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Bin James Mariachiara Honor Goodarz Kaveh Cristina Rod Zhou Bentham Di Cesare Bixby Danaei Hajifathalian , Bin Zhou, J. Bentham, M. Di Cesare, Honor Bixby, G. Danaei, Kaveh Hajifathalian, C. Taddei, R. Carrillo-Larco, Shirin Djalalinia, S. Khatibzadeh, C. Lugero, N. Peykari, Wan Zhu Zhang, James E. Bennett, V. Bilano, Gretchen A. Stevens, Melanie J. Cowan, L. Riley, Zhengming Chen, Ian R. Hambleton, Rod T Jackson, A. Kengne, Y. Khang, A. Laxmaiah, Jing Liu, R. Malekzadeh, Hannelore Neuhauser, M. Sorić, G. Starc, Johan Sundström, Mark Woodward, Majid Ezzati, Leandra Abarca-Gómez, Ziad A Abdeen, Niveen M E Abu-Rmeileh, Benjamín Acosta-Cázares, Robert J Adams, W. Aekplakorn, K. Afsana, C. A. Aguilar-Salinas, C. Agyemang, Noor Ani Ahmad, Alireza Ahmadvand, W. Ahrens, K. Ajlouni, Nazgul S. Akhtaeva, Rajaa Al-Raddadi, Mohamed M. Ali, Osman Ali, A. Alkerwi, Eman Aly, Deepak N Amarapurkar, P. Amouyel, A. Amuzu, Lars Bo Andersen, S. Anderssen, L. Ängquist, R. Anjana, D. Ansong, H. Aounallah-Skhiri, Joana Araújo, I. Ariansen, T. Aris, N. Arlappa, D. Arveiler, Krishna K Aryal, T. Aspelund, Felix K. Assah, M. Assunção, M. Avdičová, Ana Azevedo, Fereidoun Azizi, B. Babu, S. Bahijri, Nagalla Balakrishna, M. Bamoshmoosh, M. Banach, P. Bandosz, J. Banegas, C. Barbagallo, Alberto Barceló, Amina Barkat, Aluísio J D Barros, M. V. Barros, I. Bata, A. Batieha, Assembekov Batyrbek, Louise A. Baur, R. Beaglehole, H. Romdhane, M. Benet, Lowell S Benson, Antonio Bernabé-Ortiz, G. Bernotiene, Heloísa Bettiol, A. Bhagyalaxmi, Sumit Bharadwaj, S. K. Bhargava, Yufang Bi, M. Bikbov, B. Bista, P. Bjerregaard, Espen Bjertness, M. B. Bjertness, Cecilia Björkelund, A. Blokstra, Simona Bo, M. Bobák, Heiner Boeing, J. Boggia, C. Boissonnet, V. Bongard, R. Borchini, P. Bovet, L. Braeckman, I. Brajkovich, Francesco Branca, Juergen Breckenkamp, Hermann Brenner, L. Brewster, Graziella Bruno, H. Bueno‐de‐Mesquita, Anna Bugge, Con Burns, Michael Bursztyn, Antonio Cabrera de León, J. Cacciottolo, Hui Cai, C. Cameron, G. Can, A. P. C. Cândido, V. Capuano, Viviane C Cardoso, Axel C. Carlsson, M. J. Carvalho, F. F. Casanueva, Juan P. Casas, C. Caserta, S. Chamukuttan, Angelique W Chan, Queenie Chan, H. Chaturvedi, Nishi Chaturvedi, Chien-Jen Chen, Fangfang Chen, Huashuai Chen, Shuohua Chen, Ching-Yu Cheng, Imane Cherkaoui Dekkaki, Angela Chetrit, A. Chiolero, S. Chiou, A. Chiriță-Emandi, M. Chirlaque, Belong Cho, Yumi Cho, D. Christofaro, Jerzy Chudek, R. Cífková, E. Cinteză, Frank Claessens, E. Clays, H. Concin, Cyrus Cooper, Rachel Cooper, Tara C Coppinger, Simona Costanzo, D. Cottel, Chris