title: Continued increases in hypertension over three decades in Fiji, and the influence of obesity.
abstract: OBJECTIVE
  To analyse trends during 1980-2011 in hypertension prevalence and SBP/DBP by sex in Fiji Melanesian (i-Taukei) and Indian adults aged 25-64 years; and to assess effects of BMI.
  
  
  METHODS
  Unit record data from five population-based surveys were included (n = 14, 191). Surveys were adjusted to the nearest previous census to improve national representativeness. Hypertension was defined as SBP at least 140  mmHg and/or DBP at least 90  mmHg and/or on medication for hypertension. Regression (Poisson and linear) was used to assess period trends.
  
  
  RESULTS
  Over 1980-2011 hypertension prevalence (%) and mean blood pressure (BP) (SBP/DBP mmHg) increased significantly (P < 0.001) in both sexes and ethnicities. Increases in hypertension were: from 16.2 to 41.3% in i-Taukei men (mean BP from 122/73 to 135/81); from 20.5 to 37.8% in Indian men (mean BP from 122/74 to 133/81); from 25.9 to 36.9% in i-Taukei women (mean BP from 126/76 to 132/81); and from 17.6 to 33.1% in Indian women (mean BP 117/71 to 130/81). The age-adjusted trend in hypertension and mean BP (over 32 years) declined after adjusting for BMI, with effects of obesity greater in women than men, and in Indians than i-Taukei. BMI explained 45% of the age-adjusted increase in DBP over the period in Indians (both sexes), and 16% (men) and 38% (women) in i-Taukei.
  
  
  CONCLUSIONS
  Significant increases have occurred in hypertension prevalence and SBP/DBP in both sexes and ethnicities of Fiji during 1980-2011 with no indication of decline, contributing to significant premature mortality from cardiovascular disease.
authors.affiliation: aSchool of Public Health and Community Medicine, University of New South Wales, Randwick, Australia bFiji Ministry of Health, Suva cFiji National Food and Nutrition Centre, Suva Fiji dBaker IDI Heart and Diabetes Institute, Melbourne, Australia.
authors.forename: Christine
authors.initials: C
authors.lastname: Linhart
authors.forename: Isimeli
authors.initials: I
authors.lastname: Tukana
authors.forename: Sophia
authors.initials: S
authors.lastname: Lin
authors.forename: Richard
authors.initials: R
authors.lastname: Taylor
authors.forename: Stephen
authors.initials: S
authors.lastname: Morrell
authors.forename: Penina
authors.initials: P
authors.lastname: Vatucawaqa
authors.forename: Dianna
authors.initials: D
authors.lastname: Magliano
authors.forename: Paul
authors.initials: P
authors.lastname: Zimmet
mesh_terms: D000328:Adult; D044466:Asian People / Q000706:statistics & numerical data; D015992:Body Mass Index; D002318:Cardiovascular Diseases; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D005367:Fiji / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000208:ethnology; D007194:India; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology* / Q000208:ethnology; D016012:Poisson Distribution; D011158:Population Growth; D015995:Prevalence; D017678:Sex Distribution; D044465:White People / Q000706:statistics & numerical data