Abstract 062: Global Patterns Of Mean Systolic Blood Pressure Over Three Decades: Results From The Global Burden Of Disease 2019 Study

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Saate S Shakil ◽  
Catherine O Johnson ◽  
Gregory A Roth ◽  
Christian A Razo

Background: Atherosclerotic cardiovascular disease and its risk factors are increasing globally. We estimated global and regional mean levels of systolic blood pressure (SBP) for the Global Burden of Disease (GBD) 2019 study. Methods: Mean SBP in mm Hg was estimated by age (adults >25 years), sex, location and year using all available population-based health surveys and studies that systematically measured brachial blood pressure. Estimates were produced using a Bayesian statistical model, spatiotemporal Gaussian process regression, which produces a smoothed time series from 1990 to 2019, borrowing strength over space and time, then aggregates to GBD regions. Each point in the figure represents age- and sex-specific mean SBP for one of 21 GBD regions, color coded by the 7 GBD super regions; black triangles denote global mean SBP. We report 95% uncertainty intervals in brackets. Results: Globally, mean SBP increased with age, peaking at 75-84 years, followed by a plateau and slight decline amongst oldest adults. In adults >60 in 1990 and >70 in 2019, females had higher SBP than males globally; this difference declined over time. In 1990, mean SBP was highest among females in Central Europe aged 60-64 (150 [147- 154]) and High-income Asia Pacific aged 80-84 (150 [147 - 152]), and in males aged 80-84 in Western Europe (150 [147-152]) and High-income Asia Pacific (148 [146 - 150]). By 2019, mean SBP was highest among adults aged 80-84 in Western and Southern Sub-Saharan Africa for both females (150 [136 - 164]; 149 [142 - 156], respectively), and males (145 [140 - 150]; 144 [136 - 153], respectively). Conclusions: SBP increased globally with age and was higher in older women than men. The 5-year age group with highest estimated SBP shifted over time from parts of Europe and High-income Asia Pacific to parts of Sub-Saharan Africa. Elevated SBP remains a major health risk for the world’s population, suggesting a need for increased investments in understanding its etiologies and how to treat and eventually prevent it as a cause of disease.

2005 ◽  
Vol 61 (2) ◽  
Author(s):  
J. M. Frantz

There is mounting evidence of the rising incidence and prevalence of non-communicable diseases in developing countries. Governments are facing serious challenges in health care due to the rising trends in non-communicable diseases as a result of demographic and epidemiological changes, as well as economic globalization. Cardiovascular disease, cancers, diabetes, respiratory disease, obesity andother non-communicable conditions now account for 59 percent of the 56.5 million global deaths annually, and almost half, or 46 percent, of the global burden of disease. It is estimated that by 2020, non-communicable diseases will account for 60% of the global burden of disease. The burden of non-communicable diseases in sub-Saharan Africa is already substantial, and patients with these conditions make significant demands on health resources. How do these changes affect physiotherapists? This paper aims to highlight the need for physiotherapists to shift their focus from curative to preventive care in order to face the challenge of non-communicable diseases.


2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S57-S58
Author(s):  
Zachary J Collier ◽  
Priyanka Naidu ◽  
Katherine J Choi ◽  
Christopher H Pham ◽  
Tom Potokar ◽  
...  

