Abstract / Summary
Abstract Blood pressure (BP) is a major health burden in low- and middle-income countries (LMICs), where effective control remains a challenge. Community-based education may help improve outcomes in these settings. To systematically review and assess the impact of community-based educational interventions on systolic blood pressure (SBP) and diastolic blood pressure (DBP) among hypertensive individuals in LMICs. PubMed, Cochrane Library, and Web of Science were searched on February 04, 2025, for English-language studies published between January 01, 2010, and December 31, 2024. Randomized controlled trials (RCTs) and cluster randomized controlled trials (cRCTs) evaluating community-based educational interventions in hypertensive patients in LMICs were included. Study quality was assessed using the Joanna Briggs Institute checklist. A meta-analysis was conducted using random-effects models, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The Grading of Recommendations, Assessment, Development, and Evaluation framework evaluated evidence certainty. From 1253 records, 24 studies were eligible, with 26 datasets included in the meta-analysis. In the pooled analysis, interventions led to a significant reduction in SBP (−8.16 mmHg; 95% confidence interval [CI]: −10.38 to − 5.93; I² =96.12%) and DBP (−3.71 mmHg; 95% CI: −5.03 to − 2.38; I² =95.86%) in comparison to the control. Subgroup analyses confirmed consistent reductions across RCTs and cRCTs. There was no clear evidence of publication bias for either SBP or DBP. The certainty of evidence was rated low for both outcomes. Community-based educational interventions may reduce BP in LMICs, but integration into hypertension control programs is not supported at this certainty level without stronger caveats. International Prospective Register of Systematic Reviews ID: CRD42023459915.