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Contributions of Mean and Shape of Blood Pressure Distribution to Worldwide Trends and Variations in Raised Blood Pressure: A Pooled Analysis of 1018 Population-Based Measurement Studies With 88.6 Million Participants Publisher Pubmed



Ezzati M1 ; Zhou B2 ; Bentham J2, 3 ; Di Cesare M4 ; Bixby H2 ; Danaei G5 ; Hajifathalian K6 ; Taddei C2 ; Carrillolarco RM7 ; Djalalinia S8, 9 ; Khatibzadeh S10 ; Lugero C11 ; Peykari N8, 9 ; Zhang WZ12 Show All Authors
Authors
  1. Ezzati M1
  2. Zhou B2
  3. Bentham J2, 3
  4. Di Cesare M4
  5. Bixby H2
  6. Danaei G5
  7. Hajifathalian K6
  8. Taddei C2
  9. Carrillolarco RM7
  10. Djalalinia S8, 9
  11. Khatibzadeh S10
  12. Lugero C11
  13. Peykari N8, 9
  14. Zhang WZ12
  15. Bennett J2
  16. Bilano V2
  17. Stevens GA13
  18. Cowan MJ13
  19. Riley LM13
  20. Chen Z14
  21. Hambleton IR15
  22. Jackson RT16
  23. Kengne AP17
  24. Khang YH18
  25. Laxmaiah A19
  26. Liu J20
  27. Malekzadeh R8, 297
  28. Neuhauser HK21, 22
  29. Soric M23
  30. Starc G24
  31. Sundstrom J25
  32. Woodward M14, 26
  33. Abarcagomez L27
  34. Abdeen ZA28
  35. Aburmeileh NM29
  36. Acostacazares B30
  37. Adams RJ31
  38. Aekplakorn W32
  39. Afsana K33
  40. Aguilarsalinas CA34
  41. Agyemang C35
  42. Ahmad NA36, 442
  43. Ahmadvand A37
  44. Ahrens W38
  45. Ajlouni K39
  46. Akhtaeva N40
  47. Alraddadi R41
  48. Ali MM13
  49. Ali O42
  50. Alkerwi A43
  51. Aly E44
  52. Amarapurkar DN45
  53. Amouyel P46
  54. Amuzu A47
  55. Andersen LB48
  56. Anderssen SA49
  57. Angquist LH50
  58. Anjana RM51
  59. Ansong D52
  60. Aounallahskhiri H53
  61. Araujo J54
  62. Ariansen I55
  63. Aris T36, 442
  64. Arlappa N19
  65. Arveiler D56
  66. Aryal KK57
  67. Aspelund T58
  68. Assah FK59
  69. Assuncao MCF60
  70. Avdicova M61
  71. Azevedo A62
  72. Azizi F63
  73. Babu BV64
  74. Bahijri S41
  75. Balakrishna N19
  76. Bamoshmoosh M65
  77. Banach M66
  78. Bandosz P67
  79. Banegas JR68
  80. Barbagallo CM69
  81. Barcelo A70
  82. Barkat A71
  83. Barros AJD60
  84. Barros MV72
  85. Bata I73
  86. Batieha AM74
  87. Batyrbek A40
  88. Baur LA75
  89. Beaglehole R16
  90. Romdhane HB76
  91. Benet M77
  92. Benson LS78
  93. Bernabeortiz A7
  94. Bernotiene G79
  95. Bettiol H80
  96. Bhagyalaxmi A81
  97. Bharadwaj S82
  98. Bhargava SK83
  99. Bi Y84
  100. Bikbov M85
  101. Bista B57
  102. Bjerregaard P86, 87
  103. Bjertness E88
  104. Bjertness MB88
  105. Bjorkelund C89
  106. Blokstra A90
  107. Bo S91
  108. Bobak M92
  109. Boeing H93
  110. Boggia JG94
  111. Boissonnet CP95
  112. Bongard V96
  113. Borchini R97
  114. Bovet P98, 99
  115. Braeckman L100
  116. Brajkovich I101
  117. Branca F13
  118. Breckenkamp J102
  119. Brenner H103
  120. Brewster LM35
  121. Bruno G91
  122. Buenodemesquita HB90
  123. Bugge A86
  124. Burns C104
  125. Bursztyn M105
  126. De Leon AC106
  127. Cacciottolo J107
  128. Cai H108
  129. Cameron C109
