Gender disparities in midlife hypertension: a review of the evidence on the Arab region

Akl, Christelle; Akik, Chaza; Ghattas, Hala; Obermeyer, Carla Makhlouf

doi:10.1186/s40695-017-0020-z

Women's Midlife Health

Table 1 Hypertension prevalence by gender and age group in the Arab World (> = 18 years), 2000-2015

From: Gender disparities in midlife hypertension: a review of the evidence on the Arab region

Country	First Author (Year of publication)	Sample size ^a	Age group (years) ^b	Prevalence of Hypertension (%)
				By age group				Midlife ^c				Total sample
				Male	Female	Ratio M/F	95% CI	Male	Female	Ratio M/F	95% CI	Male	Female	Ratio M/F	95% CI
Self-reported hypertension
Egypt	Abolfotouh, M.A. (2008) [23]	1800	18–24	0.7	2.1	0.33	[0.04-2.59]	16.6	31.6	0.53***	[0.36-0.78]	7.3	10.5	0.70 *	[0.51-0.94]
			25–44	4.2	7.6	0.55 *	[0.32-0.97]
			45–64	16.6	31.6	0.53***	[0.36-0.78]
			> = 65	20.0	43.8	0.46	[0.19-1.09]
Jordan	Kulwicki, A. D. (2001) [25]	209	17-34	2.3	1.6	1.44 ^e	^e	11.1	11.4	0.97 ^e	^e	7.1	9.6	0.74	[0.29-1.91]
			35-54	11.1	11.4	0.97 ^e
			55-93	14.3	35.3	0.41 ^e
Kuwait	Shah, N.M. (2010) [28]	2487	50-59	30.7	32.0	0.96	[0.77-1.20]	30.7	32.0	0.96	[0.77-1.20]	52.3	49.5	1.06	[0.98-1.14]
			60-69	50.8	55.1	0.92	[0.81-1.05]
			> = 70	67.0	69.3	0.97	[0.88-1.06]
Lebanon	Tohme, R. A. (2005) [30]	2010^a	30-40	5.7	5.8	0.98	[0.52-1.86]	22.0	23.1	0.95	[0.75-1.21]	22.1	24.4	0.91	[0.78-1.09]
			41-50	13.7	15.5	0.88	[0.58-1.34]
			51-60	31.3	32.6	0.96	[0.73-1.26]
			61-70	41.0	60.6	0.68 **	[0.53-0.87]
			>70	53.4	64.6	0.83	[0.63-1.09]
Diagnosed hypertension based on BP measurements ^d
Algeria	Hamida, F. (2013) [21]	722	40-49	21.1	20.6	1.02	[0.59-1.77]	29.2	33.3	0.88	[0.63-1.21]	51.3	49.7	1.03	[0.90-1.21]
			50-59	40.8	48.1	0.85	[0.58-1.24]
			60-69	71.4	67.6	1.06	[0.85-1.32]
			> = 70	75.7	80.6	0.94	[0.80-1.11]
Jordan	Khader, Y. (2007) [24]	1121	25-44	33.0	32.2	1.02	[0.79-1.32]	^g				49.5	52.0	0.95	[0.84-1.08]
Jordan	Khader, Y. (2007) [24]	1121	45-85	63.7	73.2	0.87 *	[0.77-0.98]	^g				49.5	52.0	0.95	[0.84-1.08]
KSA	Al-Daghri, N.M. (2011) [26]	9149	18 - 45	16.8	12.2	1.38 ***	[1.18-1.61]	41.6	39.9	1.04	[0.93-1.17]	31.5	23.8	1.32 ***	[1.21-1.42]
			46 - 60	41.6	39.9	1.04	[0.93-1.17]
			61 - 80	57.2	61.1	0.94	[0.84-1.04]
	Al-Nozha, M. M. (2007) [27]	17230^a	30-39	14.1	10.4	1.36 ***	[1.18-1.57]	28.6	29.6	0.97	[0.90-1.03]	28.6	23.9	1.20 ***	[ 1.14-1.26]
			40-49	23.0	24.1	0.95	[0.86-1.06]
			50-59	34.9	39.5	0.88 **	[0.81-0.96]
			60-70	44.6	50.4	0.88 **	[0.82-0.96]
Lebanon	Matar, D. (2015) [29]	1697	21-34	20.0	9.0	2.22***	[1.43-3.39]	49.9	37.4	1.33 ***	[1.14-1.56]	42.7	29.5	1.45**^f	[1.28-1.68]
			35-49	42.0	24.0	1.75 ***	[1.33-2.28]
			50-64	60.0	54.0	1.11	[0.94-1.32]
			> = 65	76.0	68.0	1.12	[0.92-1.37]
Oman	Al-Riyami A. (2002) [31]	6414^a	20-39	23.9	16.8	1.42 ^e	^e	46.5	50.7	0.92	^e	35.3	31.3	1.13***^f	[1.06-1.22]
			40-59	46.5	50.7	0.92 ^e
			> = 60	60.9	68.1	0.89 ^e
Palestine	Khdour, M. R. (2013) [32]	2077	25-44	17.0	16.7	1.02	[0.75-1.38]	34.3	27.6	1.24 *	[1.03-1.51]	29.2	26.4	1.11**	[0.96-1.27]
			45-64	34.3	27.6	1.24 *	[1.03-1.51]
			> = 65	52.3	48.3	1.08	[0.86-1.37]
Tunisia	Ben Romdhane, H. (2012) [34]	8007^a	35-44	16.0	14.5	1.10	[0.94-1.30]	24.3	29.4	0.83***	[0.76-0.89]	27.3	33.1	0.82^f	[0.77-0.88]
			45-54	26.3	33.6	0.78***	[0.69-0.89]
			55-64	40.3	53.5	0.75***	[0.67-0.85]
			65-74	51.1	66.0	0.77***	[0.69-0.87]
	Ben Romdhane, H. (2005) [35]	1837	40-49	21.4	30.4	0.70 ^e	^e	^g				38.7	48.2	0.80***	[0.72-0.90]
			50-59	40.5	54.4	0.74 ^e
			60-69	56.0	73.0	0.77 ^e
	Bouguerra, R. (2006) [36]	3857^a	20-29	31.3	22.2	1.41 **	[1.10-1.82]	41.3	52.6	0.79***	[0.69-0.89]	45.2	44.0	1.03	[0.96-1.11]
			30-39	28.9	29.5	0.98	[0.78-1.22]
			40-49	34.4	45.5	0.76 **	[0.62-0.91]
			50-59	52.4	63.1	0.83 *	[0.71-0.98]
			60-69	65.6	75.3	0.87 *	[0.78-0.97]
			> = 70	76.1	82.5	0.92	[0.82-1.03]
	Elasmi, M. (2009) [37]	2483	35-44	9.0	17.0	0.53***	[0.39-0.75]	22.9	33.0	0.69***	[0.61-0.79]	25.0	36.0	0.69***	[0.62-0.78]
			45-54	30.0	43.0	0.70***	[0.59-0.84]
			55-64	37.0	63.0	0.59***	[0.49-0.71]
			65-69	51.0	78.0	0.65***	[0.51-0.81]
UAE	Baynouna, L. M. (2008) [39]	817	20-29	5.1	1.7	3.00	[0.32-28.01]	26.2	29.4	0.89	[0.65-1.22]	21.8	19.8	1.10	[0.84-1.44]
			30-39	11.1	7.0	1.59	[0.65-4.00]
			40-49	17.0	23.0	0.74	[0.42-1.30]
			50-59	33.6	38.8	0.87	[0.59-1.26]
			> = 60	36.8	36.7	1.00	[0.57-1.76]

