He Chuan, Lu Saien, Yu Haijie, Sun Yingxian, Zhang Xueyao
Department of Laboratory Medicine, First Hospital of China Medical University, Shenyang, Liaoning Province, China.
National Clinical Research Center for Laboratory Medicine, First Hospital of China Medical University, Shenyang, Liaoning Province, China.
BMC Med. 2025 Feb 6;23(1):74. doi: 10.1186/s12916-025-03918-1.
High systolic blood pressure (HSBP) can cause adverse cardiovascular events and is therefore associated with a heavy global disease burden. However, this disease burden is poorly understood in youth and young adults. We aimed to explore this population to better understand the evolving trends in HSBP-related disease burden, which is crucial for effectively controlling and mitigating harmful effects.
This systematic analysis used data from the 2021 Global Burden of Disease Study, spanning 1990-2021. Participants were aged 15-39 years from 204 countries/territories. We analysed HSBP-related disease burden by region, sex, age, and temporal trends. The primary outcomes were disability-adjusted life years (DALYs), mortality rates, and estimated annual percentage change.
Globally, the number of HSBP-related deaths among youth and young adults has increased by 36.11% (95% uncertainty interval [95% UI], 20.96-52.37%), whereas the number of DALYs has increased by 37.68% (95% UI, 22.69-53.65%); however, global mortality and DALY rates have remained relatively stable. In 2021, the mortality and DALY rates were 4.29 (95% UI, 3.29-5.28) and 263.37 (95% UI, 201.40-324.46) per 100,000 population, respectively. The overall HSBP-related burden was higher in males than in females, with increasing and decreasing trends for males and females, respectively. Regionally, significant improvements in HSBP-related burden were observed in most high-sociodemographic index (SDI) regions, including high-income Asia Pacific (deaths: percentage change, - 72.65%; DALYs: percentage change, - 69.30%) and Western Europe (deaths: percentage change, - 72.89%; DALYs: percentage change, - 67.48%). In contrast, middle-SDI regions had the highest number of deaths and DALYs in 2021, whereas low-middle-SDI regions had the highest mortality and DALY rates. Furthermore, low-SDI regions experienced the largest increase in the number of deaths and DALYs. The HSBP-related burden increased with age; in addition, the proportion of deaths or DALYs due to ischaemic heart disease and stroke increased with age, reaching > 75% for those > 25 years of age.
The increase in global HSBP-related burden among youth and young adults indicates that current preventative efforts are insufficient. Therefore, targeted measures are needed to counter the trends in HSBP-related diseases and reduce disparities across regions and sexes.
高收缩压（HSBP）可导致不良心血管事件，因此与全球沉重的疾病负担相关。然而，青少年和青年人群中的这种疾病负担尚不清楚。我们旨在对这一人群进行探索，以更好地了解与HSBP相关的疾病负担的演变趋势，这对于有效控制和减轻有害影响至关重要。
本系统分析使用了2021年全球疾病负担研究的数据，时间跨度为1990年至2021年。参与者来自204个国家/地区，年龄在15至39岁之间。我们按地区、性别、年龄和时间趋势分析了与HSBP相关的疾病负担。主要结局指标为伤残调整生命年（DALYs）、死亡率和估计年变化百分比。
在全球范围内，青少年和青年人群中与HSBP相关的死亡人数增加了36.11%（95%不确定区间[95% UI]，20.96 - 52.37%），而DALYs增加了37.68%（95% UI，22.69 - 53.65%）；然而，全球死亡率和DALY率保持相对稳定。2021年，每10万人口的死亡率和DALY率分别为4.29（95% UI，3.29 - 5.28）和263.37（95% UI，201.40 - 324.46）。总体而言，与HSBP相关的负担男性高于女性，男性呈上升趋势，女性呈下降趋势。在区域方面，大多数高社会人口学指数（SDI）地区，包括高收入亚太地区（死亡：百分比变化，-72.65%；DALYs：百分比变化，-69.30%）和西欧（死亡：百分比变化，-72.89%；DALYs：百分比变化，-67.48%），与HSBP相关的负担有显著改善。相比之下，中等SDI地区在2021年的死亡人数和DALYs最多，而低中等SDI地区的死亡率和DALY率最高。此外，低SDI地区的死亡人数和DALYs增加幅度最大。与HSBP相关的负担随年龄增长而增加；此外，因缺血性心脏病和中风导致的死亡或DALYs比例随年龄增长而增加，25岁以上人群这一比例超过75%。
全球青少年和青年人群中与HSBP相关的负担增加表明当前的预防措施不足。因此，需要采取针对性措施来应对与HSBP相关疾病的趋势，并减少地区和性别之间的差异。