  130. Can G110
  131. Candido APC111
  132. Capuano V112
  133. Cardoso VC80
  134. Carlsson AC113
  135. Carvalho MJ114
  136. Casanueva FF115
  137. Casas JP92
  138. Caserta CA116
  139. Chamukuttan S117
  140. Chan AW118
  141. Chan Q2
  142. Chaturvedi HK119
  143. Chaturvedi N92
  144. Chen CJ120
  145. Chen F121
  146. Chen H122
  147. Chen S123
  148. Cheng CY118
  149. Dekkaki IC71
  150. Chetrit A124
  151. Chiolero A125
  152. Chiou ST126
  153. Chiritaemandi A127
  154. Chirlaque MD128
  155. Cho B129
  156. Cho Y130
  157. Christofaro DG131
  158. Chudek J132
  159. Cifkova R133
  160. Cinteza E134
  161. Claessens F135
  162. Clays E100
  163. Concin H136
  164. Cooper C137
  165. Cooper R92
  166. Coppinger TC104
  167. Costanzo S138
  168. Cottel D139
  169. Cowell C75
  170. Craig CL109
  171. Crujeiras AB140
  172. Cruz JJ68
  173. Darrigo G141
  174. Dorsi E142
  175. Dallongeville J139
  176. Damasceno A143
  177. Dankner R124
  178. Dantoft TM144
  179. Dauchet L145
  180. Davletov K40
  181. De Backer G100
  182. De Bacquer D100
  183. De Gaetano G138
  184. De Henauw S100
  185. De Oliveira PD60
  186. De Smedt D100
  187. Deepa M51
  188. Dehghan A146
  189. Delisle H147
  190. Deschamps V148
  191. Dhana K146
  192. Di Castelnuovo AF138
  193. Diasdacosta JS149
  194. Diaz A150
  195. Dickerson TT78
  196. Do HTP151
  197. Dobson AJ152
  198. Donfrancesco C153
  199. Donoso SP154
  200. Doring A155
  201. Dorobantu M134
  202. Doua K156
  203. Drygas W157
  204. Dulskiene V79
  205. Dzakula A23
  206. Dzerve V158
  207. Dziankowskazaborszczyk E66
  208. Eggertsen R89
  209. Ekelund U49
  210. El Ati J159
  211. Elliott P2
  212. Elosua R160
  213. Erasmus RT161
  214. Erem C162
  215. Eriksen L86
  216. Eriksson JG163
  217. Escobedode La Pena J30
  218. Evans A164
  219. Faeh D165, 269
  220. Fall CH137
  221. Farzadfar F8
  222. Felixredondo FJ166
  223. Ferguson TS167
  224. Fernandes RA131
  225. Fernandezberges D168
  226. Ferrante D169
  227. Ferrari M170
  228. Ferreccio C171
  229. Ferrieres J96
  230. Finn JD172
  231. Fischer K173
  232. Foger B136
  233. Foo LH174
  234. Forslund AS175
  235. Forsner M176
  236. Fouad HM44
  237. Francis DK167
  238. Franco MC177
  239. Franco OH146
  240. Frontera G178
  241. Fuchs FD179
  242. Fuchs SC180
  243. Fujita Y181
  244. Furusawa T182
  245. Gaciong Z183
  246. Galvano F184
  247. Garciadelahera M185
  248. Gareta D186
  249. Garnett SP75
  250. Gaspoz JM187
  251. Gasull M185
  252. Gates L188
  253. Geleijnse JM189
  254. Ghasemian A37
  255. Ghimire A190
  256. Giampaoli S153
  257. Gianfagna F138, 191
  258. Gill TK31
  259. Giovannelli J145
  260. Goldsmith RA192
  261. Goncalves H60
  262. Gonzalezgross M445
  263. Gonzalezrivas JP193
  264. Gorbea MB194
  265. Gottrand F195
  266. Graffiversen S55
  267. Grafnetter D196
  268. Grajda A197
  269. Grammatikopoulou MG198
  270. Gregor RD73
  271. Grodzicki T199
  272. Grontved A86
  273. Grosso G200
