Trends in systolic blood pressure since 1980

January 01, 0001

Trends in systolic blood pressure since 1980

Data for trends in blood pressure are needed to understand the effects of its dietary, lifestyle, and pharmacological determinants, set intervention priorities and evaluate national programmes. However, few worldwide analyses of trends in blood pressure have been done. The researchers from USA, Switzerland and UK estimated worldwide trends in population mean systolic blood pressure (SBP) for adults 25 years and older in 199 countries and territories. They obtained data from published and unpublished health examination surveys and epidemiological studies (786 country- years and 5.4 million participants).

In 2008, age-standardised mean SBP worldwide was 128.1 mm Hg in men and 124.4 mm Hg in women. Globally, between 1980 and 2008, SBP decreased by 0.8 mm Hg per decade in men and 1.0 mm Hg per decade in women. Female SBP decreased by 3·5 mm Hg or more per decade in western Europe and Australasia. Male SBP fell most in high-income North America, by 2.8 mm Hg per decade, followed by Australasia and western Europe where it decreased by more than 2·0 mm Hg per decade. SBP rose in Oceania, east Africa, and south and southeast Asia for both sexes, and in west Africa for women, with the increases ranging 0.8-1.6 mm Hg per decade in men and 1·0—2·7 mm Hg per decade for women. Female SBP was highest in some east and west African countries, with means of 135 mm Hg or greater. Male SBP was highest in Baltic and east and west African countries, where mean SBP reached 138 mm Hg or more. Men and women in western Europe had the highest SBP in high-income regions.

The researchers concluded: "On average, global population SBP decreased slightly since 1980, but trends varied significantly across regions and countries. SBP is currently highest in low-income and middle-income countries. Effective population-based and personal interventions should be targeted towards low-income and middle-income countries."

It is important to consider this abstract along with the other two posted today from the Lancet. All is related to consideration of normal values. Clinical implications will be more important.

For the full abstract, click here.

The Lancet 377(9765):568-577, 12 February 2011
© 2011 Elsevier Limited
National, regional, and global trends in systolic blood pressure since 1980: systematic analysis of health examination surveys and epidemiological studies with 786 country-years and 5.4 million participants. Goodarz Danaei, Mariel M Finucane, John K Lin et al on behalf of the Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Blood Pressure). Correspondence to Majid Ezzati:

Category: GH. Global Health. Keywords: trends, blood pressure, surveys, epidemiological studies, systematic analysis, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 8 March 2011

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