Majid EzzatiBin ZhouJames BenthamMariachiara Di CesareHonor BixbyGoodarz DanaeiKaveh HajifathalianCristina TaddeiRodrigo M. Carrillo-LarcoShirin DjalaliniaShahab KhatibzadehCharles LugeroNiloofar PeykariWan Zhu ZhangJames BennettVer BilanoGretchen A. StevensMelanie J. CowanLeanne M. RileyZhengming ChenIan R. HambletonRod T. JacksonAndre Pascal KengneYoung Ho KhangAvula LaxmaiahJing LiuReza MalekzadehHannelore K. NeuhauserMaroje SorićGregor StarcJohan SundströmMark WoodwardLeandra Abarca-GómezZiad A. AbdeenNiveen M. Abu-RmeilehBenjamin Acosta-CazaresRobert J. AdamsWichai AekplakornKaosar AfsanaCarlos A. Aguilar-SalinasCharles AgyemangNoor Ani AhmadAlireza AhmadvandWolfgang AhrensKamel AjlouniNazgul AkhtaevaRajaa Al-RaddadiMohamed M. AliOsman AliAla'a AlkerwiEman AlyDeepak N. AmarapurkarPhilippe AmouyelAntoinette AmuzuLars Bo AndersenSigmund A. AnderssenLars H. ÄngquistRanjit Mohan AnjanaDaniel AnsongHajer Aounallah-SkhiriJoana AraújoInger AriansenTahir ArisNimmathota ArlappaDominique ArveilerKrishna K. AryalThor AspelundFelix K. AssahMaria Cecília F. AssunçãoMacria AvdicováAna AzevedoFereidoun AziziBontha V. BabuSuhad BahijriNagalla BalakrishnaMohamed BamoshmooshMaciej BanachPiotr BandoszJosé R. BanegasCarlo M. BarbagalloAlberto BarcelóAmina BarkatAluisio J.D. BarrosMauro V. BarrosIqbal BataAnwar M. BatiehaAssembekov BatyrbekLouise A. BaurRobert BeagleholeHabiba Ben RomdhaneMikhail BenetLowell S. BensonAntonio Bernabe-OrtizGailute BernotieneHeloisa BettiolAroor BhagyalaxmiSumit BharadwajSantosh K. BhargavaYufang BiMukharram BikbovLeibniz Institute for Prevention Research and EpidemiologyWestern Norway University of Applied SciencesLietuvos sveikatos mokslų universitetasKazakh National Medical UniversityUniversity of LilleB. J. Medical College, AhmedabadCaja Costarricense de Seguro SocialShanghai Jiao Tong University School of MedicineBeijing Anzhen HospitalBirzeit UniversityLuxembourg Institute of HealthKomfo Anokye Teaching HospitalMulago HospitalThe University of the West IndiesUniversidad Peruana Cayetano HerediaHaskoli IslandsUniversité de Yaoundé IJordan University of Science and TechnologyUniversity of Tunis El ManarHarvard School of Public HealthAl-Quds UniversityLondon School of Hygiene & Tropical MedicineUniversity of LjubljanaSouth African Medical Research CouncilUniversity of New South Wales (UNSW) AustraliaTehran University of Medical SciencesOrganisation Mondiale de la SantéUniversity of OxfordUniversidad Autónoma de MadridThe University of SydneyIndian Council of Medical ResearchUniversity of Utah, School of MedicineUniversidade de PernambucoShiraz University of Medical SciencesCleveland Clinic FoundationMohammed V University in RabatShahid Beheshti University of Medical SciencesUniversiti Malaysia SabahUniversità degli Studi di PalermoNational Institute of Nutrition IndiaBrandeis UniversityRobert Koch InstitutDalhousie UniversityImperial College LondonUniversidade Federal de PelotasMiddlesex UniversityPan American Health OrganizationSeoul National UniversityKementerian Kesihatan MalaysiaMahidol UniversityGdanski Uniwersytet MedycznyNorwegian Institute of Public HealthBombay Hospital and Medical Research CentreUniversity of KentThe University of AdelaideInstituto Nacional de la Nutrición Salvador ZubiranInstituto Mexicano del Seguro SocialUniversity of ZagrebUniversidade de Sao Paulo - USPIranian Ministry of Health and Medical EducationUniversidade do PortoMedical University of LodzUniversity of AucklandKing Abdulaziz UniversityNorges idrettshøgskoleUppsala UniversitetUniversity of AmsterdamMadras Diabetes Research FoundationNational Center for Diabetes and EndocrinologyCAFAM University FoundationGerman Center for Cardiovascular ResearchSL Jain HospitalNon-Communicable Diseases Research CenterStrasbourg University and HospitalChirayu Medical CollegeBispebjerg and Frederiksberg HospitalsUganda Heart InstituteNational Institute of Public HealthBRACNepal Health Research CouncilRegional Authority of Public HealthUfa Eye Research InstituteUniversity of Science and Technology2019-08-282019-08-282018-06-01International Journal of Epidemiology. Vol.47, No.3 (2018), 872-883i14643685030057712-s2.0-85050702158https://repository.li.mahidol.ac.th/handle/123456789/46660© The Author(s) 2018. Background: Change 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. Methods: We 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 (probittransformed) 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. Results: In 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 highincome 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. Conclusions: Change 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.Mahidol UniversityMedicineArticleSCOPUS10.1093/ije/dyy016