Effectiveness of Health Promotion Programs on Blood Pressure in People With Hypertension and Prehypertension in Southeast Asian Populations: Systematic Review and Meta-Analysis.

Abstract

Aim: To evaluate health promotion programmes for managing hypertension in Southeast Asia.

Design: Systematic review and meta-analysis.

Methods: A systematic search was conducted across five databases: MEDLINE, APA PsycInfo, Scopus, Web of Science, and CINAHL, covering studies conducted in Southeast Asia and published in English from January 2003 to December 2023. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the protocol was registered in PROSPERO. Eligibility criteria included adults aged 18 years and older with prehypertension or hypertension, evaluating health promotion programmes focusing on exercise intervention, dietary modification, and health education compared with usual care.

Results: Eleven of the twenty-six studies were included in meta-analyses and showed a statistically significant effect of the interventions on blood pressure. Two studies of dietary interventions demonstrated decreased systolic blood pressure with a pooled mean difference of 8.32 mmHg (95% CI -11.29, -5.34, p ≤ 0.001). Four studies of endurance exercise reduced systolic blood pressure with a pooled mean difference of 15.95 mmHg (95% CI -19.45, -12.46, p < 0.001). Two studies of combined diet and exercise with intensive coaching decreased systolic blood pressure with a pooled mean difference of 6.41 mmHg (95% CI -7.49, -5.33, p < 0.001). Two studies of health education show a clinically significant decrease in systolic blood pressure by 5-18 mmHg.

Patient or public contribution: Health promotion interventions are feasible and acceptable in Southeast Asian populations and significantly reduce blood pressure, particularly systolic blood pressure. Consuming a healthy diet such as the Dietary Approaches to Stop Hypertension Diet (DASH), restricting sodium, and increasing potassium intake is feasible and effective in the Southeast Asian context. To optimise impacts on blood pressure control, endurance exercise interventions should adhere to established exercise principles. Health education programs should incorporate effective coaching strategies to enhance their impact.