Trends in prevalence, mortality, and morbidity associated with high systolic blood pressure in Brazil from 1990 to 2017: estimates from the “Global Burden of Disease 2017” (GBD 2017) study

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