Global increase in elevated systolic blood pressure and associated deaths
medwireNews: The number of people with elevated systolic blood pressure (SBP) and the number of associated deaths have “increased substantially” in the past 25 years, results from the Global Burden of Disease, Injuries, and Risk Factors (GBD) 2015 study suggest.
“Compared with all other specific risks quantified in the GBD, SBP of at least 110 to 115 mmHg was the leading global contributor to preventable death in 2015,” Christopher Murray (Institute for Health Metrics and Evaluation, Seattle, Washington, USA) and colleagues write in JAMA.
The researchers analyzed data from 8.69 million participants of 844 studies conducted in 154 countries, and found that the projected number of people worldwide with SBP of at least 110 to 115 mmHg increased from 1.87 billion in 1990 to 3.47 billion in 2015.
SBP of at least 110 to 115 mmHg was associated with 10.7 million deaths in 2015, an approximate 1.5-fold increase since 1990, and the associated number of disability-adjusted life years (DALYs) increased from 148 million in 1990 to 211 million in 2015.
“These findings support increased efforts to control the burden of SBP of at least 110 to 115mmHg to reduce disease burden,” say the authors.
Additionally, the number of people with SPB of 140 mmHg or higher increased from a projected 442 million in 1990 to 874 million in 2015, with an estimated 1.5-fold increase in the annual number of associated deaths from 5.19 million in 1990 to 7.8 million in 2015.
Ischemic heart disease was identified as the most important contributor to SBP-related deaths, followed by hemorrhagic stroke and ischemic stroke.
In analyses by country, Murray and colleagues found that China, India, Russia, Indonesia, and the USA accounted for more than half of global DALYs related to SBP of at least 110 to 115mmHg.
Although the researchers caution that there was “uncertainty in some estimates” – mean SBP levels were estimated using statistical models for 41 countries with no survey data – they note that their analysis is “based on the largest available set of data” and provides “a consistent analysis of time trends from 1990 to 2015.”
The authors of an accompanying editorial, Mark Huffman and Donald Lloyd-Jones (both from Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA), agree, commenting that “[e]ven if the extensive amounts of data are fuzzy and imperfect, they provide valuable estimates of current global disease burden.”
And they believe that the GBD 2015 data “strengthen the case to lower the risk for cardiovascular diseases in those with SBP of 140 mm Hg or higher by all effective means available, including improving uptake of healthy diets, minimizing weight gain or promoting weight loss in overweight and obese individuals, and promoting uptake and adherence to effective blood pressure-lowering drugs as well as management of related cardiovascular risk.”
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