Abstract Introduction Over 1 million burns occur in Sub-Saharan Africa (SSA) each year leading to significant morbidity and mortality. Financial constraints, social stigma, political strife, inaccessible healthcare facilities, limited perioperative resources, and low workforce capacity results in steep barriers to obtaining timely and effective burn care. This study set out to better define the burn burden as well as the age and gender-related disparities within SSA, to identify specific sub-regions and countries that would benefit most from targeted interventions to enhance burn care. Methods Data for all 46 SSA countries were acquired from the 2017 Global Burden of Disease (GBD17) database of the Global Health Data Exchange. Information regarding fire, heat, and hot substance-related injuries was derived from 17,792 data sources to estimate burn-related incidence, deaths, and Disability Adjusted Life Years (DALYs) by year, sex, age, and location from 1990 to 2017. Summative statistics were created for burn incidence, deaths, DALYs, and mortality ratio (deaths: incidence; %). Spatial mapping was performed to identify burn burden for specific regions and countries. Results An estimated 28,127,199 burns occurred in SSA from 1990–2017. On average, SSA accounted for 16% of worldwide burns, 21% of burn deaths, and 25% of DALYs. Furthermore, the mortality rate was 2.2 times the global average and remained nearly double the entire 27-year period. While all SSA regions had higher incidence, deaths, and DALYs compared to the global cohort, the Southern SSA region consistently had the highest incidence (211 cases per 100,000), deaths (7 per 100,000), and DALYs (355 years per 100,000) throughout the time period, with Lesotho, Swaziland, and Zimbabwe having the highest rates. In contrast to gender similarities globally for burn indicators, all regions within SSA showed higher incidence rates (144 vs 136 cases per 100,000), deaths (5.4 vs 4.7 deaths per 100,000), and DALYs (289 vs 272 years per 100,000) for men than women when age standardized. Conclusions With an estimated 1.4 million burn injuries in 2017, SSA accounted for over 15% of all worldwide burns and 20% of global burn deaths. Although all trended rates improved over the years for each country, they were consistently worse and slower to improve in all regions of SSA compared to the rest of the world. While both Central and Southern SSA regions had the greatest burn burden, burns in Central SSA more significantly impacted those under 5 years whereas Southern SSA saw the greatest burden on the 15–49-year age group.


2020 ◽  
Author(s):  
Bruno Ramos Nascimento ◽  
Luisa Campos Caldeira Brant ◽  
Simon Yadgir ◽  
Gláucia Maria Moraes Oliveira ◽  
Gregory Roth ◽  
...  

Abstract Background Hypertension remains the leading risk factor for cardiovascular disease (CVD) worldwide, and its impact in Brazil should be assessed in order to better address the issue. We aimed to describe trends in prevalence and burden of disease attributable to high systolic blood pressure (HSBP) among Brazilians ≥ 25 years old according to sex and federal units (FU) using the Global Burden of Disease (GBD) 2017 estimates. Methods We used the comparative risk assessment developed for the GBD study to estimate trends in attributable deaths and disability-adjusted life-years (DALY), by sex, and FU for HSBP from 1990 to 2017. This study included 14 HSBP-outcome pairs. HSBP was defined as ≥ 140 mmHg for prevalence estimates and a theoretical minimum risk exposure level (TMREL) of 110–115 mmHg was considered for disease burden. We estimated the portion of deaths and DALYs attributed to HSBP. We also explored the drivers of trends in HSBP burden, as well as the correlation between disease burden and sociodemographic development index (SDI). Results In Brazil, the prevalence of HSBP is 18.9% (95% uncertainty intervals [UI] 18.5–19.3%), with an annual 0.4% increase rate, while age-standardized death rates attributable to HSBP decreased from 189.2 (95%UI 168.5-209.2) deaths to 104.8 (95%UI 94.9-114.4) deaths per 100,000 from 1990 to 2017. In spite of that, the total number of deaths attributable to HSBP increased 53.4% and HSBP raised from 3rd to 1st position, as the leading risk factor for deaths during the period. Regarding total DALYs, HSBP raised from 4th in 1990 to 2nd cause in 2017. The main driver of change of HSBP burden is population aging. Across FUs, the reduction in the age-standardized death rates attributable to HSBP correlated with higher SDI. Conclusions While HSBP prevalence shows an increasing trend, age-standardized death and DALY rates are decreasing in Brazil, probably as results of successful public policies for CVD secondary prevention and control, but suboptimal control of its determinants. Reduction was more significant in FUs with higher SDI, suggesting that the effect of health policies was heterogeneous. Moreover, HSBP has become the main risk factor for death in Brazil, mainly due to population aging.


