Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: a pooled analysis of 1018 population-based measurement studies with 88.6 million participants.
Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: a pooled analysis of 1018 population-based measurement studies with 88.6 million participants.
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DOI：
10.1093/ije/dyy016
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发表时间：
2018-06-01
影响因子：
7.7
通讯作者：
NCD Risk Factor Collaboration (NCD-RisC)
中科院分区：
文献类型：
--
作者：
NCD Risk Factor Collaboration (NCD-RisC)
高血压患病率的变化可能是由于整个血压分布的变化(代表公共卫生干预和长期趋势的综合影响)及其高血压尾部的变化(代表控制高血压人群血压的成功临床干预措施)。我们的目的是量化这两种现象对全球高血压患病率上升趋势的贡献。从1985年到2016年，我们收集了1018项基于人群的研究，对8860万参与者进行了血压测量。在每项研究中，我们首先计算了从20-29 年到70-79 年按性别和10岁年龄组划分的平均收缩压、平均舒张压和血压升高的发生率，并考虑了复杂的调查设计和调查样本权重。我们使用线性混合效应模型来量化(概率转换后的)高血压患病率与年龄组和性别特定的平均血压之间的关系。我们计算了平均SBP和DBP的变化，以及患病率-平均相关性的变化对高血压患病率变化的贡献。在2005-16年，在相同的人口平均SBP和DBP水平上，南亚、中亚、中东和北非的男性和女性的高血压患病率最高，而高收入亚太地区和高收入西部地区的男性和女性的高血压患病率最低。在大多数地区性别年龄组中，血压升高的流行率下降，一半或更多的下降是由于平均血压下降。在血压升高的患病率增加的情况下，这种变化完全是由平均血压上升推动的，部分被患病率-平均相关性的变化所抵消。平均血压的变化是世界范围内血压升高患病率变化的主要驱动因素，但分布的高血压尾部的变化也有助于患病率的变化，特别是在老年群体中。
Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20–29 years to 70–79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probit-transformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. In 2005–16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the high-income Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups.
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影响因子：
2.9
作者：
He FJ;Pombo-Rodrigues S;Macgregor GA
通讯作者：
Macgregor GA
影响因子：
8.3
作者：
Cornelissen, VA;Fagard, RH
通讯作者：
Fagard, RH
影响因子：
5.3
作者：
Cifkova, Renata;Skodova, Zdenka;Lanska, Vera
通讯作者：
Lanska, Vera
DOI：
10.1016/s0140-6736(10)62037-5
发表时间：
2011-02-12
期刊：
Lancet (London, England)
影响因子：
--
作者：
Finucane MM;Stevens GA;Cowan MJ;Danaei G;Lin JK;Paciorek CJ;Singh GM;Gutierrez HR;Lu Y;Bahalim AN;Farzadfar F;Riley LM;Ezzati M;Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Body Mass Index)
通讯作者：
Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Body Mass Index)
影响因子：
120.7
作者：
Egan, Brent M.;Zhao, Yumin;Axon, R. Neal
通讯作者：
Axon, R. Neal