Physicians' Academy for Cardiovascular Education

High SBP and associated morbidity and mortality increased substantially from 1990-2015

Jan. 18, 2017 - news

This month, a study was published in JAMA in which trends of systolic blood pressure (SBP) over the last 15 years (1990-2015) was analysed and associated with disease burden. For this, results of the Global Burden of Disease, Injuries and Risk Factor study 2015 (GBD 2015) were used, which included data of 154 countries and 844 studies in which 8.69 million people participated.

The analyses showed that between 1990 and 2015, the proportion of people with SBP between 110 and 115 mmHg globally increased from 73 119 to 81 373 per 100 000 and SBP of ≥140 mmHg from 17 307 to 20 526 per 100 000. Also, the annual deaths that were estimated to be associated with SBP increased from 135.6 to 145.2 deaths per 100 000 for SBP 110-115 mmHg and from 97.9 to 106.3 deaths per 100 000 for SBP ≥140 mmHg, as did the number of disability adjusted life-years (DALYs).

In 2015, an estimated 3.5 billion people globally had an SBP level between 110-115 mmHg and 87 million ≥140 mmHg. Moreover, 10 million deaths and 211 million DALYs were estimated to be associated with an SBP between 110-115 mmHg, which were 7.8 and 143 million respectively, for SBP ≥140 mmHg.

Although almost half of DALYs occurred in individuals with an SBP ≥150 mmHg, still nearly 30% occurred in individuals with an SBP between 115-140 mmHg and most were due to ischemic heart disease. SBP-related deaths and DALYs increased substantially with age and the total burden is greater in men than women under the age of 75. Above this age, more burden is observed in women because of longer life expectancy.

Age-standardised DALY rates varied substantially among world regions and DALYs associated with SBP between 110-115 mmHg were highest in Oceania. The highest age-standardised death rate related to these SBPs was estimated for Afghanistan and the lowest for Andorra. Of all DALYs related to SBP, 60% occurred in 10 countries, with the majority in China and India.

Source: Forouzanfar MH, Liu P, Roth GA, et al, Global burden of hypertension and systolic blood pressure of at least 110 to 115 mm Hg, 1990-2015, JAMA 2017; doi:10.1001/jama.2016.19043

Forouzanfar et al. JAMA 2017