Mansouri Asieh, Khosravi Alireza, Mehrabani-Zeinabad Kamran, Kopec Jacek A, Adawi Karam I I, Lui Michelle, Abdul Rahim Hanan F, Anwar Wagida, Fadhil Ibtihal, Sulaiman Kadhim, Bazargani Nooshin, Saade Georges, Farhan Hasan A, AlMahmeed Wael, Bokhari Syedah Saira, Hassen Nejat, Alandejani Amani, Shirani Shahin, Abdin Amr, Manla Yosef, Johnson Catherine, Stark Benjamin, Roth Gregory A, Mokdad Ali H, Shariful Islam Sheikh Mohammed, Sarrafzadegan Nizal
Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
EClinicalMedicine. 2023 Jun 7;60:102034. doi: 10.1016/j.eclinm.2023.102034. eCollection 2023 Jun.
Hypertensive heart disease (HHD), one of the end-organ damage consequences of hypertension, is an important public health issue worldwide. Data on the HHD burden in the Eastern Mediterranean region (EMR) are scarce. We aimed to investigate the burden of HHD in the EMR, its member countries, and globally from 1990 to 2019.
We used 2019 Global Burden of Disease (GBD) data to report the HHD age-standardised prevalence, disability adjusted life years (DALYs), years of life lost (YLLs), and mortality, as well as HHD risk factors attribution percent with their 95% uncertainty interval (UI). Global data are reported alongside EMR data, and its 22 respective countries. We compared the burden of HHD by socio-demographic index (SDI), sex, age groups, and countries.
The age-standardised prevalence rate (per 100,000 population) of HHD was higher in the EMR (281.7; 95% UI: 204.5-383.4) in 2019, compared with the global prevalence (233.8; 95% UI: 170.5-312.9). The EMR age-standardised DALYs (per 100,000 population) for HHD in 2019 was 561.9 (361.0-704.1), compared with 268.2 (204.6-298.1) at the global level. There was an increase in HHD prevalence, reduction in mortality, and DALYs between 1990 and 2019 (4.01%, -7.6%, and -6.5%, respectively) in EMR. Among EMR countries, the highest versus lowest rates of age-standardised prevalence, mortality, and DALYs in 2019 [estimate (95% UI)] were in Jordan [561.62 (417.9-747.6)] versus Saudi Arabia [94.9 (69.5-129.0)]; Afghanistan [74.5 (23.7-112.3)] versus Saudi Arabia [4.3 (3.3-5.9)]; and Afghanistan [1374.1 (467.2-2020.7)] versus Qatar [87.11 (64.40-114.29)], respectively.
HHD remains a significant problem in the EMR, with a higher burden than global levels. Serious efforts toward high-quality management and prevention are strongly recommended. Based on this study, our recommendation for the EMR is to adopt effective preventive strategies. For example, promoting healthy dietary patterns and prompt screening for undiagnosed HTN in public places, promoting regular blood pressure measurements at home, and creating community awareness about early detection of HTN.
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高血压性心脏病（HHD）是高血压导致的终末器官损害后果之一，是全球重要的公共卫生问题。东地中海区域（EMR）关于HHD负担的数据稀缺。我们旨在调查1990年至2019年期间EMR、其成员国以及全球范围内HHD的负担情况。
我们使用2019年全球疾病负担（GBD）数据报告HHD的年龄标准化患病率、伤残调整生命年（DALYs）、寿命损失年数（YLLs）和死亡率，以及HHD风险因素的归因百分比及其95%不确定区间（UI）。全球数据与EMR数据及其22个各自国家的数据一同报告。我们按社会人口指数（SDI）、性别、年龄组和国家比较了HHD的负担情况。
2019年，EMR地区HHD的年龄标准化患病率（每10万人）（281.7；95% UI：204.5 - 383.4）高于全球患病率（233.8；95% UI：170.5 - 312.9）。2019年EMR地区HHD的年龄标准化DALYs（每10万人）为561.9（361.0 - 704.1），而全球水平为268.2（204.6 - 298.1）。1990年至2019年期间，EMR地区HHD的患病率有所上升，死亡率和DALYs有所下降（分别为4.01%、 - 7.6%和 - 6.5%）。在EMR国家中，2019年年龄标准化患病率、死亡率和DALYs的最高值与最低值[估计值（95% UI）]分别为约旦[561.62（417.9 - 747.6）]对比沙特阿拉伯[94.9（69.5 - 129.0）]；阿富汗[74.5（23.7 - 112.3）]对比沙特阿拉伯[4.3（3.3 - 5.9）]；以及阿富汗[1374.1（467.2 - 2020.7）]对比卡塔尔[87.11（64.40 - 114.29）]。
HHD在EMR地区仍然是一个重大问题，其负担高于全球水平。强烈建议为高质量管理和预防做出认真努力。基于本研究，我们对EMR地区的建议是采取有效的预防策略。例如，推广健康饮食模式，在公共场所对未诊断的高血压进行及时筛查，促进在家定期测量血压，并提高社区对高血压早期检测的认识。
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