Cowell, Cora L Craig, A. Crujeiras, Juan J Cruz, Graziella D'Arrigo, Eleonora d'Orsi, J. Dallongeville, Albertino Damasceno, R. Dankner, T. Dantoft, Luc Dauchet, K. Davletov, Guy G De Backer, Dirk De Bacquer, Giovanni de Gaetano, S. de Henauw, P. D. de Oliveira, D. De Smedt, M. Deepa, Abbas Dehghan, Hélène Delisle, Valérie Deschamps, K. Dhana, A. Di Castelnuovo, J. S. Dias-da-Costa, Alejandro Díaz, Ty T Dickerson, Ha T. P. Do, C. Donfrancesco, Silvana P. Donoso, A. Döring, M. Dorobanțu, K. Doua, Wojciech Drygas, V. Dulskienė, A. Džakula, V. Dzērve, E. Dziankowska-Zaborszczyk, R. Eggertsen, Ulf Ekelund, J. El Ati, Paul Elliott, Roberto Elosúa, R. Erasmus, C. Erem, L. Eriksen, Johan G. Eriksson, Jorge Escobedo-de la Peña, Alun Evans, D. Faeh, Caroline H. D. Fall, F. Farzadfar, F. Félix-Redondo, Trevor S Ferguson, Romulo A Fernandes, D. Fernández-Bergés, Daniel Ferrante, M. Ferrari, C. Ferreccio, Jean Ferrieres, J. Finn, K. Fischer, B. Föger, L. Foo, Ann‐Sofie Forslund, M. Forsner, Heba M Fouad, Damian K Francis, Maria do Carmo Franco, Oscar H. Franco, G. Frontera, Flavio D. Fuchs, SANDRA C Fuchs, Y. Fujita, Takuro Furusawa, Zbigniew Gaciong, F. Galvano, M. García-de-la-Hera, D. Gareta, S. Garnett, J. Gaspoz, Magda Gasull, Louise Gates, J. Geleijnse, Anoosheh Ghasemian, Anup Ghimire, Simona Giampaoli, F. Gianfagna, Tiffany K. Gill, J. Giovannelli, R. Goldsmith, Helen Gonçalves, M. González-Gross, J. González-Rivas, M. B. Gorbea, Frédéric Gottrand, Sidsel Graff-Iversen, Dušan Grafnetter, Aneta Grajda, M. Grammatikopoulou, R. D. Gregor, T. Grodzicki, A. Grøntved, Giuseppe Grosso, Gabriella Gruden, Vera Grujic, D. Gu, Ong Peng Guan, E. Gudmundsson, V. Gudnason, Ramiro Guerrero, I. Guessous, A. L. Guimarães, M. Gulliford, Johanna Gunnlaugsdottir, Marc Gunter, Prakash C Gupta, R. Gupta, O. Gureje, Beata Gurzkowska, Laura Gutierrez, Felix Gutzwiller, F. Hadaegh, J. Halkjær, R. Hardy, R. Hari Kumar, J. Hata, Alison J Hayes, Jiang He, Yuna He, Marleen Elisabeth, Ana Henriques, L. H. Cadena, S. Herrala, R. Heshmat, Ilpo Tapani Hihtaniemi, Sai Yin Ho, Suzanne C. Ho, Michael Hobbs, A. Hofman, Gonul Horasan Dinc, A. Horimoto, Claudia M. Hormiga, Bernardo L Horta, L. Houti, Christina Howitt, T. Htay, A. Htet, Maung Maung Than Htike, Yonghua Hu, J. Huerta, M. Huisman, Abdullatif S. Husseini, I. Huybrechts, N. Hwalla, L. Iacoviello, Anna G. Iannone, M. Ibrahim, N. Wong, Nayu Ikeda, M. Ikram, V. Irazola, Muhammad Islam, Aziz al-Safi Ismail, V. Ivković, Masanori Iwasaki, Jeremy M. Jacobs, H. Jaddou, Tazeen Jafar, Konrad Jamrozik, I. Janszky, G. Jasienska, A. Jelaković, B. Jelaković, Garry L R Jennings, Seung-lyeal