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Global Burden of Hypertension and Systolic Blood Pressure of at Least 110 to 115Mmhg, 1990-2015 Publisher Pubmed



Forouzanfar MH1 ; Liu P1 ; Roth GA1 ; Ng M1 ; Biryukov S1 ; Marczak L1 ; Alexander L1 ; Estep K1 ; Abate KH2 ; Akinyemiju TF3 ; Ali R4 ; Alvisguzman N5 ; Azzopardi P6, 7 ; Banerjee A8 Show All Authors
Authors
  1. Forouzanfar MH1
  2. Liu P1
  3. Roth GA1
  4. Ng M1
  5. Biryukov S1
  6. Marczak L1
  7. Alexander L1
  8. Estep K1
  9. Abate KH2
  10. Akinyemiju TF3
  11. Ali R4
  12. Alvisguzman N5
  13. Azzopardi P6, 7
  14. Banerjee A8
  15. Barnighausen T9, 10
  16. Basu A11
  17. Bekele T12
  18. Bennett DA4
  19. Biadgilign S13
  20. Catalalopez F14, 15
  21. Feigin VL16
  22. Fernandes JC17
  23. Fischer F18, 19
  24. Gebru AA20
  25. Gona P21
  26. Gupta R22
  27. Hankey GJ23, 24, 25
  28. Jonas JB26
  29. Judd SE27
  30. Khang YH28
  31. Khosravi A29
  32. Kim YJ30
  33. Kimokoti RW31
  34. Kokubo Y32
  35. Kolte D33
  36. Lopez A34
  37. Lotufo PA35
  38. Malekzadeh R36
  39. Melaku YA37, 38
  40. Mensah GA39
  41. Misganaw A1
  42. Mokdad AH1
  43. Moran AE40
  44. Nawaz H41
  45. Neal B42, 43, 44, 45
  46. Ngalesoni FN46
  47. Ohkubo T47
  48. Pourmalek F48
  49. Rafay A49
  50. Rai RK50
  51. Rojasrueda D51
  52. Sampson UK52
  53. Santos IS53
  54. Sawhney M54
  55. Schutte AE55
  56. Sepanlou SG36
  57. Shifa GT56, 57
  58. Shiue I58, 59, 60
  59. Tedla BA61
  60. Thrift AG62
  61. Tonelli M63
  62. Truelsen T64
  63. Tsilimparis N65
  64. Ukwaja KN66
  65. Uthman OA67
  66. Vasankari T68
  67. Venketasubramanian N69
  68. Vlassov VV70
  69. Vos T1
  70. Westerman R71, 72
  71. Yan LL73
  72. Yano Y74
  73. Yonemoto N75
  74. El Sayed Zaki M76
  75. Murray CJL1, 77
Show Affiliations
Authors Affiliations
  1. 1. Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States
  2. 2. Jimma University, Jimma, Ethiopia
  3. 3. Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, United States
  4. 4. University of Oxford, Oxford, United Kingdom
  5. 5. Universidad de Cartagena, Cartagena de Indias, Colombia
  6. 6. Centre for Adolescent Health, Parkville, VIC, Australia
  7. 7. South Australian Health and Medical Research Institute, Adelaide, SA, Australia
  8. 8. University College London, Farr Institute of Health Informatics Research, London, United Kingdom
  9. 9. Harvard T.H. Chan School of Public Health, Boston, MA, United States
  10. 10. Wellcome Trust Africa Centre for Health and Population Studies, Somkhele, Mtubatuba, KwaZulu-Natal, South Africa
  11. 11. School of Health Sciences, University of Canterbury, Christchurch, New Zealand
  12. 12. Madawalabu University, Bale Goba, Ethiopia
  13. 13. Independent Public Health Consultants, Addis Ababa, Ethiopia
  14. 14. University of Valencia, INCLIVA Health Research Institute and CIBERSAM, Department of Medicine, Valencia, Spain
  15. 15. Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
  16. 16. Auckland University of Technology, National Institute for Stroke and Applied Neurosciences, Auckland, New Zealand
  17. 17. IBILI - Institute for Biomedical Imaging and Life Sciences, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
  18. 18. Bielefeld University, Bielefeld, Germany
  19. 19. Mekelle University, Mekelle, Ethiopia
  20. 20. Kilte Awlaelo-Health and Demographic Surveillance System, Ethiopia
  21. 21. University of Massachusetts Boston, United States
  22. 22. Eternal Heart Care Centre and Research Institute, Jaipur, India
  23. 23. School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia
