TY - JOUR
T1 - Global Burden of Hypertension and Systolic Blood Pressure of at Least 110 to 115 mm Hg, 1990-2015
AU - Forouzanfar, Mohammad
AU - Liu, Patrick
AU - Roth, Gregory
AU - Ng, Marie
AU - Biryukov, Stan
AU - Marczak, Laurie
AU - Alexander, Lily
AU - Estep, Kara
AU - Hassen Abate, Kalkidan
AU - Akinyemiju, Tomi F.
AU - Ali, Raghib
AU - Alvis-Guzman, Nelson
AU - Azzopardi, Peter
AU - Banerjee, Amitava
AU - Bärnighausen, Till
AU - Basu, Arindam
AU - Bekele, Tolesa
AU - Bennett, Derrick
AU - Biadgilign, Sibhatu
AU - Catalá-López, Ferrán
AU - Feigin, Valery
AU - Fernandes, João C.
AU - Fischer, Florian
AU - Gebru, Alemseged Aregay
AU - Gona, Philimon
AU - Gupta, Rajeev
AU - Hankey, Graeme
AU - Jonas, Jost
AU - Judd, Suzanne
AU - Khang, Young-Ho
AU - Khosravi, Ardeshir
AU - Kim, Yunjin
AU - Kimokoti, Ruth
AU - Kokubo, Yoshihiro
AU - Kolte, Dhaval
AU - Lopez, Alan
AU - Lotufo, Paulo
AU - Malekzadeh, Reza
AU - Melaku, Yohannes Adama
AU - Mensah, George
AU - Misganaw, Awoke
AU - Mokdad, Ali
AU - Moran, Andrew
AU - Nawaz, Haseeb
AU - Neal, Bruce
AU - Ngalesoni, Frida Namnyak
AU - Ohkubo, Takayoshi
AU - Pourmalek, Farshad
AU - Rafay, Anwar
AU - Rai, Rajesh Kumar
AU - Rojas-Rueda, David
AU - Sampson, Uchechukwu
AU - Santos, Itamar
AU - Sawhney, Monika
AU - Schutte, Aletta Elisabeth
AU - Sepanlou, Sadaf
AU - Shifa, Girma Temam
AU - Shiue, Ivy
AU - Tedla, Bemnet Amare
AU - Thrift, Amanda
AU - Tonelli, Marcello
AU - Truelsen, Thomas
AU - Tsilimparis, Nikolaos
AU - Ukwaja, Kingsley Nnanna
AU - Uthman, Olalekan
AU - Vasankari, Tommi
AU - Venketasubramanian, Narayanaswamy
AU - Vlassov, Vasiliy Victorovich
AU - Vos, Theo
AU - Westerman, Ronny
AU - Yan, Lijing
AU - Yano, Yuichiro
AU - Yonemoto, Naohiro
AU - Zaki, Maysaa El Sayed
AU - Murray, Christopher
PY - 2017/1/10
Y1 - 2017/1/10
N2 - 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 115 mm Hg and SBP of 140 mm Hg 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 (≥110-115 mm Hg and also ≥140 mm Hg) by age, sex, country, and year.
Results
Between 1990-2015, the rate of SBP of at least 110 to 115 mm Hg increased from 73 119 (95% uncertainty interval [UI], 67 949-78 241) to 81 373 (95% UI, 76 814-85 770) per 100 000, and SBP of 140 mm Hg or higher increased from 17 307 (95% UI, 17 117-17 492) to 20 526 (95% UI, 20 283-20 746) per 100 000. The estimated annual death rate per 100 000 associated with SBP of at least 110 to 115 mm Hg 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 140 mm Hg 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 115 mm Hg increased from 148 million (95% UI, 134-162 million) to 211 million (95% UI, 193-231 million), and for SBP of 140 mm Hg or higher, the loss increased from 95.9 million (95% UI, 87.0-104.9 million) to 143.0 million (95% UI, 130.2-157.0 million). The largest numbers of SBP-related deaths were caused by ischemic heart disease (4.9 million [95% UI, 4.0-5.7 million]; 54.5%), hemorrhagic stroke (2.0 million [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 global DALYs related to SBP of at least 110 to 115 mm Hg.
Conclusions and Relevance
In international surveys, although there is uncertainty in some estimates, the rate of elevated SBP (≥110-115 and ≥140 mm Hg) 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 115 mm Hg and 874 million adults had SBP of 140 mm Hg or higher
AB - 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 115 mm Hg and SBP of 140 mm Hg 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 (≥110-115 mm Hg and also ≥140 mm Hg) by age, sex, country, and year.
Results
Between 1990-2015, the rate of SBP of at least 110 to 115 mm Hg increased from 73 119 (95% uncertainty interval [UI], 67 949-78 241) to 81 373 (95% UI, 76 814-85 770) per 100 000, and SBP of 140 mm Hg or higher increased from 17 307 (95% UI, 17 117-17 492) to 20 526 (95% UI, 20 283-20 746) per 100 000. The estimated annual death rate per 100 000 associated with SBP of at least 110 to 115 mm Hg 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 140 mm Hg 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 115 mm Hg increased from 148 million (95% UI, 134-162 million) to 211 million (95% UI, 193-231 million), and for SBP of 140 mm Hg or higher, the loss increased from 95.9 million (95% UI, 87.0-104.9 million) to 143.0 million (95% UI, 130.2-157.0 million). The largest numbers of SBP-related deaths were caused by ischemic heart disease (4.9 million [95% UI, 4.0-5.7 million]; 54.5%), hemorrhagic stroke (2.0 million [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 global DALYs related to SBP of at least 110 to 115 mm Hg.
Conclusions and Relevance
In international surveys, although there is uncertainty in some estimates, the rate of elevated SBP (≥110-115 and ≥140 mm Hg) 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 115 mm Hg and 874 million adults had SBP of 140 mm Hg or higher
U2 - 10.1001/jama.2016.19043
DO - 10.1001/jama.2016.19043
M3 - Article
SN - 0098-7484
SN - 1538-3598
VL - 317
SP - 165
JO - JAMA
JF - JAMA
IS - 2
ER -
