TY  - JOUR
TI  - Global Burden of Hypertension and Systolic Blood Pressure of at Least 110 to 115 mm Hg, 1990-2015
AU  - Mohammad H. Forouzanfar
AU  - Patrick Liu
AU  - Gregory A. Roth
AU  - Marie Ng
AU  - Stan Biryukov
AU  - Laurie B. Marczak
AU  - Lily Alexander
AU  - Kara Estep
AU  - Kalkidan Hassen Abate
AU  - Tomi Akinyemiju
AU  - Raghib Ali
AU  - Nelson Alvis‐Guzmán
AU  - Peter Azzopardi
AU  - Amitava Banerjee
AU  - Till Bärnighausen
AU  - Arindam Basu
AU  - Tolesa Bekele
AU  - Derrick Bennett
AU  - Sibhatu Biadgilign
AU  - Ferrán Catalá-López
AU  - Valery L. Feigin
AU  - João Carlos Fernandes
AU  - Florian Fischer
AU  - Alemseged Aregay Gebru
AU  - Philimon Gona
AU  - Rajeev Gupta
AU  - Graeme J. Hankey
AU  - Jost B. Jonas
AU  - Suzanne E. Judd
AU  - Young‐Ho Khang
AU  - Ardeshir Khosravi
AU  - Yun Jin Kim
AU  - Ruth W Kimokoti
AU  - Yoshihiro Kokubo
AU  - Dhaval Kolte
AU  - Alan D López
AU  - Paulo A. Lotufo
AU  - Reza Malekzadeh
AU  - Yohannes Adama Melaku
AU  - George A. Mensah
AU  - Awoke Misganaw
AU  - Ali H. Mokdad
AU  - Andrew Moran
AU  - Haseeb Nawaz
AU  - Bruce Neal
AU  - Frida Ngalesoni
AU  - Takayoshi Ohkubo
AU  - Farshad Pourmalek
AU  - Anwar Rafay
AU  - Rajesh Kumar
AU  - David Rojas‐Rueda
AU  - Uchechukwu K.A. Sampson
AU  - Itamar S Santos
AU  - Monika Sawhney
AU  - Aletta E. Schutte
AU  - Sadaf G Sepanlou
AU  - Girma Temam Shifa
AU  - Ivy Shiue
AU  - Bemnet Tedla
AU  - Amanda G. Thrift
AU  - Marcello Tonelli
AU  - Thomas Truelsen
AU  - Nikolaos Tsilimparis
AU  - Kingsley Nnanna Ukwaja
AU  - Olalekan A. Uthman
AU  - Tommi Vasankari
AU  - Narayanaswamy Venketasubramanian
AU  - Vasily Vlassov
AU  - Theo Vos
AU  - Ronny Westerman
AU  - Lijing L. Yan
AU  - Yuichiro Yano
AU  - Naohiro Yonemoto
AU  - Maysaa El Sayed Zaki
AU  - Christopher J L Murray
PY  - 2017
JO  - JAMA
DO  - 10.1001/jama.2016.19043
UR  - https://doi.org/10.1001/jama.2016.19043
AB  - Importance: Elevated systolic blood (SBP) pressure is a leading global health risk. Quantifying the levels of SBP is important to guide prevention policies and interventions. Objective: To estimate the association between SBP of at least 110 to 115 mm Hg and SBP of 140 mm Hg or higher and the burden of different causes of death and disability by age and sex for 195 countries and territories, 1990-2015. Design: A comparative risk assessment of health loss related to SBP. Estimated distribution of SBP was based on 844 studies from 154 countries (published 1980-2015) of 8.69 million participants. Spatiotemporal Gaussian process regression was used to generate estimates of mean SBP and adjusted variance for each age, sex, country, and year. Diseases with sufficient evidence for a causal relationship with high SBP (eg, ischemic heart disease, ischemic stroke, and hemorrhagic stroke) were included in the primary analysis. Main Outcomes and Measures: Mean SBP level, cause-specific deaths, and health burden related to SBP (≥110-115 mm Hg and also ≥140 mm Hg) by age, sex, country, and year. Results: Between 1990-2015, the rate of SBP of at least 110 to 115 mm Hg increased from 73 119 (95% uncertainty interval [UI], 67 949-78 241) to 81 373 (95% UI, 76 814-85 770) per 100 000, and SBP of 140 mm Hg or higher increased from 17 307 (95% UI, 17 117-17 492) to 20 526 (95% UI, 20 283-20 746) per 100 000. The estimated annual death rate per 100 000 associated with SBP of at least 110 to 115 mm Hg increased from 135.6 (95% UI, 122.4-148.1) to 145.2 (95% UI 130.3-159.9) and the rate for SBP of 140 mm Hg or higher increased from 97.9 (95% UI, 87.5-108.1) to 106.3 (95% UI, 94.6-118.1). For loss of DALYs associated with systolic blood pressure of 140 mm Hg or higher, the loss increased from 95.9 million (95% uncertainty interval [UI], 87.0-104.9 million) to 143.0 million (95% UI, 130.2-157.0 million) [corrected], and for SBP of 140 mm Hg or higher, the loss increased from 5.2 million (95% UI, 4.6-5.7 million) to 7.8 million (95% UI, 7.0-8.7 million). The largest numbers of SBP-related deaths were caused by ischemic heart disease (4.9 million [95% UI, 4.0-5.7 million]; 54.5%), hemorrhagic stroke (2.0 million [95% UI, 1.6-2.3 million]; 58.3%), and ischemic stroke (1.5 million [95% UI, 1.2-1.8 million]; 50.0%). In 2015, China, India, Russia, Indonesia, and the United States accounted for more than half of the global DALYs related to SBP of at least 110 to 115 mm Hg. Conclusions and Relevance: In international surveys, although there is uncertainty in some estimates, the rate of elevated SBP (≥110-115 and ≥140 mm Hg) increased substantially between 1990 and 2015, and DALYs and deaths associated with elevated SBP also increased. Projections based on this sample suggest that in 2015, an estimated 3.5 billion adults had SBP of at least 110 to 115 mm Hg and 874 million adults had SBP of 140 mm Hg or higher.
ER  -