Introduction: Uncontrolled hypertension can lead to increased morbidity and mortality secondary to end-organ damage. Community-based health interventions promote health changes in a community setting and have been shown to promote better and more cost-effective healthcare. Existing meta-analyses on community-based interventions in hypertension control are confined to a certain country, have high risks of bias, and have shown heterogeneous results. A gap in the applicability of these conclusions necessitates the present study Objective: Synthesize available evidence on the effectiveness of community-based interventions in addition to standard of care in the control of blood pressure among hypertensive adults. Methods: A meta-analysis of randomized and non-randomized controlled trials among hypertensive adults was conducted. A literature search from various search engines and electronic databases such as PubMed, Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, Google Scholar, Proquest, medRvix, and Grey literature was done by the investigators. Separate forest plots were generated for each desired outcome. Results: Six studies were included. The pooled estimates showed a trend in favor of community-based interventions in the control of blood pressure [RR = 0.86, 95% CI 0.62 to 1.19, p = 0.37], reduction of systolic blood pressure, reduction of diastolic blood pressure [MD = -2.52, 95% CI -3.64 to -1.28, p < 0.001] and medication adherence [RR = 0.82, 95% CI 0.72 to 0.93, p = 0.0025]. However, there was high heterogeneity across studies. Subgroup analysis showed a favorable trend with lower heterogeneity in decreasing diastolic BP in particular, among community health worker-led interventions, and those involving health education and/or physical activity Conclusions/Recommendations Adherence to the current standard of care in the management of hypertension is still advised. There appears to be a trend towards control of blood pressure with community-based interventions; and a reduction of diastolic blood pressure with interventions that are led by community health workers involving health education and/or physical activity. There is a need to empower community health workers and conduct additional studies on the specific community-based interventions targeting communities as a whole whenever resources and current health restrictions allow
Hypertension ; Systematic Review ; Meta-Analysis

Systematic reviews and meta-analysis combine results and analysis of data from different primary studies (e.g. cross-sectional studies, case-control studies, cohort studies) conducted on similar or related research topics. They are secondary studies that guide clinical decision-making, delivery of care and policy development. This article aims to discuss how to conduct a systematic review and meta-analysis. The steps in conducting a systematic review and meta-analysis include: 1) Identify the purpose including formulating the research question and validating the purpose of the literature scan, 2) Formulate the objectives, 3) Literature search including selection of studies based on population, intervention, comparison and outcome, 4) Retrieval of full text articles, 5) Critical appraisal of articles, 6) Data extraction, 7) Data analysis and 8) Writing the final report. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) is a useful guide in conducting and write systematic review and meta-analysis. While ethics approval is not usually required for systematic review and meta-analysis, authors of such study should still observe good practices including avoiding plagiarism, maintaining transparency and ensuring data accuracy.

Systematic Review ; Meta-analysis