Introduction Information on levels and trends of risk factors is essential for policy making. However, very few comprehensive and consistent global estimates are available. We collected a global database of population level summaries of systolic blood pressure (SBP), body mass index (BMI), serum total cholesterol (TC) and fasting plasma glucose (FPG) and estimated levels and trends since 1980.
Methods For each risk factor, we searched for published articles, analysed health surveys, and included unpublished reports. We excluded non-random samples or self-reported measurements. We used a Bayesian hierarchical model with a non-linear age component and a smoothing time trend for each sex separately.
Results BMI had the most available data (960 country-years), followed by SBP (786), FPG (346) and TC (321). SBP declined in high-income regions by 2.1 to 3.9 mm Hg/decade, remained the same in East and South Asia and increased in Oceania and Eastern sub-Saharan Africa. TC declined in high-income regions by 0.2 mmol/l/decade and increased in East and South-East Asia and Pacific by 0.08–0.09 mmol/l/decade. BMI increased in virtually all regions with a global slope of 0.4 kg/m2/decade in men and 0.5 in women. FPG levels rose by 0.07–0.08 mmol/l/decade globally. FPG rose in all regions except for East and South-East Asia and Central and Eastern Europe.
Conclusion There was a large variation in levels and trends of metabolic risk factors. Population and individual-level interventions should be formulated to continue beneficial trends and reverse the hazardous ones. National health surveys are essential in monitoring such interventions.
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