TY - JOUR
T1 - Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017
T2 - a systematic analysis for the Global Burden of Disease Study 2017
AU - GBD 2017 Risk Factor Collaborators
AU - Stanaway, Jeffrey D.
AU - Afshin, Ashkan
AU - Gakidou, Emmanuela
AU - Lim, Stephen S.
AU - Abate, Degu
AU - Abate, Kalkidan Hassen
AU - Abbafati, Cristiana
AU - Abbasi, Nooshin
AU - Abbastabar, Hedayat
AU - Abd-Allah, Foad
AU - Abdela, Jemal
AU - Abdelalim, Ahmed
AU - Abdollahpour, Ibrahim
AU - Abdulkader, Rizwan Suliankatchi
AU - Abebe, Molla
AU - Abebe, Zegeye
AU - Abera, Semaw F.
AU - Abil, Olifan Zewdie
AU - Abraha, Haftom Niguse
AU - Abrham, Aklilu Roba
AU - Abu-Raddad, Laith Jamal
AU - Abu-Rmeileh, Niveen M.E.
AU - Accrombessi, Manfred Mario Kokou
AU - Acharya, Dilaram
AU - Acharya, Pawan
AU - Adamu, Abdu A.
AU - Adane, Akilew Awoke
AU - Adebayo, Oladimeji M.
AU - Adedoyin, Rufus Adesoji
AU - Adekanmbi, Victor
AU - Ademi, Zanfina
AU - Adetokunboh, Olatunji O.
AU - Adib, Mina G.
AU - Admasie, Amha
AU - Adsuar, Jose C.
AU - Afanvi, Kossivi Agbelenko
AU - Afarideh, Mohsen
AU - Agarwal, Gina
AU - Aggarwal, Anju
AU - Aghayan, Sargis Aghasi
AU - Agrawal, Anurag
AU - Agrawal, Sutapa
AU - Ahmadi, Alireza
AU - Ahmadi, Mehdi
AU - Ahmadieh, Hamid
AU - Ahmed, Muktar Beshir
AU - Aichour, Amani Nidhal
AU - Aichour, Ibtihel
AU - Aichour, Miloud Taki Eddine
AU - Akbari, Mohammad Esmaeil
AU - Akinyemiju, Tomi
AU - Akseer, Nadia
AU - Al-Aly, Ziyad
AU - Al-Eyadhy, Ayman
AU - Al-Mekhlafi, Hesham M.
AU - Alahdab, Fares
AU - Alam, Khurshid
AU - Alam, Samiah
AU - Alam, Tahiya
AU - Alashi, Alaa
AU - Alavian, Seyed Moayed
AU - Alene, Kefyalew Addis
AU - Ali, Komal
AU - Ali, Syed Mustafa
AU - Alijanzadeh, Mehran
AU - Alizadeh-Navaei, Reza
AU - Aljunid, Syed Mohamed
AU - Alkerwi, Ala'a
AU - Alla, François
AU - Alsharif, Ubai
AU - Altirkawi, Khalid
AU - Alvis-Guzman, Nelson
AU - Amare, Azmeraw T.
AU - Ammar, Walid
AU - Anber, Nahla Hamed
AU - Anderson, Jason A.
AU - Andrei, Catalina Liliana
AU - Androudi, Sofia
AU - Animut, Megbaru Debalkie
AU - Anjomshoa, Mina
AU - Ansha, Mustafa Geleto
AU - Antó, Josep M.
AU - Antonio, Carl Abelardo T.
AU - Anwari, Palwasha
AU - Appiah, Lambert Tetteh
AU - Appiah, Seth Christopher Yaw
AU - Arabloo, Jalal
AU - Aremu, Olatunde
AU - Ärnlöv, Johan
AU - Artaman, Al
AU - Aryal, Krishna K.
AU - Asayesh, Hamid
AU - Ataro, Zerihun
AU - Ausloos, Marcel
AU - Avokpaho, Euripide F.G.A.
AU - Awasthi, Ashish
AU - Quintanilla, Beatriz Paulina Ayala
AU - Ayer, Rakesh
AU - Ayuk, Tambe B.
AU - Azzopardi, Peter S.
AU - Babazadeh, Arefeh
AU - Badali, Hamid
AU - Badawi, Alaa
AU - Balakrishnan, Kalpana
AU - Bali, Ayele Geleto
AU - Ball, Kylie
AU - Ballew, Shoshana H.
AU - Banach, Maciej
AU - Banoub, Joseph Adel Mattar
AU - Barac, Aleksandra
AU - Barker-Collo, Suzanne Lyn
AU - Bärnighausen, Till Winfried
AU - Barrero, Lope H.
AU - Basu, Sanjay
AU - Baune, Bernhard T.
AU - Bazargan-Hejazi, Shahrzad
AU - Bedi, Neeraj
AU - Beghi, Ettore
AU - Behzadifar, Masoud
AU - Behzadifar, Meysam
AU - Béjot, Yannick
AU - Bekele, Bayu Begashaw
AU - Bekru, Eyasu Tamru
AU - Belay, Ezra
AU - Belay, Yihalem Abebe
AU - Bell, Michelle L.
AU - Bello, Aminu K.
AU - Bennett, Derrick A.
AU - Bensenor, Isabela M.
AU - Bergeron, Gilles
AU - Berhane, Adugnaw
AU - Bernabe, Eduardo
AU - Bernstein, Robert S.
