Data de publicação
30 de setembro de 2020
Periódico
Population Health Metrics
Resumo
Background – Hypertension remains the leading risk factor for cardiovascular disease (CVD) worldwide, and its impact in Brazil should be assessed in order to better address the issue. We aimed to describe trends in prevalence and burden of disease attributable to high systolic blood pressure (HSBP) among Brazilians ≥ 25 years old according to sex and federal units (FU) using the Global Burden of Disease (GBD) 2017 estimates.
Methods – We used the comparative risk assessment developed for the GBD study to estimate trends in attributable deaths and disability-adjusted life-years (DALY), by sex, and FU for HSBP from 1990 to 2017. This study included 14 HSBP-outcome pairs. HSBP was defined as ≥ 140 mmHg for prevalence estimates, and a theoretical minimum risk exposure level (TMREL) of 110–115 mmHg was considered for disease burden. We estimated the portion of deaths and DALYs attributed to HSBP. We also explored the drivers of trends in HSBP burden, as well as the correlation between disease burden and sociodemographic development index (SDI).
Results – In Brazil, the prevalence of HSBP is 18.9% (95% uncertainty intervals [UI] 18.5–19.3%), with an annual 0.4% increase rate, while age-standardized death rates attributable to HSBP decreased from 189.2 (95%UI 168.5–209.2) deaths to 104.8 (95%UI 94.9–114.4) deaths per 100,000 from 1990 to 2017. In spite of that, the total number of deaths attributable to HSBP increased 53.4% and HSBP raised from 3rd to 1st position, as the leading risk factor for deaths during the period. Regarding total DALYs, HSBP raised from 4th in 1990 to 2nd cause in 2017. The main driver of change of HSBP burden is population aging. Across FUs, the reduction in the age-standardized death rates attributable to HSBP correlated with higher SDI.
Conclusions – While HSBP prevalence shows an increasing trend, age-standardized death and DALY rates are decreasing in Brazil, probably as results of successful public policies for CVD secondary prevention and control, but suboptimal control of its determinants. Reduction was more significant in FUs with higher SDI, suggesting that the effect of health policies was heterogeneous. Moreover, HSBP has become the main risk factor for death in Brazil, mainly due to population aging.
DOI/link
doi.org/10.1186/s12963-020-00218-z
Autoria
Vínculo institucional
Lattes
Orcid
Bruno Ramos Nascimento
Faculdade de Medicina, Universidade Federal de Minas Gerais
Luísa Campos Caldeira Brant
Faculdade de Medicina, Universidade Federal de Minas Gerais
Simon Yadgir
Institute for Health Metrics and Evaluation, University of Washington
Gláucia Maria Moraes Oliveira
Faculdade de Medicina, Universidade Federal do Rio de Janeiro
Gregory Roth
Institute for Health Metrics and Evaluation, University of Washington
Scott Devon Glenn
Institute for Health Metrics and Evaluation, University of Washington
Meghan Mooney
Institute for Health Metrics and Evaluation, University of Washington
Mohsen Naghavi
Institute for Health Metrics and Evaluation, University of Washington
Valéria Maria Azeredo Passos
Faculdade Ciências Médicas de Minas Gerais
Bruce Bartholow Duncan
Programa de Pós-graduação em Epidemiologia e Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul
Diego Augusto Santos Silva
Universidade Federal de Santa Catarina, Centro de Pesquisa em Cineantropometria e Desempenho Humano
Deborah Carvalho Malta
Escola de Enfermagem, Departamento Materno Infantil e Saúde Pública, Universidade Federal de Minas Gerais
Antonio Luiz Pinho Ribeiro
Faculdade de Medicina, Universidade Federal de Minas Gerais