scholarly journals Trends in prevalence, mortality and morbidity associated with high systolic blood pressure in Brazil from 1990 to 2017: estimates from the “Global Burden of Disease 2017” (GBD2017) study

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


2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
L C Brant ◽  
B R Nascimento ◽  
G A Veloso ◽  
C S Gomes ◽  
C Polanczyk ◽  
...  

Abstract Introduction Cardiovascular diseases (CVD) continue to be the main cause of death in Brazil, a middle-income country. As such, it is essential to understand the trends of risk factors (RFs) for CVDs in order to implement effective and tailored public policies. Purpose The present study sought to analyze the trend of RF for CVD and the disease burden attributable to these from 1990 to 2019, in Brazil and its states, based on estimates from the Global Burden of Disease Study 2019 (2019 GBD). Methods To estimate RF exposure, the Summary Exposure Value (SEV) (risk-weighted prevalence) was used, whereas for disease burden attributed to RFs, mortality and Disability-adjusted life-years (DALY) by CVD were used. For comparisons over time and between states, the age-standardized rates were considered. The sociodemographic index (SDI) was used as a marker of socioeconomic conditions. Results In 2019, 82% of CVD mortality in Brazil was attributable to RFs. For SEV, there was a reduction in smoking and environmental RFs, as well as an increase in metabolic RFs. High systolic blood pressure and dietary risks continue to be the main RFs for CVD mortality and DALY (Figure 1). While there was a decline in age-standardized mortality rates attributable to the evaluated RFs, there was also a stability or increase in crude mortality rates, with the exception of smoking. It is important to highlight the increase in the risk of death attributable to a high body mass index (BMI) (35 to 46/100,000 in habitants in 1990 and 2019). Regarding the analysis per state, SEVs and mortality attributable to RF were higher in those states with lower SDIs. Conclusion Despite the reduction in CVD mortality and DALY rates attributable to RF, the stability or increase in crude rates attributable to metabolic RFs is worrisome, requiring investments and a renewal of health policies. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Health Surveillance Secretariat, Brazilian Ministry of Health Figure 1


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.


2021 ◽  
Vol 6 (5) ◽  
pp. e005847
Author(s):  
Mamata Tamrakar ◽  
Priti Kharel ◽  
Adrian Traeger ◽  
Chris Maher ◽  
Mary O'Keeffe ◽  
...  

IntroductionCompleteness of Global Burden of Disease (GBD) Study data is acknowledged as a limitation. To date, no study has evaluated this issue for low back pain, a leading contributor to disease burden globally.MethodsWe retrieved reports, in any language, based on citation details from the GBD 2017 study website. Pairs of raters independently extracted the following data: number of prevalence reports tallied across countries, age groups, gender and years from 1987 to 2017. We also considered if studies enrolled a representative sample and/or used an acceptable measure of low back pain.ResultsWe retrieved 488 country-level reports that provide prevalence data for 103 of 204 countries (50.5%), with most prevalence reports (61%) being for high-income countries. Only 16 countries (7.8%) have prevalence reports for each of the three decades of the GBD. Most of the reports (79%) did not use an acceptable measure of low back pain when estimating prevalence.ConclusionWe found incomplete coverage across countries and time, and limitations in the primary prevalence studies included in the GBD 2017 study. This means there is considerable uncertainty about GBD estimates of low back pain prevalence and the disease burden metrics derived from prevalence.


2013 ◽  
Vol 2 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Jürgen Rehm ◽  
Guilherme Borges ◽  
Gerhard Gmel ◽  
Kathryn Graham ◽  
Bridget Grant ◽  
...  

Rehm, J., Borges, G., Gmel, G., Graham, K., Grant, B., Parry, C., Poznyak, V. & Room R. (2013). The comparative risk assessment for alcohol as part of the Global Burden of Disease 2010 study: What changed from the last study? International Journal of Alcohol and Drug Research, 2(1), 1-5.  doi: 10.7895/ijadr.v2i1.132 (http://dx.doi.org/10.7895/ijadr.v2i1.132)In December 2012, the new results of the Comparative Risk Assessment (CRA) for alcohol within the Global Burden of Disease and Injury (GBD) Study 2010 were presented at a joint meeting of the GBD Group and the journal Lancet at the Royal Society in London (Lim et al., 2012). At first glance, there do not appear to be many changes to alcohol consumption as a risk factor for death and disability: it is identified as the third most important risk factor, as it was in the last CRA (World Health Organization, 2009). The burden of disease attributable to alcohol had increased, compared to the 2004 estimate (Rehm, Mathers et al., 2009), but this could be due to an increase in global population, or to variations in the methodologies behind the 2004 and 2010 estimates.


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