  274. Gruden G91
  275. Grujic V201
  276. Gu D202
  277. Guan OP203
  278. Gudmundsson EF204
  279. Gudnason V58
  280. Guerrero R205
  281. Guessous I188
  282. Guimaraes AL446
  283. Gulliford MC206
  284. Gunnlaugsdottir J204
  285. Gunter M207
  286. Gupta PC208
  287. Gupta R209
  288. Gureje O210
  289. Gurzkowska B211
  290. Gutierrez L212
  291. Gutzwiller F165, 269
  292. Hadaegh F63
  293. Halkjaer J213
  294. Hardy R92
  295. Kumar RH19
  296. Hata J214
  297. Hayes AJ75
  298. He J215
  299. He Y216
  300. Hendriks ME217
  301. Henriques A54
  302. Cadena LH218
  303. Herrala S219
  304. Heshmat R220
  305. Hihtaniemi IT2
  306. Ho SY221
  307. Ho SC222
  308. Hobbs M223
  309. Hofman A146
  310. Dinc GH224
  311. Horimoto AR225
  312. Hormiga CM226
  313. Horta BL60
  314. Houti L227
  315. Howitt C15
  316. Htay TT228
  317. Htet AS229
  318. Htike MMT229
  319. Hu Y230
  320. Huerta JM185
  321. Huisman M231
  322. Husseini AS29
  323. Huybrechts I207
  324. Hwalla N232
  325. Iacoviello L138, 191
  326. Iannone AG112
  327. Ibrahim MM233
  328. Wong NI36, 442
  329. Ikeda N234
  330. Ikram MA146
  331. Irazola VE212
  332. Islam M235
  333. Alsafi Ismail A174
  334. Ivkovic V236
  335. Iwasaki M237
  336. Jacobs JM238
  337. Jaddou H74
  338. Jafar T239
  339. Jamrozik K31
  340. Janszky I240
  341. Jasienska G199
  342. Jelakovic A236
  343. Jelakovic B241
  344. Jennings G242
  345. Jeong SL243
  346. Jiang CQ244
  347. Joffres M245
  348. Johansson M207
  349. Jokelainen JJ219
  350. Jonas JB246
  351. Jorgensen T247
  352. Joshi P248
  353. Jozwiak J249
  354. Juolevi A163
  355. Jurak G24
  356. Juresa V23
  357. Kaaks R103
  358. Kafatos A250
  359. Kajantie EO163
  360. Kalterleibovici O124
  361. Kamaruddin NA251
  362. Karki KB57
  363. Kasaeian A8
  364. Katz J252
  365. Kauhanen J253
  366. Kaur P254
  367. Kavousi M146
  368. Kazakbaeva G85
  369. Keil U255
  370. Boker LK256
  371. Keinanenkiukaanniemi S219
  372. Kelishadi R257
  373. Kemper HCG258
  374. Kerimkulova A259
  375. Kersting M260
  376. Key T14
  377. Khader YS74
  378. Khalili D63
  379. Khateeb M39
  380. Khaw KT261
  381. Kiechlkohlendorfer U262
  382. Kiechl S262
  383. Killewo J263
  384. Kim J264
  385. Kim YY243
  386. Klumbiene J79
  387. Knoflach M262
  388. Kolle E49
  389. Kolsteren P265
  390. Korrovits P266
  391. Koskinen S163
  392. Kouda K181
  393. Kowlessur S267
  394. Koziel S268
  395. Kriemler S165, 269
  396. Kristensen PL86
  397. Krokstad S240
  398. Kromhout D270
  399. Kruger HS271
  400. Kubinova R272
  401. Kuciene R79
  402. Kuh D92
  403. Kujala UM273
  404. Kulaga Z211
  405. Kumar RK274
  406. Kurjata P157
  407. Kusuma YS275
  408. Kuulasmaa K163
  409. Kyobutungi C276
  410. Laatikainen T163
  411. Lachat C100
  412. Lam TH221
  413. Landrove O277
  414. Lanska V196
  415. Lappas G278
  416. Larijani B279
  417. Laugsand LE240
  418. Bao KLN151
  419. Le TD151
  420. Leclercq C280
  421. Lee J281
  422. Lee J281
