Browsing by Author "Bentham, James"

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    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
    (2018) Ezzati, Majid; Zhou, Bin; Bentham, James; Bixby, Honor; Donoso Moscoso, Silvana Patricia; Zuñiga Cisneros, Julio
    BackgroundChange 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.MethodsWe 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.ResultsIn 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.ConclusionsChange 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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    Trends in cardiometabolic risk factors in the Americas between 1980 and 2014: a pooled analysis of population-based surveys
    (2020) Miranda, Jaime J; Carrillo Larco, Rodrigo M; Ferreccio, Catterina; Hambleton, Ian R; Bentham, James; Lotufo, Paulo A; Bixby, Honor; Taddei, Cristina; Andrade Tenesaca, Dolores Susana; Bernabe Ortiz, Antonio; Bettiol, Heloisa; Boggia de Izaguirre, josé Gabriel; Donoso Moscoso, Silvana Patricia; Ochoa Avilés, Angélica María; Di Cesare, Mariachiara; Nieto Martínez, Ramfis; Bin, Zhou; Hajifathalian, Kaveh; Abarca Gómez, Leandra; Acosta Cazares, Benjamin; Aguilar Salinas, Carlos A.; Assuncao , Maria Cecília F.; Barceló, Alberto; Dornellas de Barros, Aluísio Jardim; Gomes de Barros, Mauro Virgilio; Bata, Iqbal; Batista, Rosangela L; Brewster, Lizzy M; Cardoso, Viviane C; Chan, Queenie; Destro Christofaro, Diego Giulliano
    Background Describing the prevalence and trends of cardiometabolic risk factors that are associated with noncommunicable diseases (NCDs) is crucial for monitoring progress, planning prevention, and providing evidence to support policy efforts. We aimed to analyse the transition in body-mass index (BMI), obesity, blood pressure, raised blood pressure, and diabetes in the Americas, between 1980 and 2014. Methods We did a pooled analysis of population-based studies with data on anthropometric measurements, biomarkers for diabetes, and blood pressure from adults aged 18 years or older. A Bayesian model was used to estimate trends in BMI, raised blood pressure (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg), and diabetes (fasting plasma glucose ≥7·0 mmol/L, history of diabetes, or diabetes treatment) from 1980 to 2014, in 37 countries and six subregions of the Americas. Findings 389 population-based surveys from the Americas were available. Comparing prevalence estimates from 2014 with those of 1980, in the non-English speaking Caribbean subregion, the prevalence of obesity increased from 3·9% (95% CI 2·2–6·3) in 1980, to 18·6% (14·3–23·3) in 2014, in men; and from 12·2% (8·2–17·0) in 1980, to 30·5% (25·7–35·5) in 2014, in women. The English-speaking Caribbean subregion had the largest increase in the prevalence of diabetes, from 5·2% (2·1–10·4) in men and 6·4% (2·6–10·4) in women in 1980, to 11·1% (6·4–17·3) in men and 13·6% (8·2–21·0) in women in 2014). Conversely, the prevalence of raised blood pressure has decreased in all subregions; the largest decrease was found in North America from 27·6% (22·3–33·2) in men and 19·9% (15·8–24·4) in women in 1980, to 15·5% (11·1–20·9) in men and 10·7% (7·7–14·5) in women in 2014. Interpretation Despite the generally high prevalence of cardiometabolic risk factors across the Americas, estimates also showed a high level of heterogeneity in the transition between countries. The increasing prevalence of obesity and diabetes observed over time requires appropriate measures to deal with these public health challenges. Our results support a diversification of health interventions across subregions and countrie