  24. 24. Harry Perkins Institute of Medical Research, Nedlands, WA, Australia
  25. 25. Western Australian Neuroscience Research Institute, Nedlands, WA, Australia
  26. 26. Ruprecht-Karls-University Heidelberg, Department of Ophthalmology, Medical Faculty Mannheim, Mannheim, Germany
  27. 27. University of Alabama at Birmingham, United States
  28. 28. Seoul National University, College of Medicine, Seoul, South Korea
  29. 29. Iranian Ministry of Health and Medical Education, Tehran, Iran
  30. 30. Southern University College, Johor, Malaysia
  31. 31. Simmons College, Boston, MA, United States
  32. 32. National Cerebral and Cardiovascular Center, Department of Preventive Cardiology, Suita, Osaka, Japan
  33. 33. Brown University, Rhode Island Hospital, Providence, RI, United States
  34. 34. University of Melbourne, Melbourne School of Population and Global Health, Melbourne, QLD, Australia
  35. 35. University of Sao Paulo, Sao Paulo, Brazil
  36. 36. Tehran Universities of Medical Sciences, Digestive Disease Research Institute, Tehran, Iran
  37. 37. Mekelle University, School of Public Health, Mekelle, Ethiopia
  38. 38. University of Adelaide, School of Medicine, Adelaide, SA, Australia
  39. 39. National Institutes of Health, Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, Bethesda, MD, United States
  40. 40. Columbia University, New York, NY, United States
  41. 41. Southern Illinois University, Springfield, United States
  42. 42. George Institute for Global Health, Sydney, NSW, Australia
  43. 43. University of Sydney, Sydney, NSW, Australia
  44. 44. Royal Prince Alfred Hospital, Sydney, NSW, Australia
  45. 45. Imperial College London, London, United Kingdom
  46. 46. Ministry of Health and Social Welfare, Dares Salaam, Tanzania
  47. 47. Teikyo University, School of Medicine, Tokyo, Japan
  48. 48. University of British Columbia, Vancouver, BC, Canada
  49. 49. Contech School of Public Health, Lahore, Punjab, Pakistan
  50. 50. Society for Health and Demographic Surveillance, Suri, India
  51. 51. ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
  52. 52. National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD, United States
  53. 53. University of Sao Paulo, Internal Medicine Department, Sao Paulo, Brazil
  54. 54. Marshall University, Huntington, WV, United States
  55. 55. South African Medical Research Council, North-West University, Potchefstroom, South Africa
  56. 56. Arba Minch University, SNNPR, Arba Minch, Ethiopia
  57. 57. Addis Ababa University, Addis Ababa, Ethiopia
  58. 58. Northumbria University, Faculty of Health and Life Sciences, Newcastle upon Tyne, United Kingdom
  59. 59. University of Edinburgh, Alzheimer Scotland Dementia Research Centre, Edinburgh, United Kingdom
  60. 60. University of Gondar, Gondar, Ethiopia
  61. 61. James Cook University, Cairns, QLD, Australia
  62. 62. Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
  63. 63. University of Calgary, Calgary, AB, Canada
  64. 64. University of Copenhagen, Department of Neurology, Rigshospitalet, Copenhagen, Denmark
  65. 65. University Heart Center of Hamburg, Hamburg, Germany
  66. 66. Federal Teaching Hospital, Department of Internal Medicine, Abakaliki, Nigeria
  67. 67. University of Warwick, Warwick Medical School, Coventry, United Kingdom
  68. 68. UKK Institute for Health Promotion Research, Tampere, Finland
  69. 69. Raffles Neuroscience Centre, Raffles Hospital, Singapore, Singapore
  70. 70. National Research University, Higher School of Economics, Moscow, Russian Federation
