Global prevalence and trends in hypertension and type 2 diabetes mellitus among slum residents: a systematic review and meta-analysis

BMJ Open. 2022 Feb 24;12(2):e052393. doi: 10.1136/bmjopen-2021-052393.

Abstract

Objective: First, to obtain regional estimates of prevalence of hypertension and type 2 diabetes in urban slums; and second, to compare these with those in urban and rural areas.

Design: Systematic review and meta-analysis.

Eligibility criteria: Studies that reported hypertension prevalence using the definition of blood pressure ≥140/90 mm Hg and/or prevalence of type 2 diabetes.

Information sources: Ovid MEDLINE, Cochrane CENTRAL and EMBASE from inception to December 2020.

Risk of bias: Two authors extracted relevant data and assessed risk of bias independently using the Strengthening the Reporting of Observational Studies in Epidemiology guideline.

Synthesis of results: We used random-effects meta-analyses to pool prevalence estimates. We examined time trends in the prevalence estimates using meta-regression regression models with the prevalence estimates as the outcome variable and the calendar year of the publication as the predictor.

Results: A total of 62 studies involving 108 110 participants met the inclusion criteria. Prevalence of hypertension and type 2 diabetes in slum populations ranged from 4.2% to 52.5% and 0.9% to 25.0%, respectively. In six studies presenting comparator data, all from the Indian subcontinent, slum residents were 35% more likely to be hypertensive than those living in comparator rural areas and 30% less likely to be hypertensive than those from comparator non-slum urban areas.

Limitations of evidence: Of the included studies, only few studies from India compared the slum prevalence estimates with those living in non-slum urban and rural areas; this limits the generalisability of the finding.

Interpretation: The burden of hypertension and type 2 diabetes varied widely between countries and regions and, to some degree, also within countries.

Prospero registration number: CRD42017077381.

Keywords: diabetes & endocrinology; hypertension; public health.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Diabetes Mellitus*
  • Diabetes Mellitus, Type 2* / epidemiology
  • Humans
  • Hypertension* / epidemiology
  • India
  • Poverty Areas
  • Prevalence