Browsing by Author "Carrillo Larco, Rodrigo M"

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Repositioning of the global epicentre of non-optimal cholesterol
(2020) Taddei, Cristina; Bin, Zhou; Bixby, Honor; Carrillo Larco, Rodrigo M; Ezzati, Majid; Ochoa Avilés, Angélica María; Donoso Moscoso, Silvana Patricia
High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol—which is a marker of cardiovascular risk—changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million–4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.
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