  423. Lehtimaki T282
  424. Leonmunoz LM68
  425. Levitt NS283
  426. Li Y5
  427. Lilly CL284
  428. Lim WY281
  429. Limacosta MF285
  430. Lin HH286
  431. Lin X287
  432. Lind L25
  433. Linneberg A144
  434. Lissner L89
  435. Litwin M211
  436. Lorbeer R288
  437. Lotufo PA80
  438. Lozano JE289
  439. Luksiene D79
  440. Lundqvist A163
  441. Lunet N54
  442. Lytsy P290
  443. Ma G230
  444. Ma J230
  445. Machadocoelho GLL291
  446. Machi S292
  447. Maggi S293
  448. Magliano DJ294
  449. Magriplis E295
  450. Majer M23
  451. Makdisse M296
  452. Malhotra R118
  453. Rao KM19
  454. Malyutina S298
  455. Manios Y299
  456. Mann JI300
  457. Manzato E301
  458. Margozzini P171
  459. Marquesvidal P302
  460. Marques LP142
  461. Marrugat J303
  462. Martorell R304
  463. Mathiesen EB305
  464. Matijasevich A80
  465. Matsha TE306
  466. Mbanya JN59
  467. Posso AJMD307
  468. Mcfarlane SR167
  469. Mcgarvey ST308
  470. Mclachlan S309
  471. Mclean RM300
  472. Mclean SB310
  473. Mcnulty BA311
  474. Medienebenchekor S227
  475. Medzioniene J79
  476. Meirhaeghe A312
  477. Meisinger C155
  478. Menezes AB60
  479. Menon GR64
  480. Meshram II19
  481. Metspalu A173
  482. Meyer HE88
  483. Mi J121
  484. Mikkel K173
  485. Miller JC300
  486. Minderico CS313
  487. Miquel JF171
  488. Miranda JJ7
  489. Mirrakhimov E259
  490. Misigojdurakovic M23
  491. Modesti PA314
  492. Mohamed MK315
  493. Mohammad K8
  494. Mohammadifard N316
  495. Mohan V51
  496. Mohanna S7
  497. Yusoff MFMD36, 442
  498. Mollehave LT144
  499. Moller NC86
  500. Molnar D317
  501. Momenan A63
  502. Mondo CK11
  503. Monyeki KDK447
  504. Moon JS318
  505. Moreira LB180
  506. Morejon A319
  507. Moreno LA320
  508. Morgan K321
  509. Moschonis G322
  510. Mossakowska M323
  511. Mostafa A315
  512. Mota J114
  513. Motlagh ME324
  514. Motta J325
  515. Msyamboza KP326
  516. Thetmu T327
  517. Muiesan ML328
  518. Mullernurasyid M155
  519. Murphy N207
  520. Mursu J253
  521. Musil V23
  522. Nabipour I329
  523. Nagel G330
  524. Naidu BM36, 442
  525. Nakamura H331
  526. Namesna J61
  527. Nang EK281
  528. Nangia VB332
  529. Narake S208
  530. Nauck M333
  531. Navarretemunoz EM185
  532. Ndiaye NC334
  533. Neal WA284
  534. Nenko I199
  535. Neovius M113
  536. Nervi F171
  537. Nguyen CT335
  538. Nguyen ND336
  539. Nguyen QN337
  540. Nguyen QV338
  541. Nietomartinez RE339
  542. Niiranen TJ163, 340
  543. Ning G84
  544. Ninomiya T214
  545. Nishtar S341
  546. Noale M293
  547. Noboa OA94
  548. Noorbala AA8
  549. Norat T2
  550. Noto D69
  551. Al Nsour M342
  552. Oreilly D164
  553. Oda E343
  554. Oehlers G344
  555. Oh K130
  556. Ohara K331
  557. Olinto MTA149
  558. Oliveira IO60
  559. Omar MA36, 442
  560. Onat A110
  561. Ong SK345
  562. Ono LM142
  563. Ordunez P70
  564. Ornelas R346
  565. Osmond C347
  566. Ostojic SM201
  567. Ostovar A329
  568. Otero JA226
  569. Overvad K348
  570. Owusudabo E349
  571. Paccaud FM350
