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Wellcome Trust
Alliance for Health Policy and Systems Research
Bernard Lown Scholars in Cardiovascular Health Program at Harvard T H Chan School of Public Health
Bloomberg Philanthropies
FONDECYT via CIENCIACTIVA/CONCYTEC
British Council
British Embassy
Newton-Paulet Fund
DFID/MRC/Wellcome Global Health Trials
Fogarty International Center
Grand Challenges Canada
International Development Research Center Canada
Inter-American Institute for Global Change Research
Medical Research Council
National Cancer Institute
National Heart, Lung, and Blood Institute
National Institute of Mental Health
Swiss National Science Foundation
Wellcome
World Diabetes Foundation
Academy of Medical Sciences Springboard Award
Royal Society
Background Describing the prevalence and trends of cardiometabolic risk factors that are associated with noncommunicable diseases (NCDs) is crucial for monitoring progress, planning prevention, and providing evidence to support policy efforts. We aimed to analyse the transition in body-mass index (BMI), obesity, blood pressure, raised blood pressure, and diabetes in the Americas, between 1980 and 2014. Methods We did a pooled analysis of population-based studies with data on anthropometric measurements, biomarkers for diabetes, and blood pressure from adults aged 18 years or older. A Bayesian model was used to estimate trends in BMI, raised blood pressure (systolic blood pressure >= 140 mm Hg or diastolic blood pressure >= 90 mm Hg), and diabetes (fasting plasma glucose >= 7.0 mmol/L, history of diabetes, or diabetes treatment) from 1980 to 2014, in 37 countries and six subregions of the Americas. Findings 389 population-based surveys from the Americas were available. Comparing prevalence estimates from 2014 with those of 1980, in the non-English speaking Caribbean subregion, the prevalence of obesity increased from 3.9% (95% CI 2.2-6.3) in 1980, to 18.6% (14.3-23.3) in 2014, in men; and from 12.2% (8.2-17.0) in 1980, to 30.5% (25.7-35.5) in 2014, in women. The English-speaking Caribbean subregion had the largest increase in the prevalence of diabetes, from 5.2% (2.1-10.4) in men and 6.4% (2.6-10.4) in women in 1980, to 11.1% (6.4-17.3) in men and 13.6% (8.2-21-0) in women in 2014). Conversely, the prevalence of raised blood pressure has decreased in all subregions; the largest decrease was found in North America from 27.6% (22.3-33.2) in men and 19.9% (15.8-24-4) in women in 1980, to 15.5% (11.1-20.9) in men and 10.7% (7.7-14.5) in women in 2014. Interpretation Despite the generally high prevalence of cardiometabolic risk factors across the Americas, estimates also showed a high level of heterogeneity in the transition between countries. The increasing prevalence of obesity and diabetes observed over time requires appropriate measures to deal with these public health challenges. Our results support a diversification of health interventions across subregions and countries. Copyright (C) 2019 The Author(s). Published by Elsevier.
Univ Peruana Cayetano Heredia, Lima, Peru
Imperial Coll London, London, England
Pontificia Univ Catolica Chile, Santiago, Chile
Univ West Indies, Cave Hill, Barbados
Univ Sao Paulo, Sao Paulo, SP, Brazil
Miami Vet Affairs Healthcare Syst, Miami, FL USA
Univ Kent, Canterbury, Kent, England
Cleveland Clin, Cleveland, OH 44106 USA
Yale Univ, New Haven, CT 06520 USA
Caja Costarricense Seguro Social, San Jose, Costa Rica
Inst Mexicano Seguro Social, Mexico City, DF, Mexico
Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Mexico City, DF, Mexico
Univ Cuenca, Cuenca, Ecuador
Univ Fed Pelotas, Pelotas, Brazil
Pan Amer Hlth Org, Washington, DC USA
Univ Pernambuco, Recife, PE, Brazil
Dalhousie Univ, Halifax, NS, Canada
