Heavy Disease Burden of High Systolic Blood Pressure During 1990-2019: Highlighting Regional, Sex, and Age Specific Strategies in Blood Pressure Control

Ming-Ming Chen,Yanxiao Ji,Hui Liu,Zhibing Lu,Peng Zhang,Juan-Juan Qin,Ye-Mao Liu,Fang Lei,Haomiao Li,Xingyuan Zhang,Zhi-Gang She,Xiao-Jing Zhang,Jingjing Cai,Hongliang Li,Ze Chen

doi:10.3389/fcvm.2021.754778

Abstract

Objective: High systolic blood pressure (HSBP) remains the leading risk factor for mortality worldwide; however, limited data have revealed all-cause and cause-specific burdens attributed to HSBP at global and regional levels. This study aimed to estimate the global burden and priority diseases attributable to HSBP by region, sex, and age.Methods: Based on data and evaluation methods from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, we estimated trends of age-standardized mortality rate (ASMR), the age-standardized rate of disability-adjusted life years (ASDRs), and the age-standardized rate of years lived with disability (ASYRs) attributable to HSBP during 1990-2019. Further, we analyzed cause-specific burdens attributable to HSBP by sex, age, year, and region.Results: Globally, a significant downtrend was found in the ASMR attributed to HSBP while ASYRs did not change substantially during 1990-2019. The majority of HSBP burden has shifted from high-middle sociodemographic index (SDI) regions to lower SDI regions. All-cause and most cause-specific burdens related to HSBP were improved in high SDI regions but the downtrends have stagnated in recent years. Although many cause-specific deaths associated with HSBP declined, chronic kidney disease (CKD) and endocarditis associated deaths were aggravated globally and ischemic heart disease (IHD), atrial fibrillation and flutter, aortic aneurysm (AA), and peripheral artery disease (PAD) associated deaths were on the rise in low/low-middle/middle SDI regions. Additionally, males had higher disease burdens than females. Middle-aged people with CVDs composed the major subgroup affected by HSBP while older people had the highest ASMRs associated with HSBP.Conclusions: This study revealed the global burden and priority diseases attributable to HSBP with wide variation by region, sex, and age, calling for effective and targeted strategies to reduce the prevalence and mortality of HSBP, especially in low/low-middle/middle SDI regions.

Highlights

High systolic blood pressure (HSBP) represents a major health problem and is responsible for a dramatic economic burden worldwide [1, 2], affecting 4.06 billion people and leading to 10.8 million deaths in 2019 [3]
Based on GBD 2019, data on deaths, disability-adjusted life years (DALYs), years of life lost (YLLs) and years of life lived with disability (YLDs) attributable to HSBP by sex, age (5-year groups within the ages of 20-95 years,
From 1990 to 2019, the age-standardized mortality rates (ASMRs) attributed to HSBP declined from 197.87(95% uncertainty intervals (UIs): 174.93, 220.93) to 138.88(95% UI: 121.25, 155.73) for both sexes with an EPAC of −1.32 (Table 1)

Summary

Introduction

High systolic blood pressure (HSBP) represents a major health problem and is responsible for a dramatic economic burden worldwide [1, 2], affecting 4.06 billion people and leading to 10.8 million deaths in 2019 [3]. The growing evidence for the tight association of HSBP with CVDs, chronic kidney disease (CKD), coronavirus disease 2019, and other metabolic diseases has emphasized the importance of controlling systolic blood pressure (SBP) for preventing related complications [5,6,7,8,9,10,11]. The reduction in overall mortality is another major concern in the context of SBP control but is not clearly defined at the global level. There is an urgent need for an up-to-date analysis of the disease burdens attributable to HSBP globally and regionally, guiding targeted prevention and control strategies in different regions

Methods

Results

Conclusion