Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

NCD Risk Factor Collaboration (NCD-RisC), Bin Zhou, James Bentham, Mariachiara Di Cesare, Honor Bixby, Goodarz Danaei, Kaveh Hajifathalian, Cristina Taddei, Rodrigo M. Carrillo-Larco, Shirin Djalalinia, Shahab Khatibzadeh, Charles Lugero, Niloofar Peykari , Wan Zhu Zhang, James Bennett, Ver Bilano, Gretchen A. Stevens, Melanie J. Cowan, Leanne M. Riley, Zhengming ChenIan R. Hambleton, Rod T. Jackson , Andre Pascal Kengne, Young-Ho Khang, Avula Laxmaiah, Jing Liu, Reza Malekzadeh, Hannelore K. Neuhauser , Maroje Sorić, Gregor Starc, Johan Sundstrom, Mark Woodward, Majid Ezzati, Leandra Abarca-Gómez, Ziad A. Abdeen, Niveen Abu-Rmeileh, Benjamin Acosta-Cazares, Robert Adams, Wichai Aekplakorn, Kaosar Afsana, Carlos A. Aguilar-Salinas, Charles Agyemang, Noor Ani Ahmad, Alireza Ahmadvand, Wolfgang Ahrens, Kamel Ajlouni, Nazgul Akhtaeva, Rajaa Al-Raddadi, Mohamed M. Ali, Osman Ali, Ala'a Alkerwi, Eman Aly, Deepak N. Amarapurkar, Philippe Amouyel, Antoinette Amuzu, Lars Bo Andersen, Sigmund A. Anderssen, Lars H. Ängquist, Ranjit Mohan Anjana, Daniel Ansong, Hajer Aounallah-Skhiri, Joana Araújo, Inger Ariansen, Tahir Aris, Nimmathota Arlappa, Dominique Arveiler, Krishna K. Aryal, Thor Aspelund, Felix K. Assah, Maria Cecília F. Assunção, Mária Avdicová, Ana Azevedo, Fereidoun Azizi, Bontha V. Babu, Suhad Bahijri, Nagalla Balakrishna, Mohamed Bamoshmoosh, Maciej Banach, Piotr Bandosz, José R. Banegas, Carlo M. Barbagallo, Alberto Barceló, Amina Barkat, Aluisio J. D. Barros, Mauro V. Barros, Iqbal Bata, Anwar M. Batieha, Assembekov Batyrbek, Louise A. Baur, Robert Beaglehole, Habiba Ben Romdhane, Mikhail Benet, Lowell S. Benson, Antonio Bernabe-Ortiz, Gailute Bernotiene, Heloisa Bettiol, Aroor Bhagyalaxmi, Sumit Bharadwaj, Santosh K. Bhargava, Yufang Bi, Mukharram Bikbov, Bihungum Bista, Peter Bjerregaard, Espen Bjertness, Marius B. Bjertness, Cecilia Bjökelund, Anneke Blokstra, Simona Bo, Martin Bobak, Heiner Boeing, Jose G. Boggia, Carlos P. Boissonnet, Vanina Bongard, Rossana Borchini, Pascal Bovet, Lutgart Braeckman, Imperia Brajkovich, Francesco Branca, Juergen Breckenkamp, Hermann Brenner, Lizzy M. Brewster, Graziella Bruno, H. Bas Bueno-de-Mesquita, Anna Bugge, Con Burns, Michael Bursztyn, Antonio Cabrera De León, Joseph Cacciottolo, Hui Cai, Christine Cameron, Günay Can, Ana Paula C. Cândido, Vincenzo Capuano, Viviane C. Cardoso, Axel C. Carlsson, Maria J. Carvalho, Felipe F. Casanueva, Juan-Pablo Casas, Carmelo A. Caserta, Snehalatha Chamukuttan, Angelique W. Chan, Queenie Chan, Himanshu K. Chaturvedi, Nishi Chaturvedi, Chien Jen Chen, Fangfang Chen, Huashuai Chen, Shuohua Chen, Zhengming Chen, Ching-Yu Cheng, Imane Cherkaoui Dekkaki, Angela Chetrit, Arnaud Chiolero, Shu-Ti Chiou, Adela Chirita-Emandi, María-Dolores Chirlaque, Belong Cho, Yumi Cho, Diego G. Christofaro, Jerzy Chudek, Renata Cifkova, Eliza Cinteza, Frank Claessens, Els Clays, Hans Concin, Cyrus Cooper, Rachel Cooper, Tara C. Coppinger, Simona Costanzo, Dominique Cottel, Chris Cowell, Cora L. Craig, Ana B. Crujeiras, Juan J. Cruz, Graziella D'Arrigo, Eleonora D'Orsi, Jean Dallongeville, Albertino Damasceno, Goodarz Danaei, Rachel Dankner, Thomas M. Dantoft , Luc Dauchet, Kairat Davletov, Guy De Backer, Dirk De Bacquer, Giovanni De Gaetano, Stefaan De Henauw, Paula Duarte de Oliveira, Delphine De Smedt, Mohan Deepa, Abbas Dehghan, Hélène Delisle, Valérie Deschamps, Klodian Dhana, Augusto F. Di Castelnuovo, Juvenal Soares Dias-Da-Costa, Alejandro Diaz, Ty T. Dickerson, Shirin Djalalinia, Ha T.P. Do, Annette J. Dobson, Chiara Donfrancesco, Silvana P. Donoso, Angela Döring, Maria Dorobantu, Kouamelan Doua, Wojciech Drygas, Virginija Dulskiene, Aleksandar Džakula, Vilnis Dzerve, Elzbieta Dziankowska-Zaborszczyk, Robert Eggertsen, Ulf Ekelund, Jalila El Ati, Paul Elliott, Roberto Elosua , Rajiv T. Erasmus, Cihangir Erem, Louise Eriksen, Johan G. Eriksson, Jorge Escobedo De La Peña, Alun Evans, David Faeh, Caroline H. Fall, Farshad Farzadfar, Francisco J. Felix-Redondo, Trevor S. Ferguson, Romulo A. Fernandes, Daniel Fernández-Bergés, Daniel Ferrante, Marika Ferrari, Catterina Ferreccio, Jean Ferrieres, Joseph D. Finn, Krista Fischer, Bernhard Föger, Leng Huat Foo, Ann Sofie Forslund, Maria Forsner, Heba M. Fouad, Damian K. Francis

Research output: Contribution to journalArticlepeer-review

24 Citations (Scopus)
4 Downloads (Pure)

Abstract

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.

Original languageEnglish
Pages (from-to)872-883i
Number of pages12
JournalInternational Journal of Epidemiology
Volume47
Issue number3
DOIs
Publication statusPublished - Jun 2018
Externally publishedYes

Bibliographical note

Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

Keywords

  • Blood pressure
  • Global health
  • Hypertension
  • Non-communicable disease
  • Population health

Fingerprint Dive into the research topics of 'Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants'. Together they form a unique fingerprint.

Cite this