2020 ◽  
Vol 18 (S1) ◽  
Author(s):  
Bruno Ramos Nascimento ◽  
Luísa Campos Caldeira Brant ◽  
Simon Yadgir ◽  
Gláucia Maria Moraes Oliveira ◽  
Gregory Roth ◽  
...  

Abstract Background Hypertension remains the leading risk factor for cardiovascular disease (CVD) worldwide, and its impact in Brazil should be assessed in order to better address the issue. We aimed to describe trends in prevalence and burden of disease attributable to high systolic blood pressure (HSBP) among Brazilians ≥ 25 years old according to sex and federal units (FU) using the Global Burden of Disease (GBD) 2017 estimates. Methods We used the comparative risk assessment developed for the GBD study to estimate trends in attributable deaths and disability-adjusted life-years (DALY), by sex, and FU for HSBP from 1990 to 2017. This study included 14 HSBP-outcome pairs. HSBP was defined as ≥ 140 mmHg for prevalence estimates, and a theoretical minimum risk exposure level (TMREL) of 110–115 mmHg was considered for disease burden. We estimated the portion of deaths and DALYs attributed to HSBP. We also explored the drivers of trends in HSBP burden, as well as the correlation between disease burden and sociodemographic development index (SDI). Results In Brazil, the prevalence of HSBP is 18.9% (95% uncertainty intervals [UI] 18.5–19.3%), with an annual 0.4% increase rate, while age-standardized death rates attributable to HSBP decreased from 189.2 (95%UI 168.5–209.2) deaths to 104.8 (95%UI 94.9–114.4) deaths per 100,000 from 1990 to 2017. In spite of that, the total number of deaths attributable to HSBP increased 53.4% and HSBP raised from 3rd to 1st position, as the leading risk factor for deaths during the period. Regarding total DALYs, HSBP raised from 4th in 1990 to 2nd cause in 2017. The main driver of change of HSBP burden is population aging. Across FUs, the reduction in the age-standardized death rates attributable to HSBP correlated with higher SDI. Conclusions While HSBP prevalence shows an increasing trend, age-standardized death and DALY rates are decreasing in Brazil, probably as results of successful public policies for CVD secondary prevention and control, but suboptimal control of its determinants. Reduction was more significant in FUs with higher SDI, suggesting that the effect of health policies was heterogeneous. Moreover, HSBP has become the main risk factor for death in Brazil, mainly due to population aging.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A L P Ribeiro ◽  
L C C Brant ◽  
S Yadgir ◽  
G M M Oliveira ◽  
S D Glenn ◽  
...  

Abstract Background Hypertension remains the leading risk factor for cardiovascular disease worldwide. In Brazil, a third of adults have hypertension. The prevalence and impact of this risk factor on disease burden in Brazil and its federal units should be assessed in order to better address the issue. Objective To describe trends in prevalence and burden of diseases attributable to high systolic blood pressure (HSBP) among Brazilians ≥25 years old according to sex and federal units using the Global Burden of Disease (GBD) 2017 estimates. Methods We used the comparative risk assessment developed for the GBD study to estimate trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALY), by sex, and federal units for HSBP from 1990 to 2017. This study included 14 HSBP-outcome pairs that met the GBD study criteria for evidence of causation. HSBP was defined as ≥140mmHg for prevalence estimates and, to evaluate the burden of HSBP, a theoretical minimum risk exposure level (TMREL) of 110–115 mmHg was considered. We estimated the portion of deaths and DALYs that could be attributed to HSBP. We also explored the drivers of trends in attributable burden of HSBP, as well as the relation of HSBP burden and sociodemographic development. Results In Brazil, the prevalence of HSBP is 18.9 (95% uncertainty intervals [UI] 18.5 to 19.3%) and the age-standardized death rate attributable to HSBP decreased from 189.2 (95%UI 168.5 to 209.2) deaths to 104.8 (95%UI 94.9 to 114.4) deaths per 100,000 from 1990 to 2017. In spite of that, the total number of deaths attributable to HSBP increased 53.4% and HSBP raised from 3rd to 1st position, as the leading risk factor for deaths during the period. Regarding total DALYs, HSBP raised from 4th in 1990 to 2nd cause in 2017 - in the last, only behind smoking. The main driver in the change of HSBP burden in Brazil is population aging. Across federal units, the reduction in the age-standardized death rates attributable to HSBP are heterogeneous and the greater reduction correlated to higher sociodemographic development. Conclusions The age-standardized death and DALY rates attributable to HSBP are decreasing in Brazil, probably as results of successful public health policies for primary prevention and control of HSBP. However, the reduction was more significant in federal units with higher sociodemographic development, suggesting that the effect of health policies was heterogeneous. Moreover, HSBP has become the main risk factor for death in the country, mainly due to population aging. As such, the Brazilian health system should increase investments in policies to address the situation and prepare itself to cope with higher burden of HSBP in the near future. Acknowledgement/Funding The GBD 2017 Brazil study is primarily funded by the Bill & Melinda Gates Foundation