  572. Padez C351
  573. Pahomova E158
  574. Pajak A199
  575. Palli D352
  576. Palmieri L153
  577. Pan WH120
  578. Pandajonas S353
  579. Panza F354
  580. Papandreou D355
  581. Park SW356
  582. Parnell WR300
  583. Parsaeian M8
  584. Patel ND357
  585. Pecin I241, 358
  586. Pednekar MS208
  587. Peer N17
  588. Peeters PH359
  589. Peixoto SV285
  590. Peltonen M163
  591. Pereira AC225
  592. Peters A155
  593. Petersmann A333
  594. Petkeviciene J79
  595. Pham ST360
  596. Pigeot I38
  597. Pikhart H92
  598. Pilav A361
  599. Pilotto L362
  600. Pitakaka F363
  601. Piwonska A157
  602. Plansrubio P364
  603. Polasek O365
  604. Porta M160
  605. Portegies MLP146
  606. Pourshams A366
  607. Poustchi H367
  608. Pradeepa R51
  609. Prashant M64
  610. Price JF309
  611. Puder JJ302
  612. Puiu M127
  613. Punab M266
  614. Qasrawi RF28
  615. Qorbani M368
  616. Bao TQ369
  617. Radic I201
  618. Radisauskas R79
  619. Rahman M33
  620. Raitakari O370
  621. Raj M274
  622. Rao SR254
  623. Ramachandran A117
  624. Ramos E62
  625. Rampal L371
  626. Rampal S372
  627. Rangel Reina DA307
  628. Redon J373
  629. Reganit PM374
  630. Ribeiro R375
  631. Riboli E2
  632. Rigo F376
  633. Rinke De Wit TF377
  634. Rittidias RM378
  635. Robinson SM137
  636. Robitaille C379
  637. Rodriguezartalejo F68
  638. Rodriguezperez MC380
  639. Rodriguezvillamizar LA381
  640. Rojasmartinez R382
  641. Romaguera D140
  642. Ronkainen K253
  643. Rosengren A89
  644. Roy JGR310
  645. Rubinstein A212
  646. Ruizbetancourt BS30
  647. Rutkowski M67
  648. Sabanayagam C203
  649. Sachdev HS383
  650. Saidi O76
  651. Sakarya S384
  652. Salanave B148
  653. Martinez ES218
  654. Salmeron D385
  655. Salomaa V163
  656. Salonen JT386
  657. Salvetti M328
  658. Sanchezabanto J387
  659. Sans S388
  660. Santos DA389
  661. Santos IS60
  662. Santos RN390
  663. Santos R114
  664. Saramies JL391
  665. Sardinha LB389
  666. Sarganas G21
  667. Sarrafzadegan N392
  668. Saum KU103
  669. Savva S393
  670. Scazufca M390
  671. Schargrodsky H394
  672. Schipf S333
  673. Schmidt CO333
  674. Schottker B103
  675. Schultsz C217
  676. Schutte AE17, 271
  677. Sein AA229
  678. Sen A240, 395
  679. Sepanlou SG8
  680. Sharma SK190
  681. Shaw JE294
  682. Shibuya K396
  683. Shin DW397
  684. Shin Y203
  685. Siramlee K345
  686. Siantar R203
  687. Sibai AM232
  688. Silva DAS398
  689. Simon M117
  690. Simons J399
  691. Simons LA26
  692. Sjostrom M113
  693. Skovbjerg S144
  694. Slowikowskahilczer J66
  695. Slusarczyk P323
  696. Smeeth L47
  697. Smith MC14
  698. Snijder MB400
  699. So HK221
  700. Sobngwi E59
  701. Soderberg S175
  702. Solfrizzi V401
  703. Sonestedt E402
  704. Song Y230
  705. Sorensen TIA403
  706. Jerome CS404
  707. Soumare A405
  708. Staessen JA406
  709. Stathopoulou MG334
  710. Stavreski B242
  711. Steenejohannessen J49
  712. Stehle P407
  713. Stein AD304
  714. Stergiou GS408
  715. Stessman J238