Jeong, Chao Qiang Jiang, Michel Joffres, M. Johansson, J. Jokelainen, J. Jonas, T. Jørgensen, Pradeep Joshi, J. Jozwiak, A. Juolevi, G. Jurak, V. Jureša, R. Kaaks, A. Kafatos, E. Kajantie, O. Kalter‐Leibovici, N. Kamaruddin, K. Karki, A. Kasaeian, Joanne Katz, Jussi Kauhanen, Prabhdeep Kaur, M. Kavousi, G. Kazakbaeva, Ulrich Keil, L. K. Boker, Sirkka Keinänen-Kiukaanniemi, R. Kelishadi, Han C G Kemper, A. Kengne, A. Kerimkulova, M. Kersting, Timothy J. Key, Yousef S. Khader, Davood Khalili, M. Khateeb, K. Khaw, Ursula Kiechl-Kohlendorfer, S. Kiechl, J. Killewo, Jeongseon Kim, Yeon-Yong Kim, J. Klumbienė, M. Knoflach, E. Kolle, P. Kolsteren, P. Korrovits, Seppo Koskinen, K. Kouda, S. Kowlessur, S. Koziel, S. Kriemler, P. L. Kristensen, S. Krokstad, D. Kromhout, H. Kruger, R. Kubínová, R. Kuciene, Diana Kuh, U. Kujala, Z. Kułaga, R. Krishna Kumar, P. Kurjata, Y. S. Kusuma, Kari Kuulasmaa, C. Kyobutungi, Tiina Laatikainen, C. Lachat, Tai Hing Lam, O. Landrove, Věra Lánská, G. Lappas, Bagher Larijani, L. E. Laugsand, Khanh Le Nguyen Bao, T. Le, Catherine Leclercq, Jeannette Lee, Jeonghee Lee, T. Lehtimäki, L. M. León-Muñoz, Naomi S. Levitt, Yanping Li, Christa L Lilly, W. Lim, M. F. Lima-Costa, Hsien-Ho Lin, Xu Lin, Lars Lind, Allan Linneberg, Lauren Lissner, M. Litwin, R. Lorbeer, P. Lotufo, J. Lozano, D. Lukšienė, Annamari Lundqvist, N. Lunet, Per Lytsy, Guansheng Ma, Jun Ma, G. Machado-Coelho, S. Machi, Stefania Maggi, D. Magliano, E. Magriplis, Marjeta Majer, Marcia Makdisse, Rahul Malhotra, K. Mallikharjuna Rao, S. Malyutina, Yannis Manios, Jim I Mann, E. Manzato, P. Margozzini, P. Marques-Vidal, L. P. Marques, J. Marrugat, R. Martorell, E. Mathiesen, A. Matijasevich, T. Matsha, J. Mbanya, Anselmo J. Mc Donald Posso, S. McFarlane, S. Mcgarvey, S. McLachlan, Rachael M Mclean, Scott B. McLean, B. McNulty, S. Médiène-Benchekor, J. Medzioniene, A. Meirhaeghe, Christa Meisinger, A. M. B. Menezes, G. Menon, I. Meshram, A. Metspalu, Haakon E Meyer, Jie Mi, Kairit Mikkel, Jody C Miller, C. Minderico, Juan Francisco, J. Miranda, E. Mirrakhimov, M. Misigoj-Durakovic, P. Modesti, Mostafa K. Mohamed, Kazem Mohammad, N. Mohammadifard, Viswanathan Mohan, S. Mohanna, Muhammad Fadhli Mohd Yusoff, L. Møllehave, N. C. Møller
75 19. 3. 2018.

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

Abstract Background 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. Methods 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. Results 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. Conclusions 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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