LINK TO RESEARCH
The Lancet Global Health
NCD Risk Factor Collaboration (NCD-RisC)—Americas Working Group
Background: Describing the prevalence and trends of cardiometabolic risk factors that
are associated with non-communicable 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.
Funding: Wellcome Trust.
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