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Title Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19.1 million participants Type Comment
Year 2017 Publication Lancet (London, England) Abbreviated Journal Lancet
Volume 389 Issue 10064 Pages 37-55
Keywords Bayes Theorem; *Blood Pressure; *Global Health; Humans; Prevalence; Risk Factors
Abstract BACKGROUND: Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defined as systolic blood pressure of 140 mm Hg or higher or diastolic blood pressure of 90 mm Hg or higher. METHODS: For this analysis, we pooled national, subnational, or community population-based studies that had measured blood pressure in adults aged 18 years and older. We used a Bayesian hierarchical model to estimate trends from 1975 to 2015 in mean systolic and mean diastolic blood pressure, and the prevalence of raised blood pressure for 200 countries. We calculated the contributions of changes in prevalence versus population growth and ageing to the increase in the number of adults with raised blood pressure. FINDINGS: We pooled 1479 studies that had measured the blood pressures of 19.1 million adults. Global age-standardised mean systolic blood pressure in 2015 was 127.0 mm Hg (95% credible interval 125.7-128.3) in men and 122.3 mm Hg (121.0-123.6) in women; age-standardised mean diastolic blood pressure was 78.7 mm Hg (77.9-79.5) for men and 76.7 mm Hg (75.9-77.6) for women. Global age-standardised prevalence of raised blood pressure was 24.1% (21.4-27.1) in men and 20.1% (17.8-22.5) in women in 2015. Mean systolic and mean diastolic blood pressure decreased substantially from 1975 to 2015 in high-income western and Asia Pacific countries, moving these countries from having some of the highest worldwide blood pressure in 1975 to the lowest in 2015. Mean blood pressure also decreased in women in central and eastern Europe, Latin America and the Caribbean, and, more recently, central Asia, Middle East, and north Africa, but the estimated trends in these super-regions had larger uncertainty than in high-income super-regions. By contrast, mean blood pressure might have increased in east and southeast Asia, south Asia, Oceania, and sub-Saharan Africa. In 2015, central and eastern Europe, sub-Saharan Africa, and south Asia had the highest blood pressure levels. Prevalence of raised blood pressure decreased in high-income and some middle-income countries; it remained unchanged elsewhere. The number of adults with raised blood pressure increased from 594 million in 1975 to 1.13 billion in 2015, with the increase largely in low-income and middle-income countries. The global increase in the number of adults with raised blood pressure is a net effect of increase due to population growth and ageing, and decrease due to declining age-specific prevalence. INTERPRETATION: During the past four decades, the highest worldwide blood pressure levels have shifted from high-income countries to low-income countries in south Asia and sub-Saharan Africa due to opposite trends, while blood pressure has been persistently high in central and eastern Europe. FUNDING: Wellcome Trust.
Address
Corporate Author NCD Risk Factor Collaboration (NCD-RisC) Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 0140-6736 ISBN Medium
Area Expedition Conference
Notes PMID:27863813; PMCID:PMC5220163 Approved no
Call Number HUNT @ maria.stuifbergen @ Serial 1897
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Author (up) Davies, S.J.C.; Bjerkeset, O.; Nutt, D.J.; Lewis, G.
