Abstract
INTRODUCTION: Monitoring trends in risk factors (RFs) and the burden of diseases attributable to exposure to RFs is an important measure to identify public health advances and current inadequate efforts. Objective: Analyze the global burden of disease attributable to exposure RFs in Brazil, and its changes from 1990 to 2019, according to the sex and age group. METHODS: This study used data from the Global Burden of Disease study. The Summary Exposure Value, which represents weighted prevalence by risk, was used to estimate exposure to RFs. The mortality and DALYs (Disability Adjusted Life Years) measurements were used to estimate the burden of diseases. For comparisons by year and between Brazilian states, age-standardized rates were used. RESULTS: Arterial hypertension was the factor responsible for most deaths in both sexes. For DALYs, the most important RF was the high body mass index (BMI) for women and alcohol consumption for men. Smoking had a substantial reduction in the attributable burden of deaths in the period. An important reduction was identified in the exposure to RFs related to socioeconomic development, such as unsafe water, lack of sanitation, and child malnutrition. Metabolic RFs, such as high BMI, hypertension, and alcohol consumption showed an increase in the attributable burden. CONCLUSIONS: Our findings point to an increase in metabolic RFs, which are the main RFs for mortality and DALYs. These results can help to consolidate and strengthen public policies that promote healthy lifestyles, thus reducing disease and death.
Highlights
Monitoring trends in risk factors (RFs) and the burden of diseases attributable to exposure to RFs is an important measure to identify public health advances and current inadequate efforts
Metabolic RFs, such as high body mass index (BMI), hypertension, and alcohol consumption showed an increase in the attributable burden
Our findings point to an increase in metabolic RFs, which are the main RFs for mortality and disability-adjusted life years (DALYs)
Summary
Monitoring trends in risk factors (RFs) and the burden of diseases attributable to exposure to RFs is an important measure to identify public health advances and current inadequate efforts. The RFs that interfere in the health-disease process include non-modifiable factors (genetic heritage, age, sex, race/ethnicity); proximal factors that are associated with specific behaviors and can be modified (smoking, physical inactivity, and inadequate eating); intermediate factors, such as metabolic risks; occupational factors and environmental exposure; and more distal factors that are hierarchical and determine the others. A pre-analysis of the burden attributable to the group of RF of the GDB was conducted with estimates from the 2015 GBD3 and later, in 2016, with revised estimates[6], showing that a unhealthy diet, metabolic RFs, alcohol, and tobacco consumption are important protagonists in the overall death and disease burden in Brazil. More recent studies evaluated the burden attributable to specific RFs, such as hypertension[7], obesity[8], hyperglycemia[9], physical inactivity[10], and smoking[11] Those estimates were not calculated together, which hindered the comparison between the RFs and their consequences in the overall disease burden
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