Particulate matter air pollution and high systolic blood pressure (SBP) are the top contributors to the global disease burden, especially to blood pressure deaths. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, published in The Lancet, provides a comprehensive analysis of health risks, exposure levels, and disease burden. It covers 88 risk factors across 204 countries and 811 subnational locations from 1990 to 2021. This study highlights major health risks impacting global health.
GBD (The Global Burden of Diseases) – measures how much illness, disability, and death different diseases and injuries cause around the world.
Leading Contributors to Global Disease Burden
The GBD 2021 study identifies particulate matter air pollution as the leading contributor to the global disease burden in 2021. It accounts for 8% of the total Disability-Adjusted Life Years (DALYs). High systolic blood pressure (SBP) follows closely, contributing 7.8% of total DALYs. Other significant contributors include smoking, low birth weight, short gestation, and high fasting plasma glucose (FPG). These factors accounted for 5.7%, 5.6%, and 5.4% of total DALYs, respectively[16].
👉 Disability-Adjusted Life Years (DALYs): This is a measure of overall disease burden. It combines years of life lost due to premature death and years lived with disability.
👉 Gestation: This refers to the period of development during the carrying of an embryo or fetus inside the womb.
👉 Fasting Plasma Glucose (FPG): This is a test that measures blood sugar levels after fasting for at least 8 hours.
Age-Specific Risk Factors
The study in blood pressure deaths highlights the variation in leading risk factors across different age groups. For individuals between zero and four years old and those between five and 14 years old, unsafe water, low birth weight, short gestation, inadequate handwashing, and poor sanitation were the leading risk factors. For older people, high body-mass index (BMI), high FPG, high SBP, and elevated low-density lipoprotein (LDL) cholesterol levels were identified as the primary risk factors.
👉 Body-Mass Index (BMI): This is a measure of body fat based on height and weight.
👉 Low-Density Lipoprotein (LDL): Often referred to as “bad” cholesterol, high levels can lead to plaque buildup in arteries and result in heart disease.
The Impact of the COVID-19 Pandemic
The COVID-19 pandemic highlighted health disparities at both individual and geographic levels, with regards to blood pressure deaths. These disparities are driven by various risk factors and differences in healthcare systems worldwide. The GBD’s risk factor meta-analyses serve as valuable resources for policymakers. They help address emerging or persistent health challenges. By estimating the relative health risk associated with exposure to multiple risk factors and their attributable disease burden, the GBD provides essential data for these analyses.
Linking Blood Pressure Deaths to Risk Factors
Linking disease burden to risk factors is crucial. It helps prioritization with limited resources. The current study identified several risk factors for which insufficient actions have been taken. This highlights the need for targeted interventions and policies to address these risk factors effectively.
What the Study Says About Blood Pressure Deaths
High systolic blood pressure (SBP) remains a significant public health challenge. Blood pressure deaths: it is a leading risk factor for mortality worldwide. In 2019, high SBP affected 4.06 billion people and led to 10.8 million deaths globally. The GBD 2021 study found that high SBP accounted for 7.8% of total DALYs, making it one of the top contributors to the global disease burden.
High SBP is closely associated with cardiovascular diseases (CVDs). These are the leading contributors to mortality and disability. The burden of cardiovascular disease attributable to high SBP has been extensively studied.
It reveals significant geographical variations and temporal trends. For instance, in China, high SBP was responsible for 2.67 million cardiovascular disease deaths and 48.16 million years of life lost (YLLs) in 2019. The age-standardized cardiovascular disease mortality rate attributable to high SBP was 268.99 per 100,000 people. This means that, after adjusting for age differences in the population, there were about 269 deaths from cardiovascular disease for every 100,000 people, specifically linked to high SBP.
👉 Years of Life Lost (YLLs): This is a measure of premature mortality. It represents the number of years a person would have lived if they had not died prematurely.
Regional and Demographic Variations in Blood Pressure Deaths
The burden of high SBP varies significantly across regions and demographic groups. For example, the prevalence of high SBP and its associated disease burden is higher in low and middle-income countries compared to high-income countries. Additionally, males tend to have higher disease burdens than females. Middle-aged individuals with CVDs are the most affected subgroup.
Impact on Older Adults
High blood pressure is a big problem, especially for older people. From 1990 to 2019, the number of older people dying because of high blood pressure went up by 54.1%. The number of years they lived with illness or disability from it also increased by 52.4%.
However, even though more people are affected, the rates of death and disability from high blood pressure have gone down by about 27%. This suggests that we’re getting better at managing high blood pressure.
Conclusion
The GBD 2021 study provides a detailed and comprehensive analysis of the global health landscape. It highlights the major health risks and their impact on disease burden. Particulate matter air pollution and high systolic blood pressure (SBP) have emerged as the top contributors to the global disease burden. This underscores the need for targeted interventions and policies to address these risk factors. The study also emphasizes the importance of linking disease burden to risk factors. This helps inform prioritization with limited resources. Despite its limitations, the GBD 2021 study serves as a valuable resource for policymakers and healthcare professionals worldwide. It provides essential data to address emerging and persistent health challenges.
Further reading
Measuring the Global Burden of Disease and Risk Factors, 1990–2001 – NCBI, 2024
Environmental Health: Estimations of Attributable Burden of Disease Due to a Risk Factor – WHO, 2024
Health and Environmental Effects of Particulate Matter (PM) – EPA, 2024
Global Burden of Disease Study 2019 (GBD 2019) Results – Nature, 2024
What We Learned About Global Burden of Disease – World Bank, 2024
Effects of Elevated Systolic Blood Pressure on Ischemic Heart Disease Burden – Health Data, 2024
Global Burden of Disease Study 2019 (GBD 2019) Results – The Lancet, 2024
COVID-19 Pandemic Highlights Longstanding Health Inequities in U.S. – Harvard, 2024
Health Threats from High Blood Pressure – American Heart Association, 2024
Health Impacts of Air Quality – WHO, 2024
