Elevated blood pressure among workforce populations in sub-Saharan Africa: a systematic review and meta-analysis

Abstract Background Hypertension drives premature cardiovascular disease among working-age adults in sub-Saharan Africa (SSA), yet evidence from occupational blood pressure (BP) screening remains fragmented. We synthesised available data on blood pressure levels and hypertension prevalence among workforce populations in the region. Methods We conducted a systematic review and random-effects meta-analysis of observational studies reporting BP levels or hypertension prevalence among adult workforce cohorts in SSA. Medical and scientific bibliographic databases were searched for English-language studies published between 2010 and 2021. Eligible studies included adult workers from occupational or workplace settings. Data extraction and risk-of-bias assessment (Hoy tool) were performed independently. Pooled prevalence, mean systolic and diastolic BP (SBP/DBP), and sex-specific prevalence ratios were estimated using DerSimonian–Laird models, with between-study heterogeneity quantified byI². Results Twelve cross-sectional studies with 7,652 participants (4,759 men [62%] and 1,837 women) from six countries were analysed. The pooled prevalence of hypertension was 26% (95% CI 22–31%; I² = 93.7%). Mean SBP and DBP were 125 mmHg (95% CI 122–128) and 80 mmHg (95% CI 78–82), respectively. There were more males than females (prevalence ratio 1.54; 95% CI 1.12–2.12) with hypertension. Sensitivity analyses showed stable estimates, and no publication bias was detected (Egger’s test) whilst heterogeneity was medium-to-high across (I² ≈ 67.2% to 94%; all P  < 0.005). Conclusions Hypertension remains prevalent among working adults in SSA. Accordingly, more systematic workforce screening for, and proactive management of, hypertension in this vitally important group (from multiple health and socio-economic perspectives) is needed.