  716. Stieber J155
  717. Stockl D155
  718. Stocks T402
  719. Stokwiszewski J409
  720. Stronks K35
  721. Strufaldi MW177
  722. Sun CA410
  723. Sung YT222
  724. Suriyawongpaisal P32
  725. Sy RG374
  726. Tai ES281
  727. Tammesoo ML173
  728. Tamosiunas A79
  729. Tan EJ75
  730. Tang X230
  731. Tanser F186
  732. Tao Y230
  733. Tarawneh MR411
  734. Tarquimamani CB387
  735. Tautu OF134
  736. Taylor A31
  737. Theobald H113
  738. Theodoridis X198
  739. Thijs L406
  740. Thuesen BH144
  741. Tjonneland A213
  742. Tolonen HK163
  743. Tolstrup JS86
  744. Topbas M162
  745. Topormadry R199
  746. Tormo MJ412
  747. Torrent M413
  748. Traissac P414
  749. Trichopoulos D5
  750. Trichopoulou A415
  751. Trinh OTH336
  752. Trivedi A416
  753. Tshepo L417
  754. Tullochreid MK167
  755. Tullu F418
  756. Tuomainen TP253
  757. Tuomilehto J419
  758. Turley ML420
  759. Tynelius P113
  760. Tzourio C405
  761. Ueda P5
  762. Ugel EE421
  763. Ulmer H262
  764. Uusitalo HMT422
  765. Valdivia G171
  766. Valvi D5
  767. Van Der Schouw YT423
  768. Van Herck K100
  769. Van Minh H424
  770. Van Rossem L359
  771. Van Schoor NM425
  772. Van Valkengoed IGM400
  773. Vanderschueren D135
  774. Vanuzzo D362
  775. Vatten L240
  776. Vega T289
  777. Velasquezmelendez G426
  778. Veronesi G191
  779. Verschuren WMM90
  780. Verstraeten R265
  781. Victora CG60
  782. Viet L90
  783. Viikarijuntura E427
  784. Vineis P2
  785. Vioque J428
  786. Virtanen JK253
  787. Visvikissiest S334
  788. Viswanathan B98
  789. Vlasoff T429
  790. Vollenweider P302
  791. Voutilainen S253
  792. Wade AN430
  793. Wagner A431
  794. Walton J104
  795. Wan Bebakar WM174
  796. Wan Mohamud WN432
  797. Wang MD379
  798. Wang Q433
  799. Wang YX434
  800. Wang YW126
  801. Wannamethee SG92
  802. Wareham N261
  803. Wedderkopp N86
  804. Weerasekera D420
  805. Whincup PH435
  806. Widhalm K436
  807. Widyahening IS437
  808. Wiecek A132
  809. Wijga AH90
  810. Wilks RJ167
  811. Willeit J262
  812. Willeit P261, 262
  813. Williams EA52
  814. Wilsgaard T305
  815. Wojtyniak B438
  816. Wongmcclure RA27
  817. Wong JYY345
  818. Wong TY118
  819. Woo J222
  820. Wu AG402
  821. Wu FC172
  822. Wu S123
  823. Xu H439
  824. Yan W440
  825. Yang X216
  826. Ye X287
  827. Yiallouros PK441
  828. Yoshihara A237
  829. Youngercoleman NO167
  830. Yusoff AF36, 442
  831. Zainuddin AA443
  832. Zambon S301
  833. Zampelas A295
  834. Zdrojewski T67
  835. Zeng Y122, 230
  836. Zhao D20
  837. Zhao W216
  838. Zheng W108
  839. Zheng Y203
  840. Zhu D444
  841. Zhussupov B40
  842. Zimmermann E50
  843. Cisneros JZ325

Source: International Journal of Epidemiology Published:2018


Abstract

Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probittransformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the highincome Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups. © The Author(s) 2018.
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