2019 ◽  
Vol 7 (10) ◽  
pp. e1375-e1387 ◽  
Author(s):  
Hebe N Gouda ◽  
Fiona Charlson ◽  
Katherine Sorsdahl ◽  
Sanam Ahmadzada ◽  
Alize J Ferrari ◽  
...  

2020 ◽  
Vol 29 ◽  
Author(s):  
Jiayuan Wu ◽  
Jie Liu ◽  
Shasha Li ◽  
Huan Ma ◽  
Yufeng Wang

Abstract Aim Eating disorders have increasingly become a public health concern globally. This study aimed to reveal the burden of eating disorders at the global, regional and national levels using the Global Burden of Disease (GBD) Study 2017 data. Methods We extracted the age-standardised rates (ASRs) of prevalence and disability-adjusted life years (DALYs) and their 95% uncertainty intervals (UIs) of eating disorders, including anorexia nervosa and bulimia nervosa, between 1990 and 2017 from the GBD 2017 data. The estimated annual percentage changes (EAPCs) were calculated to quantify the secular trends of the burden of eating disorders. Results The ASRs of prevalence and the DALYs of eating disorders continuously increased worldwide from 1990 to 2017 by an average of 0.65 (95% UI: 0.59–0.71) and 0.66 (95% UI: 0.60–0.72), respectively. The burden of eating disorders was higher in females than in males, but the increment in ASRs was greater in males than in females over time. In 2017, the highest burden of eating disorders was observed in the high sociodemographic index (SDI) regions, especially Australasia (ASR of prevalence = 807.13, 95% UI: 664.20–982.30; ASR of DALYs = 170.74, 95% UI: 113.43–244.14, per 100 000 population), Western Europe and high-income North America. However, the most significant increment of the burden of eating disorders was observed in East Asia (EAPC for prevalence = 2.23, 95% UI: 2.14–2.32; EAPC for DALYs = 2.22, 95% UI: 2.13–2.31), followed by South Asia. An increasing trend in the burden of eating disorders at the national level was observed among most countries or territories. The countries with the top three highest increasing trends were Equatorial Guinea, Bosnia and Herzegovina and China. Positive associations were found between the burden estimates and the SDI levels in almost all geographic regions during the observed 28-year period. We also found that the human development indexes in 2017 were positively correlated with the EAPCs of the ASRs of prevalence (ρ = 0.222, P = 0.002) and DALYs (ρ = 0.208, P = 0.003). Conclusion The highest burden of eating disorders remains in the high-income western countries, but an increasing trend was observed globally and in all SDI-quintiles, especially in Asian regions that were highly populous. These results could help governments worldwide formulate suitable medical and health policies for the prevention and early intervention of eating disorders.


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