Transitions of cardio-metabolic risk factors in the Americas between 1980 and 2014

Background: Describing the levels and trends of cardio-metabolic risk factors associated with non-communicable diseases (NCDs) is vital for monitoring progress, planning prevention and provide evidence to support policy efforts. We aimed to analyse the transition in body-mass index (BMI), obesity, blood pressure, raised blood pressure (RBP) and diabetes in the Americas, 1980-2014. Methods: Pooled analysis of population-based studies with data on anthropometric measurements, biomarkers for diabetes, and blood pressure from adults aged 18+ years. A Bayesian model was used to estimate trends in BMI, RBP (systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg) and diabetes (fasting plasma glucose ≥7.0 mmol/l, history of diabetes, or diabetes treatment) from 1980 to 2014 in 37 countries and 6 sub-regions of the Americas. Findings: 389 population-based surveys from the Americas were available. Comparing the 2014 with the 1980 prevalence estimates, the obesity ratio was the largest in the non-English-speaking Caribbean sub-region (4.71 in men and 2.50 in women) showing that the prevalence in 2014 for men is almost five times larger than it was in 1980. The English-speaking Caribbean sub-region had the largest ratio regarding diabetes (2.14 in men and 2.13 in women). Conversely, the ratio for RBP signals that the frequency of this condition has diminished across the region; the largest decrease was found in North America (0.56 in men and 0.54 in women). Interpretation: Despite the generally high prevalence of cardio-metabolic risk factors across the Americas region, estimates also show a high level of heterogeneity in the transition between countries