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Prevalence of high blood pressure under 2017 ACC/AHA guidelines: a systematic review and meta-analysis

Journal of Human Hypertension volume 35, pages 193–206 (2021)Cite this article

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Abstract

To understand the prevalence of high blood pressure among the general adult population under the new diagnostic criteria. PubMed and Embase databases were systematically searched. Two investigators independently performed data extraction and quality assessment, and the disagreements were resolved by consensus with a third investigator. The random-effects model was performed to pool the prevalence of high blood pressure among the population. Subgroup and meta-regression analyses were performed to explore the source of heterogeneity. The study protocol has been registered with PROSPERO, number CRD42019147330. In total, 52 articles included in the meta-analysis with a total of 54 studies. An obvious increase in the prevalence of high blood pressure was identified by the application of new diagnostic criteria. The pooled prevalence of high blood pressure among the population was 53.01% (95% confidence interval 51.13–54.88%). Subgroup analysis showed that the WHO region, national, and age could significantly influence the prevalence of hypertension (P < 0.01). Meta-regression analyses revealed that study quality and sex ratio (male, %) did not contribute to the heterogeneity of the results (P > 0.05). The sensitivity analysis showed that the results were stable. With the use of new diagnostic criteria, the prevalence of high blood pressure has shown an upward trend, especially in Europe countries. Prevention and control measures should focus more on improving cardiovascular and cerebrovascular status in Europe countries. Standard electronic blood pressure monitors were recommended for use in future studies, and at least two more readings should be taken during a visit.

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Fig. 1: Flow chart of literature selection process.
Fig. 2: Forest plot of pooled prevalence of high blood pressure among population based on 54 studies.
Fig. 3: Prevalence of hypertension among adults across the World.

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  1. These authors contributed equally: Peisheng Xiong, Zhixi Liu

Authors and Affiliations

  1. Zhanggong District Center for Disease Control and Prevention, Ganzhou, 341000, Jiangxi, PR China

    Peisheng Xiong

  2. Shantou University Medical College, Shantou, 515000, Guangdong, PR China

    Zhixi Liu

  3. Shenzhen Cancer Hospital, Shenzhen, 518000, Guangdong, PR China

    Meijuan Xiong

  4. Ganzhou People’s Hospital, Ganzhou, 341000, Jiangxi, PR China

    Feng Xie

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Study design: Pei-Sheng Xiong, Zhi-Xi Liu. Data collection: Mei-Juan Xiong, Pei-Sheng Xiong, Zhi-Xi Liu. Analysis and interpretation of data: Pei-Sheng Xiong, Zhi-Xi Liu, Feng Xie. Drafting of the manuscript: Pei-Sheng Xiong. Approval of the final version for publication: all the authors.

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Xiong, P., Liu, Z., Xiong, M. et al. Prevalence of high blood pressure under 2017 ACC/AHA guidelines: a systematic review and meta-analysis. J Hum Hypertens 35, 193–206 (2021). https://doi.org/10.1038/s41371-020-00454-8

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