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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dc.contributor.author NCD Risk Factor Collaboration (NCD-RisC)
dc.date.accessioned 2016-11-29T16:10:24Z
dc.date.available 2016-11-29T16:10:24Z
dc.date.issued 2016-11
dc.identifier.citation NCD Risk Factor Collaboration (NCD-RisC) (2016) 'Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19·1 million participants', The Lancet, Article in Press. doi: 10.1016/S0140-6736(16)31919-5 en
dc.identifier.issn 0140-6736
dc.identifier.uri http://hdl.handle.net/10468/3324
dc.identifier.doi 10.1016/S0140-6736(16)31919-5
dc.description.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. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Elsevier en
dc.rights © The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license en
dc.rights.uri https://creativecommons.org/licenses/by/4.0/ en
dc.subject Blood pressure en
dc.subject Systolic blood pressure en
dc.subject Cardiovascular diseases en
dc.subject Chronic kidney disease en
dc.subject Worldwide trends en
dc.subject Population-based studies en
dc.subject NCD Risk Factor Collaboration en
dc.title Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19·1 million participants en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Janette Walton, Firm Programme, University College Cork, Cork, Ireland. +353-21-490-3000 Email: janette.walton@ucc.ie en
dc.internal.availability Full text available en
dc.date.updated 2016-11-29T16:03:12Z
dc.description.version Published Version en
dc.internal.rssid 373745993
dc.contributor.funder Wellcome Trust en
dc.description.status Peer reviewed en
dc.identifier.journaltitle The Lancet en
dc.internal.copyrightchecked No !!CORA!! en
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress janette.walton@ucc.ie en


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© The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license Except where otherwise noted, this item's license is described as © The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license
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