄比亚 HTN 控制的英文原始记录，这些记录在 2023 年 6 月 29 日之前可用。数据使用 Microsoft Excel 中准备的格式提取，并导出到软件 STATA 17.0 进行分析。该研究方案在 PROSPERO 注册，参考号 CRD42023440121。 结果系统评价和荟萃分析共纳入 26 项研究，涉及 9,046 名 HTN 患者，其中 11 项研究用于评估导致血压失控的因素（BP ）在埃塞俄比亚的患者中。埃塞俄比亚人口中未受控制的高血压患病率估计为 51% [95% 置信区间 (CI)，42%–60%]。基于评估工具、地区和随访期的亚组分析显示，根据美国心脏协会/美国心脏病学会 (AHA/ACC) 的指南，血压不受控制的患病率最高 (89%; 95 % CI：87%–91%）和亚的斯亚贝巴（58%；95% CI：40%–76%），血压未受控制的最低比例出现在 3 个月的随访期间（34%；95 % CI：29%–39%）。糖尿病的存在对不受控制的高血压影响最大（合并比值比：5.19；CI：1.41-19.11）。单变量荟萃回归方法证实，样本量、发表年份和亚组并不是汇总估计值中异质性的来源。 Egger的回归检验并未表明存在发表偏倚。结论埃塞俄比亚一半以上的高血压患者血压未得到控制。糖尿病、高龄、男性和合并症的存在是导致埃塞俄比亚高血压不受控制的因素之一。该领域的相关机构应实施可能有助于高血压患者实现最佳血压的干预策略和建议。系统审查注册https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023440121，普洛斯彼罗（CRD42023440121）。