TY - JOUR
T1 - Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure
T2 - A pooled analysis of 1018 population-based measurement studies with 88.6 million participants
AU - NCD Risk Factor Collaboration (NCD-RisC)
AU - Ezzati, Majid
AU - Zhou, Bin
AU - Bentham, James
AU - Di Cesare, Mariachiara
AU - Bixby, Honor
AU - Danaei, Goodarz
AU - Hajifathalian, Kaveh
AU - Taddei, Cristina
AU - Carrillo-Larco, Rodrigo M.
AU - Djalalinia, Shirin
AU - Khatibzadeh, Shahab
AU - Lugero, Charles
AU - Peykari, Niloofar
AU - Zhang, Wan Zhu
AU - Bennett, James
AU - Bilano, Ver
AU - Stevens, Gretchen A.
AU - Cowan, Melanie J.
AU - Riley, Leanne M.
AU - Chen, Zhengming
AU - Hambleton, Ian R.
AU - Jackson, Rod T.
AU - Kengne, Andre Pascal
AU - Khang, Young Ho
AU - Laxmaiah, Avula
AU - Liu, Jing
AU - Malekzadeh, Reza
AU - Neuhauser, Hannelore K.
AU - Sorić, Maroje
AU - Starc, Gregor
AU - Sundström, Johan
AU - Woodward, Mark
AU - Abarca-Gómez, Leandra
AU - Abdeen, Ziad A.
AU - Abu-Rmeileh, Niveen M.
AU - Acosta-Cazares, Benjamin
AU - Adams, Robert J.
AU - Aekplakorn, Wichai
AU - Afsana, Kaosar
AU - Aguilar-Salinas, Carlos A.
AU - Agyemang, Charles
AU - Ahmad, Noor Ani
AU - Ahmadvand, Alireza
AU - Ahrens, Wolfgang
AU - Ajlouni, Kamel
AU - Akhtaeva, Nazgul
AU - Al-Raddadi, Rajaa
AU - Ali, Mohamed M.
AU - Ali, Osman
AU - Alkerwi, Ala'a
N1 - Publisher Copyright:
© The Author(s) 2018.
PY - 2018/6
Y1 - 2018/6
N2 - 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.
AB - 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.
KW - Blood pressure
KW - Global health
KW - Hypertension
KW - Non-communicable disease
KW - Population health
UR - https://www.scopus.com/pages/publications/85050702158
U2 - 10.1093/ije/dyy016
DO - 10.1093/ije/dyy016
M3 - Artículo
C2 - 29579276
AN - SCOPUS:85050702158
SN - 0300-5771
VL - 47
SP - 872-883i
JO - International Journal of Epidemiology
JF - International Journal of Epidemiology
IS - 3
ER -
ODS 3: Salud y bienestar