Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19·1 million participants

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Abstract

Background Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defined as systolic blood pressure of 140 mm Hg or higher or diastolic blood pressure of 90 mm Hg or higher. Methods For this analysis, we pooled national, subnational, or community population-based studies that had measured blood pressure in adults aged 18 years and older. We used a Bayesian hierarchical model to estimate trends from 1975 to 2015 in mean systolic and mean diastolic blood pressure, and the prevalence of raised blood pressure for 200 countries. We calculated the contributions of changes in prevalence versus population growth and ageing to the increase in the number of adults with raised blood pressure. Findings We pooled 1479 studies that had measured the blood pressures of 19·1 million adults. Global age-standardised mean systolic blood pressure in 2015 was 127·0 mm Hg (95% credible interval 125·7–128·3) in men and 122·3 mm Hg (121·0–123·6) in women; age-standardised mean diastolic blood pressure was 78·7 mm Hg (77·9–79·5) for men and 76·7 mm Hg (75·9–77·6) for women. Global age-standardised prevalence of raised blood pressure was 24·1% (21·4–27·1) in men and 20·1% (17·8–22·5) in women in 2015. Mean systolic and mean diastolic blood pressure decreased substantially from 1975 to 2015 in high-income western and Asia Pacific countries, moving these countries from having some of the highest worldwide blood pressure in 1975 to the lowest in 2015. Mean blood pressure also decreased in women in central and eastern Europe, Latin America and the Caribbean, and, more recently, central Asia, Middle East, and north Africa, but the estimated trends in these super-regions had larger uncertainty than in high-income super-regions. By contrast, mean blood pressure might have increased in east and southeast Asia, south Asia, Oceania, and sub-Saharan Africa. In 2015, central and eastern Europe, sub-Saharan Africa, and south Asia had the highest blood pressure levels. Prevalence of raised blood pressure decreased in high-income and some middle-income countries; it remained unchanged elsewhere. The number of adults with raised blood pressure increased from 594 million in 1975 to 1·13 billion in 2015, with the increase largely in low-income and middle-income countries. The global increase in the number of adults with raised blood pressure is a net effect of increase due to population growth and ageing, and decrease due to declining age-specific prevalence. Interpretation During the past four decades, the highest worldwide blood pressure levels have shifted from high-income countries to low-income countries in south Asia and sub-Saharan Africa due to opposite trends, while blood pressure has been persistently high in central and eastern Europe. Funding Wellcome Trust.

Detaljer

Författare
Enheter & grupper
Externa organisationer
  • Imperial College London
  • Middlesex University
  • Harvard University
  • World Health Organization Centre for Health Development
  • University of California, Berkeley
  • Tufts University
  • Cayetano Heredia University
  • Tehran University of Medical Sciences
  • Brandeis University
  • Mulago Hospital
  • Yale University
  • Lausanne University Hospital
  • Ministry of Health, Seychelles
  • National Center for Cardiovascular Diseases
  • National Institute of Health and Nutrition Tokyo
  • University of Auckland
  • Simon Fraser University
  • South African Medical Research Council
  • National Institute for Health and Welfare
  • University of Hong Kong
  • National Institute of Nutrition, India
  • Capital University of Medical Sciences
  • Robert Koch Institut
  • Uppsala universitet
  • London School of Hygiene and Tropical Medicine
  • University of Zagreb
  • University of Sydney
  • University of Oxford
  • Costa Rican Social Security Fund (CCSS)
  • Al-Quds University
  • Qatar University
  • Birzeit University
  • Instituto Mexicano del Seguro Social
  • University of Adelaide
  • Mahidol University
  • Bangladesh Rural Advancement Committee (BRAC)
Forskningsområden

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Originalspråkengelska
Sidor (från-till)37-55
Antal sidor19
TidskriftThe Lancet
Volym389
Utgåva nummer10064
StatusPublished - 2017 jan 7
PublikationskategoriForskning
Peer review utfördJa