TY - JOUR
T1 - Worldwide trends in blood pressure from 1975 to 2015
T2 - a pooled analysis of 1479 population-based measurement studies with 19·1 million participants
AU - Zhou, B.
AU - Bentham, James
AU - Di Cesare, Mariachiara
AU - Bixby, Honor
AU - Danaei, Goodarz
AU - Cowan, Melanie J.
AU - Paciorek, Christopher J.
AU - Singh, Gitanjali
AU - Hajifathalian, Kaveh
AU - Bennett, James E.
AU - Taddei, Cristina
AU - Bilano, Ver
AU - Carrillo-Larco, Rodrigo M.
AU - Djalalinia, Shirin
AU - Khatibzadeh, Shahab
AU - Lugero, Charles
AU - Peykari, Niloofar
AU - Zhang, Wan Zhu
AU - Lu, Yuan
AU - Stevens, Gretchen A.
AU - Riley, Leanne M.
AU - Bovet, Pascal
AU - Elliott, Paul
AU - Gu, Dongfeng
AU - Ikeda, Nayu
AU - Jackson, Rod T.
AU - Joffres, Michel
AU - Kengne, Andre Pascal
AU - Laatikainen, Tiina
AU - Lam, Tai Hing
AU - Laxmaiah, Avula
AU - Liu, Jing
AU - Miranda, J. Jaime
AU - Mondo, Charles K.
AU - Neuhauser, Hannelore K.
AU - Sundström, Johan
AU - Smeeth, Liam
AU - Sorić, Maroje
AU - Woodward, Mark
AU - Ezzati, Majid
AU - Abarca-Gómez, Leandra
AU - Abdeen, Ziad A.
AU - Rahim, Hanan Abdul
AU - Abu-Rmeileh, Niveen M.
AU - Acosta-Cazares, Benjamin
AU - Peeters, Petra H.
AU - van der Schouw, Yvonne T.
AU - van Rossem, Lenie
AU - Verschuren, W. M.Monique
AU - Widyahening, Indah S.
N1 - Publisher Copyright:
© 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2017/1/7
Y1 - 2017/1/7
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85006784962&partnerID=8YFLogxK
U2 - 10.1016/S0140-6736(16)31919-5
DO - 10.1016/S0140-6736(16)31919-5
M3 - Article
C2 - 27863813
AN - SCOPUS:85006784962
SN - 0140-6736
VL - 389
SP - 37
EP - 55
JO - The Lancet
JF - The Lancet
IS - 10064
ER -