People with high blood pressure are at the greatest risk of ill health and an early death, according to the Global Burden of Disease Study, with tobacco use as the second biggest danger, and alcohol use third. Among young people, aged between 15 and 49, a drinking habit is the most likely cause of disability and an early grave.
High blood pressure can be caused or made worse by diet, such as too much sodium in salt and salty foods, but some populations have a genetic predisposition, as in India. In Europe and North America, many middle-aged people are given pills to bring their blood pressure down because it is a big risk factor for stroke, one of the main causes of death in the world today.
The IHME study finds that in 2010, high blood pressure was to blame for 9.4 million early deaths and 7% of DALYs (disability-adjusted life years – a standardised measure of the amount of poor health a person suffers). This compared with 6.3 million people killed as a consequence of smoking or inhaling other people's smoke. Tobacco also caused 6.3% of global DALYs.
Alcohol caused 5 million deaths in 2010 and 5.5% of global DALYs. Drinking can cause liver cancer and cirrhosis, but also plays a part in other diseases, such as cancer of the oesophagus, and kills because intoxicated people often end up in violent incidents and accidents. The study shows that alcohol has become a big problem now in eastern Europe, where it is responsible for a quarter of all disease. It also takes a big toll across Latin America.
Poor diet and inactivity together are responsible for 12.5 million deaths and 10% of disability. The biggest nutritional issues are diets that are low in fruit and diets high in sodium.
Indoor stoves burning wood, animal dung, charcoal and coal, which pollute the air in homes in sub-Saharan Africa and Asia, are a big risk for disease and early death. The study estimates that they caused 4 million deaths – double the estimate WHO made in 2009. They can cause lung cancer and disease, lower respiratory infections in children, cardiovascular disease and cataracts.
Radha Muthiah, executive director of the Global Alliance for Clean Cookstoves, which is trying to get clean and affordable alternatives into poor homes, said: "These results provide further momentum to our mission to ensure that cooking doesn't kill." Malnutrition and not breastfeeding for long enough are the other two major risks in sub-Saharan Africa.
