META-ANALYSIS OF PSYCHO-SOCIAL RISK FACTORS ASSOCIATED WITH HYPERTENSION IN ADULTS AGED 18-49 YEARS: A SYSTEMATIC REVIEW OF EPIDEMIOLOGICAL STUDIES IN PAKISTAN

Abstract

Introduction: Elevated blood pressure is a current global health issue and is fast becoming a concern in the Pakistani population especially for individuals aged 18-49 years. This age group is now exposed to psycho-social risks embraced by modern life such as stress, SES disparities, unhealthy lifestyles and eating habits. The proposed meta-analysis will systematically review and meta-analyze epidemiological studies carried out Pakistan to determine the psycho-social risk factors for hypertension among the population of the country.

Methods: The search was done coordinately with relevant databases of publications, such as PubMed, Google Scholar and Science Direct and confined to publications from the year 2000 to 2023. The review involved observational studies that addressed the psycho-social risk factors of hypertension to the target group of individuals, aged 18-49 years, in Pakistan. Among the identified 61 articles, the final meta-analysis included 24 articles. Potential source of bias in the quality of studies was assessed through the Newcastle Ottawa Scale and the summary weighted OR for each risk factor was determined using Rev Man software.

Results: Specific psycho-social behaviors and conditions were clearly highlighted by the meta-analysis as contributing strongly towards hypertension. Stress was the most significant factor, with a pooled OR of 2.45 (95% CI: 1.85-3.20). Low socioeconomic status was also a strong predictor, with an OR of 1.85 (95% CI: 1.Smoking had the highest prevalence of prevalence in all groups and carried an odds ratio of 1.65 (95%CI 1.25-2.10), followed by physical inactivity OR 1.75 (95%CI 1.30-2.35), and poor dietary habits OR 1.55 (95%CI 1.20-2.00). The level of heterogeneity for the studies was found to be moderate but sensitivity analysis was conducted to check for the validity of the result.

Conclusion: This meta-analysis has also emphasized the fact that psycho-social risk factors make substantial contribution to hypertension among the adults of age group 18-49 years in Pakistan. There is need for population-based intervention to reduce stress, facilitate improvement in the healthy lifestyles and reduce Socio demographic factors that has being major contributors to hypertension among Moroccan immigrants. Such a study should be carried out in the future to examine the casual relationship between psycho-social factors and hypertension research.