Univ Fed Maranhao, Sao Luis, Maranhao, Brazil
CAFAM Univ Fdn, Bogota, Colombia
Univ Republica, Montevideo, Uruguay
Ctr Educ Med & Invest Clin, Buenos Aires, DF, Argentina
Univ Amsterdam, Amsterdam, Netherlands
Canadian Fitness & Lifestyle Res Inst, Ottawa, ON, Canada
Univ Fed Juiz de Fora, Juiz De Fora, Brazil
Univ Estadual Paulista, Sao Paulo, SP, Brazil
Univ Fed Santa Catarina, Florianopolis, SC, Brazil
Univ Montreal, Montreal, PQ, Canada
Univ Vale Rio dos Sinos, Sao Leopoldo, Brazil
Natl Council Sci & Tech Res, Buenos Aires, DF, Argentina
Univ West Indies, Kingston, Jamaica
Minist Hlth, Buenos Aires, DF, Argentina
Inst Nacl Salud Publ, Mexico City, DF, Mexico
Univ Fed Sao Paulo, Sao Paulo, SP, Brazil
Hosp Clin Porto Alegre, Porto Alegre, RS, Brazil
Univ Fed Rio Grande do Sul, Porto Alegre, RS, Brazil
McGill Univ, Montreal, PQ, Canada
Andes Clin Cardiometab Studies, Timotes, Venezuela
Natl Inst Hyg Epidemiol & Microbiol, Havana, Cuba
Univ ICESI, Cali, Colombia
Univ Estadual Montes Claros, Montes Claros, MG, Brazil
Kings Coll London, London, England
Inst Clin Effectiveness & Hlth Policy, Buenos Aires, DF, Argentina
Natl Inst Publ Hlth, Mexico City, DF, Mexico
Univ Autonoma Bucaramanga, Bucaramanga, Colombia
Kingston Gen Hosp, Kingston, ON, Canada
Heart Inst, Sao Paulo, SP, Brazil
Fdn Oftalmol Santander, Bucaramanga, Colombia
Simon Fraser Univ, Burnaby, BC V5A 1S6, Canada
Inst Trop Med, Antwerp, Belgium
Minist Salud Publ, Havana, Cuba
Harvard TH Chan Sch Publ Hlth, Boston, MA USA
West Virginia Univ, Morgantown, WV 26506 USA
Fundacao Oswaldo Cruz, Rene Rachou Res Inst, Rio De Janeiro, Brazil
Univ Fed Ouro Preto, Ouro Preto, Brazil
Hosp Israelita Albert Einstein, Sao Paulo, SP, Brazil
Emory Univ, Atlanta, GA 30322 USA
Gorgas Mem Inst Hlth Studies, Panama City, Panama
STAT Canada, Ottawa, ON, Canada
Univ Med Sci, Havana, Cuba
Gorgas Mem Inst Publ Hlth, Panama City, Panama
Univ Puerto Rico, Med Sci Campus, San Juan, PR 00936 USA
Univ Wisconsin, Madison, WI 53706 USA
Minas Gerais State Secretariat Hlth, Belo Horizonte, MG, Brazil
Univ Nove de Julho, Sao Paulo, SP, Brazil
Publ Hlth Agcy Canada, Ottawa, ON, Canada
Univ Ind Santander, Bucaramanga, Colombia
Natl Inst Hlth, Lima, Peru
Univ Sao Paulo, Clin Hosp, Sao Paulo, SP, Brazil
Hosp Italiano Buenos Aires, Buenos Aires, DF, Argentina
Univ Ctr Occidental Lisandro Alvarado, Barranquilla, Colombia
Epidemiol & Microbiol Inst, Havana, Cuba
Univ Fed Minas Gerais, Belo Horizonte, MG, Brazil
WHO, Geneva, Switzerland
Middlesex Univ, London, England
Univ Estadual Paulista, Sao Paulo, SP, Brazil
Alliance for Health Policy and Systems Research: HQHSR1206660
Bernard Lown Scholars in Cardiovascular Health Program at Harvard T H Chan School of Public Health: BLSCHP-1902
Newton-Paulet Fund: 223-2018
Newton-Paulet Fund: 224-2018
DFID/MRC/Wellcome Global Health Trials: MR/M007405/1
Fogarty International Center: R21TW009982
Fogarty International Center: D71TW010877
Grand Challenges Canada: 0335-04
International Development Research Center Canada: IDRC 106887
International Development Research Center Canada: 108167
Inter-American Institute for Global Change Research: IAI CRN3036
Medical Research Council: MR/P008984/1
Medical Research Council: MR/P024408/1
Medical Research Council: MR/P02386X/1
National Cancer Institute: 1P20CA217231
National Heart, Lung, and Blood Institute: HHSN268200900033C
National Heart, Lung, and Blood Institute: 5U01HL114180
National Heart, Lung, and Blood Institute: 1UM1HL134590
National Institute of Mental Health: 1U19MH098780
Swiss National Science Foundation: 40P740-160366
Wellcome: 074833/Z/04/Z
Wellcome: 093541/Z/10/Z
Wellcome: 107435/Z/15/Z
Wellcome: 103994/Z/14/Z
Wellcome: 205177/Z/16/Z
Wellcome: 214185/Z/18/Z
World Diabetes Foundation: WDF15-1224
