Patient barriers to blood pressure control and their implications in low-, middle-, and high-income countries.

Mohamed Hassan Elnaem, Nur Hasyimah Kamarudin, Manar Mosaad

Research output: Other contributionpeer-review


Blood pressure (BP) control remains a challenge, modulated by significantly differing factors between settings. Hence, this work was undertaken to summarise BP control's prevalence and associated barriers and outline possible implications for customised hypertension care in low- and middle-income countries (LMICs) and high-income countries (HICs). Three scholarly databases—ScienceDirect, PubMed, and Google Scholar—were thoroughly examined using predefined search terms to identify potentially relevant studies. Original research articles published in English between 2011 and 2020 that reported the associated factors and barriers to BP control were included. A total of 24 studies were included in this review. Thirteen studies were primarily conducted in LMICs, while the other eleven studies were conducted in HICs. The BP control in the LMICs studies ranges from 12.5–60%. Meanwhile, the BP control in the HICs ranged from 36.3–62%. Barriers related to disease knowledge and medication adherence more frequently in LMIC studies. Meanwhile, advancing age as a challenge to attaining BP control was more common in HIC studies. There was a relatively consistent reporting of barriers to pharmacotherapy optimisation and lifestyle changes across LMICs and HICs studies. The optimal BP control barriers vary between LMICs and HICs, suggesting the need for customised approaches and interventions. Further studies to implement and evaluate the effectiveness of multifaceted interventions in achieving hypertension therapeutic outcomes are still recommended, particularly in LMICs.
Original languageEnglish
Publication statusPublished (in print/issue) - 15 Feb 2022


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