Global Burden of Hypertension and Systolic Blood Pressure of at Least 110 to 115 mm Hg, 1990-2015.
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Forouzanfar Mohammad H, Liu Patrick, Roth Gregory A, Ng Marie, Biryukov Stan, Marczak Laurie, Alexander Lily, Estep Kara, Hassen Abate Kalkidan, Akinyemiju Tomi F, Ali Raghib, Alvis-Guzman Nelson, Azzopardi Peter, Banerjee Amitava, Bärnighausen Till, Basu Arindam, Bekele Tolesa, Bennett Derrick A, Biadgilign Sibhatu, Catalá-López Ferrán, Feigin Valery L, Fernandes Joao C, Fischer Florian, Gebru Alemseged Aregay, Gona Philimon, Gupta Rajeev, Hankey Graeme J, Jonas Jost B, Judd Suzanne E, Khang Young-Ho, Khosravi Ardeshir, Kim Yun Jin, Kimokoti Ruth W, Kokubo Yoshihiro, Kolte Dhaval, Lopez Alan, Lotufo Paulo A, Malekzadeh Reza, Melaku Yohannes Adama, Mensah George A, Misganaw Awoke, Mokdad Ali H, Moran Andrew E, Nawaz Haseeb, Neal Bruce, Ngalesoni Frida Namnyak, Ohkubo Takayoshi, Pourmalek Farshad, Rafay Anwar, Rai Rajesh Kumar, Rojas-Rueda David, Sampson Uchechukwu K, Santos Itamar S, Sawhney Monika, Schutte Aletta E, Sepanlou Sadaf G, Shifa Girma Temam, Shiue Ivy, Tedla Bemnet Amare, Thrift Amanda G, Tonelli Marcello, Truelsen Thomas, Tsilimparis Nikolaos, Ukwaja Kingsley Nnanna, Uthman Olalekan A, Vasankari Tommi, Venketasubramanian Narayanaswamy, Vlassov Vasiliy Victorovich, Vos Theo, Westerman Ronny, Yan Lijing L, Yano Yuichiro, Yonemoto Naohiro, Zaki Maysaa El Sayed, Murray Christopher J L
Аннотация
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). For loss of DALYs associated with systolic blood pressure of 140 mm Hg or higher, the loss increased from 95.9 million (95% uncertainty interval [UI], 87.0-104.9 million) to 143.0 million (95% UI, 130.2-157.0 million) [corrected], and for SBP of 140 mm Hg or higher, the loss increased from 5.2 million (95% UI, 4.6-5.7 million) to 7.8 million (95% UI, 7.0-8.7 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.