Control status of hypertension in India: systematic review and meta-analysis

Abstract

Background and aims: Uncontrolled hypertension is a major risk factor for cardiovascular diseases (CVDs). The present study aimed to conduct a systematic review and meta-analysis to estimate the pooled prevalence of control status of hypertension in India. Methods and results: We carried out systematic search (PROSPERO No.: CRD42021239800) in PubMed and Embase published between April 2013 and March 2021 followed by meta-analysis with random-effects model. The pooled prevalence of controlled hypertension was estimated across geographic regions. The quality, publication bias and heterogeneity of the included studies were also assessed. We included 19 studies with 44 994 hypertensive population, among which 17 studies had low risk of bias. We found statistically significant heterogeneity (P ≤ 0.05) and absence of publication bias among the included studies. The pooled prevalence of control status among patients with hypertension was 15% (95% CI: 12–19%) and among those under treatment was 46% (95% CI: 40–52%). The control status among patients with hypertension was significantly higher in Southern India 23% (95% CI: 16–31%) followed by Western 13% (95% CI: 4–16%), Northern 12% (95% CI: 8–16%), and Eastern India 5% (95% CI: 4–5%). Except for Southern India, the control status was lower among the rural areas compared with urban areas. Conclusion: We report high prevalence of uncontrolled hypertension in India irrespective of treatment status, geographic regions and urban and rural settings. There is urgent need to improve control status of hypertension in the country.