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Home / Journal of Hypertension, Volume 41, Number 6

The impact of dietary and lifestyle interventions on blood pressure management in sub-Saharan Africa: a systematic review and metanalysis

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Objectives:

Current literature is lacking a comprehensive review of data on dietary interventions in blood pressure (BP) management in sub-Saharan African countries. We assessed the association of dietary and other lifestyle interventions with BP-lowering effects in populations within sub-Saharan Africa.Methods:

We performed a systematic review and random-effects meta-analysis to determine the impact of dietary and lifestyle interventions on SBP and DBP in sub-Saharan Africa. We searched the MEDLINE, EMBASE, and Web of Science databases. We included intervention studies that were randomized and nonrandomized conducted in Africans residing in sub-Saharan Africa investigating diet and other lifestyle, physical activity, weight loss, tobacco, and alcohol cessation modifications. We determined the effect of diet and other lifestyle interventions on SBP and DBP. We expressed effect size as weighted mean difference and 95% confidence interval (CI).

Main results

: We identified six studies with a total of 1412 individuals, 38% males, mean age of 52.8 years (SD = 11.5). The weighted mean difference of dietary and other lifestyle interventions on SBP and DBP was −7.33 mmHg, (95% CI: −9.90 to −4.76, P < 0.001) and −2.98 mmHg, (95% CI: −4.28 to −1.69, P < 0.001), respectively. In the metaregression analyses, the duration of the interventions did not have any effect on changes in SBP and DBP.

Principal conclusion

: Dietary modifications showed a beneficial overall improvement in SBP and DBP in Africans. However, aside from low-salt interventions, studies on dietary potassium, healthy dietary patterns, and lifestyle modifications have not been investigated extensively in Africans and are in critical need. In addition, researchers will need to consider the settings (rural, urban, or semiurban) and the predominant existing dietary habits while designing studies on dietary interventions in sub-Saharan Africa.

PROSPERO registration:

CRD42020207923.

Keywords: diet; hypertension; interventions; lifestyle; sub-Saharan Africa

Document Type: Research Article

Affiliations: 1: Nephrology Section, Department of Medicine, Boston Medical Center, Boston University School of Medicine 2: School of Public Health, Boston University, Boston, Massachusetts 3: Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, John Hopkins University, Baltimore, Maryland 4: Department of Public Health, Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA 5: Noncommunicable Diseases Research Unit, South African Medical Research Council, Durban and Cape Town, Department of Medicine, University of Cape Town, Cape Town, South Africa

Publication date: June 28, 2023

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