  71. 71. Federal Institute for Population Research, Wiesbaden, Germany
  72. 72. German National Cohort Consortium, Heidelberg, Germany
  73. 73. Global Health Research Center, Duke Kunshan University, Kunshan, China
  74. 74. Department of Preventive Medicine, Northwestern University, Chicago, IL, United States
  75. 75. National Center of Neurology and Psychiatry, Kodaira, Japan
  76. 76. Mansoura Faculty of Medicine, Mansoura, Egypt
  77. 77. Institute for Health Metrics and Evaluation, 2301 Fifth Ave, Seattle, 98121, WA, United States

Source: JAMA - Journal of the American Medical Association Published:2017


Abstract

IMPORTANCE Elevated systolic blood (SBP) pressure is a leading global health risk. Quantifying the levels of SBP is important to guide prevention policies and interventions. OBJECTIVE To estimate the association between SBP of at least 110 to 115mmHg and SBP of 140mmHg or higher and the burden of different causes of death and disability by age and sex for 195 countries and territories, 1990-2015. DESIGN A comparative risk assessment of health loss related to SBP. Estimated distribution of SBP was based on 844 studies from 154 countries (published 1980-2015) of 8.69 million participants. Spatiotemporal Gaussian process regression was used to generate estimates of mean SBP and adjusted variance for each age, sex, country, and year. Diseases with sufficient evidence for a causal relationship with high SBP (eg, ischemic heart disease, ischemic stroke, and hemorrhagic stroke) were included in the primary analysis. MAIN OUTCOMES AND MEASURES Mean SBP level, cause-specific deaths, and health burden related to SBP (≤110-115mmHg and also≤140mmHg) by age, sex, country, and year. RESULTS Between 1990-2015, the rate of SBP of at least 110 to 115mmHg increased from 73 119 (95%uncertainty interval [UI], 67 949-78 241) to 81 373 (95%UI, 76 814-85 770) per 100000, and SBP of 140mmHg or higher increased from 17 307 (95%UI, 17 117-17 492) to 20526 (95%UI, 20283-20746) per 100000. The estimated annual death rate per 100000associated with SBP of at least 110 to 115mmHg increased from 135.6 (95%UI, 122.4-148.1) to 145.2 (95%UI 130.3-159.9) and the rate for SBP of 140mmHg or higher increased from 97.9 (95%UI, 87.5-108.1) to 106.3 (95%UI, 94.6-118.1). Loss of disability-adjusted life-years (DALYs) associated with SBP of at least 110 to 115mmHg increased from 148 million (95%UI, 134-162 million) to 211 million (95% UI, 193-231 million), and for SBP of 140mmHg or higher, the loss increased from 95.9 million (95%UI, 87.0-104.9 million) to 143.0million (95%UI, 130.2-157.0million). The largest numbers of SBP-related deathswere caused by ischemic heart disease (4.9 million [95%UI, 4.0-5.7 million]; 54.5%), hemorrhagic stroke (2.0million [95%UI, 1.6-2.3 million]; 58.3%), and ischemic stroke (1.5 million [95%UI, 1.2-1.8 million]; 50.0%). In 2015, China, India, Russia, Indonesia, and the United States accounted for more than half of the globalDALYs related to SBP of at least 110 to 115mmHg. CONCLUSIONS AND RELEVANCE In international surveys, although there is uncertainty in some estimates, the rate of elevated SBP (≤110-115 and≤140mmHg) increased substantially between 1990 and 2015, and DALYs and deaths associated with elevated SBP also increased. Projections based on this sample suggest that in 2015, an estimated 3.5 billion adults had SBP of at least 110 to 115mmHg and 874 million adults had SBP of 140mmHg or higher. © 2017 American Medical Association.
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