Title A U-shaped relationship between systolic blood pressure and panic symptoms: the HUNT study Type Journal Article
Year 2012 Publication Psychological Medicine Abbreviated Journal Psychol Med
Volume 42 Issue 9 Pages 1969-1976
Keywords Anxiety Disorders/*epidemiology; *Blood Pressure; Comorbidity; Cross-Sectional Studies; Depression/epidemiology; Female; Humans; Hypertension/*epidemiology; Male; Middle Aged; Norway/epidemiology; Odds Ratio; *Panic; Panic Disorder/*epidemiology
Abstract BACKGROUND: Previous studies on the relationship between blood pressure (BP) and psychological morbidity are conflicting. To resolve this confusing picture we examined the hypothesis that there is a non-linear relationship between panic and systolic BP (SBP) and explored the association of generalized anxiety symptoms with SBP. Method We used data from the population-based Nord-Trondelag health study (HUNT) in which all 92 936 individuals aged >/=20 years residing in one Norwegian county were invited to participate. Panic was assessed using one item from the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS) and generalized anxiety with the remaining six items of this subscale. SBP was the mean of two measurements by an automatic device. RESULTS: A total of 64 871 respondents had SBP recorded (70%). Both unadjusted (n=61 408) and adjusted analyses provided evidence for a non-linear relationship between panic and SBP, represented by a U-shaped curve with a minimum prevalence of panic at around 140 mmHg. The relationship was strengthened after adjustment for confounders, with the quadratic term significantly associated with panic (p=0.03). Generalized anxiety symptoms were associated only with low SBP. CONCLUSIONS: The U-shaped relationship between SBP and panic provides a unifying explanation for the separate strands of published literature in this area. The results support the hypothesis that high BP and panic disorder could share brainstem autonomic and serotonergic abnormalities. By contrast, generalized anxiety symptoms were more common only at lower BPs, suggesting that any biological link between panic and high BP does not extend to generalized anxiety.
Address Academic Unit of Psychiatry, University of Bristol, Bristol, UK. simon.davies@bristol.ac.uk
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 0033-2917 ISBN Medium
Area Expedition Conference
Notes PMID:22251707 Approved no
Call Number HUNT @ maria.stuifbergen @ Serial 1517
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Author (up) Sorensen, T.; Danbolt, L.J.; Lien, L.; Koenig, H.G.; Holmen, J.
Title The relationship between religious attendance and blood pressure: the HUNT Study, Norway Type Journal Article
Year 2011 Publication International Journal of Psychiatry in Medicine Abbreviated Journal Int J Psychiatry Med
Volume 42 Issue 1 Pages 13-28
Keywords Adult; Aged; Aged, 80 and over; *Blood Pressure; *Cross-Cultural Comparison; Female; Health Surveys; Humans; Hypertension/psychology; Male; Middle Aged; Norway; *Religion and Medicine; Sex Factors; United States; Young Adult
Abstract OBJECTIVE: Research from the United States shows a possible relationship between religious attendance (RA) and blood pressure (BP). The religious context in the United States differs widely from Scandinavia. The aim was, therefore, to test whether the relationship between RA and BP is specific to the religious culture in the United States or whether a similar relationship exists between RA and BP in a Norwegian context. DESIGN AND METHOD: Data from the Nord-Trondelag Health Study's third wave, HUNT 3 (2006-08), was used. The associations between RA and diastolic (DBP) and systolic (SBP) blood pressure in women (n = 20,066) and men (n = 15,898) were investigated in a cross-sectional study using multiple regression analyses. RESULTS: Mean DBP for women/men was 71.0 mmHg/76.7 mmHg. Mean SBP was 128.5 mmHg/134.0 mmHg; 39.1%/42.8% of women/men never attended religious services, 3.8%/3.4% attended more than 3x/month. The bivariate associations were statistically significant between RA and SBP in both genders and women's DBP but not men's DBP. After adjustment, inverse associations between RA and DBP/SBP for both genders were found. The RA-DBP relationship (p < 0.001) demonstrated a gradient in effect for both genders, with increasing RA associated with decreasing DBP, with 1.50/1.67 mmHg lower in women/men respectively in those attending more than 3x/month, 0.87/1.16 mmHg lower in those attending 1-3x/month, and 0.49/0.10 mmHg less in those attending 1-6x/6 months. Differences in RA-SBP (p < 0.05) were 2.12/1.71 mmHg, 0.30/0.11 mmHg, and 0.58/0.63 mmHg, respectively. CONCLUSION: In a large population-based survey in Norway, RA was associated with lower DBP and SBP after adjusting for relevant variables.
Address MF Norwegian School of Theology, Oslo, Norway. torgeir.sorensen@mf.no
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 0091-2174 ISBN Medium
Area Expedition Conference
Notes PMID:22372022 Approved no
Call Number HUNT @ maria.stuifbergen @ Serial 1631
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