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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

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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