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©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
Prevalence, awareness and control of hypertension in Malaysia from 1980-2018: A systematic review and meta-analysis
Man Jun Soo, Zhen Yee Chow, Siew Mooi Ching, Chun Han Tan, Kai Wei Lee, Navin Kumar Devaraj, Hani Syahida Salim, Vasudevan Ramachandran, Poh Ying Lim, Dhashani Sivaratnam, Fan Kee Hoo, Ai Theng Cheong, Yook Chin Chia
Man Jun Soo, Siew Mooi Ching, Kai Wei Lee, Navin Kumar Devaraj, Hani Syahida Salim, Ai Theng Cheong, Department of Family Medicine, Universiti Putra Malaysia, Serdang 43400, Malaysia
Zhen Yee Chow, Chun Han Tan, Hospital Seberang Jaya, Perai 13700, Malaysia
Vasudevan Ramachandran, Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang 43400, Malaysia
Poh Ying Lim, Department of Community Health, Universiti Putra Malaysia, Serdang 43400, Malaysia
Dhashani Sivaratnam, Department of Surgery, Universiti Putra Malaysia, Serdang 43400, Malaysia
Fan Kee Hoo, Department of Medicine, Universiti Putra Malaysia, Serdang 43400, Malaysia
Yook Chin Chia, Department of Medical Sciences, Sunway University, Bandar Sunway 47500, Malaysia
Author contributions: Ching SM, Chia YC, Devaraj NK, Hoo FK, Chow ZY, Lim PY and Tan CH conceived and designed the study; Chow ZY, an CH, Soo MJ and Lee KW performed the study; Ching SM, Soo MJ, Lee KW, Chow ZY, Lim PY and Tan CH analyzed the data; Ching SM, Soo MJ, Lee KW, Chow ZY and Tan CH wrote the paper; Ching SM, Soo MJ, Lee KW, Chow ZY, Tan CH, Cheong AT and Devaraj NK contributed to the data interpretation; Chia YC, Ching SM, Cheong AT, Devaraj NK, Salim HS, Ramachandran V, Sivaratnam D, Lee KW and Hoo FK critically revised the manuscript; all authors have read and approved the manuscript.
Conflict-of-interest statement: The authors declare that they have no competing interests.
PRISMA 2009 Checklist statement: This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Siew Mooi Ching, MD, MMed (FamMed), Associate Professor, Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Serdang 43400, Malaysia. sm_ching@upm.edu.my
Received: June 27, 2020
Peer-review started: June 27, 2020
First decision: August 8, 2020
Revised: August 22, 2020
Accepted: August 27, 2020
Article in press: August 27, 2020
Published online: August 28, 2020
BACKGROUND
Hypertension is a common public health problem worldwide and is a well-known risk factor for increased risk of cardiovascular diseases, contributing to high morbidity and mortality. However, there has been no systematic review and meta-analysis of a multiethnic population such as that of Malaysia.
AIM
To determine the trend in prevalence, awareness and control rate of hypertension in Malaysia.
METHODS
Systematic searches were conducted in six databases (PubMed, Scopus, Ovid, CINAHL, Malaysian Medical Repository and Malaysia Citation Index) for articles published between 1980 and 2018. Two authors reviewed the studies and performed quality assessment and data extraction independently. Pooled estimates of hypertension prevalence, awareness and control rate were calculated using the DerSimonian-Laird random-effects model. Subgroup and sensitivity analyses were performed.
RESULTS
We included 56 studies involving a total of 241796 participants. The overall pooled prevalence of hypertension aged ≥ 18 years was 29.7%. The prevalence of hypertension was the lowest in the 1980s (16.2%, 95% confidence interval (CI): 13.4, 19.0), increasing up to 36.8% (95%CI: 6.1, 67.5) in the 1990s, then decreasing to 28.7% (95%CI: 21.7, 35.8) in the 2000s and 26.8% (95%CI: 21.3, 32.3) in the 2010s. The prevalence of awareness was 51.4% (95%CI: 46.6, 56.3), while 33.3% (95%CI: 28.4, 38.2) of those on treatment had achieved control of their blood pressure.
CONCLUSION
In Malaysia, three in ten adults aged ≥ 18 years have hypertension, while four in ten adults aged ≥ 30 years have hypertension. Five out of ten people are aware of their hypertension status and only one-third of those under treatment achieved control of their hypertension. Concerted efforts by policymakers and healthcare professionals to improve awareness and control of hypertension should be of high priority.
Core Tip: This is a systematic review and meta-analysis reporting that the pooled prevalence of hypertension in people aged ≥ 18 years in Malaysia was 29.7%. The pooled prevalence of awareness towards hypertension was 51.4 % and blood pressure control rate was 33.3%.