AU - Beuran, Mircea
AU - Beyranvand, Tina
AU - Bhala, Neeraj
AU - Bhalla, Ashish
AU - Bhattarai, Suraj
AU - Bhutta, Zulfiqar A.
AU - Biadgo, Belete
AU - Bijani, Ali
AU - Bikbov, Boris
AU - Bilano, Ver
AU - Bililign, Nigus
AU - Sayeed, Muhammad Shahdaat Bin
AU - Bisanzio, Donal
AU - Biswas, Tuhin
AU - Bjorge, Tone
AU - Blacker, Brigette F.
AU - Bleyer, Archie
AU - Borschmann, Rohan
AU - Bou-Orm, Ibrahim R.
AU - Boufous, Soufiane
AU - Bourne, Rupert
AU - Brady, Oliver J.
AU - Brauer, Michael
AU - Brazinova, Alexandra
AU - Breitborde, Nicholas J.K.
AU - Brenner, Hermann
AU - Briko, Andrey Nikolaevich
AU - Britton, Gabrielle
AU - Brugha, Traolach
AU - Buchbinder, Rachelle
AU - Burnett, Richard T.
AU - Busse, Reinhard
AU - Butt, Zahid A.
AU - Cahill, Leah E.
AU - Cahuana-Hurtado, Lucero
AU - Campos-Nonato, Ismael R.
AU - Cárdenas, Rosario
AU - Carreras, Giulia
AU - Carrero, Juan J.
AU - Carvalho, Félix
AU - Castaneda-Orjuela, Carlos A.
AU - Rivas, Jacqueline Castillo
AU - Castro, Franz
AU - Catalá-López, Ferrán
AU - Causey, Kate
AU - Cercy, Kelly M.
AU - Cerin, Ester
AU - Chaiah, Yazan
AU - Chang, Hsing Yi
AU - Chang, Jung Chen
AU - Chang, Kai Lan
AU - Charlson, Fiona J.
AU - Chattopadhyay, Aparajita
AU - Chattu, Vijay Kumar
AU - Chee, Miao Li
AU - Cheng, Ching Yu
AU - Chew, Adrienne
AU - Chiang, Peggy Pei Chia
AU - Chimed-Ochir, Odgerel
AU - Chin, Ken Lee
AU - Chitheer, Abdulaal
AU - Choi, Jee Young J.
AU - Chowdhury, Rajiv
AU - Christensen, Hanne
AU - Christopher, Devasahayam J.
AU - Chung, Sheng Chia
AU - Cicuttini, Flavia M.
AU - Cirillo, Massimo
AU - Cohen, Aaron J.
AU - Collado-Mateo, Daniel
AU - Cooper, Cyrus
AU - Cooper, Owen R.
AU - Coresh, Josef
AU - Cornaby, Leslie
AU - Cortesi, Paolo Angelo
AU - Cortinovis, Monica
AU - Costa, Megan
AU - Cousin, Ewerton
AU - Criqui, Michael H.
AU - Cromwell, Elizabeth A.
AU - Cundiff, David K.
AU - Daba, Alemneh Kabeta
AU - Dachew, Berihun Assefa
AU - Dadi, Abel Fekadu
AU - Damasceno, Albertino Antonio Moura
AU - Dandona, Lalit
AU - Dandona, Rakhi
AU - Darby, Sarah C.
AU - Dargan, Paul I.
AU - Daryani, Ahmad
AU - Gupta, Rajat Das
AU - Neves, José Das
AU - Dasa, Tamirat Tesfaye
AU - Dash, Aditya Prasad
AU - Davitoiu, Dragos Virgil
AU - Davletov, Kairat
AU - De La Cruz-Góngora, Vanessa
AU - La Hoz, Fernando Pio De
AU - Leo, Diego De
AU - Neve, Jan Walter De
AU - Dharmaratne, Samath Dhamminda
AU - Doyle, Kerrie E.
AU - Farvid, Maryam S.
AU - Goli, Srinivas
AU - Hankey, Graeme J.
AU - Hendrie, Delia
AU - Khan, Muhammad Shahzeb
AU - Khan, Muhammad Ali
AU - Li, Shanshan
AU - Nguyen, Anh Quynh
AU - Nguyen, Ha Thu
AU - Phillips, Michael R.
AU - Sahebkar, Amirhossein
AU - Smith, David L.
AU - Stokes, Mark A.
AU - Thomas, Hannah J.
AU - Zhang, Kai
AU - Takahashi, Ken
PY - 2018/11/10
Y1 - 2018/11/10
N2 - Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk-outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk-outcome pairs, and new data on risk exposure levels and risk- outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017.
AB - Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk-outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk-outcome pairs, and new data on risk exposure levels and risk- outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017.
KW - CARDIOVASCULAR-DISEASES
KW - BLOOD-PRESSURE
KW - CHOLESTEROL
KW - TRENDS
UR - http://www.scopus.com/inward/record.url?scp=85056201749&partnerID=8YFLogxK
U2 - 10.1016/S0140-6736(18)32225-6
DO - 10.1016/S0140-6736(18)32225-6
M3 - Article
C2 - 30496105
SN - 0140-6736
VL - 392
SP - 1923
EP - 1994
JO - Lancet
JF - Lancet
IS - 10159
ER -