BP blood pressure, CI Confidence interval, F Female, M Male, SBP systolic blood pressure, DBP diastolic blood pressure
*p <0.05 ** p ≤ 0.01; *** p ≤ 0.001: significant difference between genders. For the age groups and the midlife age categories, p-values were calculated based on chi-square tests assessing the significance of differences in sample proportion. For the total sample, p-values were presented either as reported in the original publications [21, 24, 26,27,28,29,30,31,32, 34,35,36,37], or calculated based on chi-square tests [23, 25, 39]
^aNationally representative studies
^bThe age groups that were selected for each study in order to generate midlife prevalence of hypertension are highlighted in bold.
^cPrevalence of midlife hypertension by gender was compiled by selecting the age groups falling between 35 to 65 years in the original publications
^dHypertension was assessed by actual BP measurements [26, 27, 39], or by either BP measurements or self-report of previous diagnosis [21, 24, 29, 31, 32, 34,35,36,37]. For BP measurements, hypertension was identified when SBP > =140 and/or DBP > =90 mmHg for all studies except for Khader et al., 2007 [24] and Bouguerra et al., 2006 [36], where the cut-offs used were SBP > =130 and/or DBP > =85 mmHg
^eSignificance between genders and 95% confidence intervals could not be calculated due to insufficient data [25, 31, 35]
^fThe significant difference between genders for the total sample, reported from the original publications, was adjusted in three studies [29, 31, 34]
^gPrevalence of midlife hypertension could not be determined due to overlapping age ranges [24], or insufficient data to generate pooled prevalence [35]

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