MANIFESTAÇÕES ESTOMATOGNÁTICAS DE PACIENTES INFECTADOS PELO VÍRUS DA IMUNODEFICIÊNCIA HUMANA HIV/AIDS EM ÂMBITO HOSPITALAR: REVISÃO INTEGRATIVA DA LITERATURA

This article is a literature review that addresses a study of high relevance for dental care in patients with systemic impairment as a consequence of HIV, with a focus on hospital management. Human Immunodeficiency Virus (HIV) infection is a condition that affects 39 million people worldwide, presenting consequences in several areas and multifactorial circumstances in the human body, such as the pandemic, where there was a significant increase in deaths among HIV-positive people, including when the virus is associated with other opportunistic diseases, around 40.4 million deaths in the period 2020-2022 were from diseases associated with AIDS during the pandemic. The stomatognathic manifestations of HIV are significant in interfering with the patient's quality of life, and can react to medications, exacerbate autoimmune diseases, accentuate signs and symptoms of opportunistic infections, worsen oral ulcers that arise as a result of oncological treatment and changes in patients with other underlying diseases undergoing hospital treatment. The objective of this article is to provide an updated view of the patient as a whole and stomatognathic manifestations, in addition to highlighting the importance of early diagnosis through clinical evaluation of the oral cavity and adjacent structures, providing valuable information for health professionals, researchers and managers. hospitals, contributing to a more effective and compassionate approach to the care of HIV-positive patients with stomatognathic manifestations. Knowledge of these manifestations and their appropriate treatment, in addition to adding to the patient's well-being, is also capable of assisting in diagnosis and reducing morbidity associated with HIV.Este artigo é uma revisão de literatura que aborda um estudo de alta relevância para o atendimento odontológico em pacientes com comprometimento sistêmico como consequência do HIV, com enfoque no manejo hospitalar. A infecção pelo Vírus da Imunodeficiência Humana (HIV) é uma condição que afeta 39 milhões de pessoas no mundo, apresentando consequências em diversas áreas e circunstâncias multifatoriais  no corpo humano, como exemplo  a pandemia, onde  houve um aumento significativo de óbitos entre soropositivos, inclusive quando o vírus está associado a demais doenças oportunistas, cerca de 40,4 milhões de óbitos no período de 2020-2022 foram de doenças associadas a AIDS durante a pandemia. As manifestações estomatognáticas do HIV são significativas para interferir na qualidade de vida do paciente, podendo reagir a medicamentos, exacerbar doenças autoimunes, acentuar sinais e sintomas de infecções oportunistas, agregar piora nas úlceras orais que surgem com decorrência do tratamento oncológico e alterações em pacientes com outras doenças de base em tratamento hospitalar. O objetivo deste artigo é fornecer uma visão atualizada do paciente como um todo e das manifestações estomatognáticas, além de destacar a importância do diagnóstico precoce através da avaliação clínica da cavidade oral e estruturas adjacentes, através de informações valiosas para profissionais de saúde, pesquisadores e gestores hospitalares, contribuindo para uma abordagem mais eficaz e compassiva no cuidado de pacientes soropositivos com manifestações estomatognáticas. O conhecimento dessas manifestações e seu tratamento adequado além de agregar ao bem-estar do paciente é igualmente capaz de auxiliar no diagnóstico e reduzir a morbidade associada ao HIV

PERFIL EPIDEMIOLÓGICO DAS CRIANÇAS COM PNEUMONIA NO ESPÍRITO SANTO ENTRE 2018 E 2023

INTRODUCTION: Pneumonia is a clinical syndrome characterized by inflammation of the lung parenchyma, being the main infectious cause of death in children worldwide. In Brazil, pneumonia is considered the third cause of infant mortality. Coordination of care for children with pneumonia is essential, enabling early diagnosis and treatment, as well as continuity of care. OBJECTIVE: To identify socioeconomic, environmental and clinical factors of pediatric patients affected by pneumonia, focusing on the state of Espírito Santo. METHOD: Cross-sectional research, with a qualitative and quantitative approach, with data from January 2018 to August 2023. Data collection was carried out through the SUS Hospital Information System (SIH/SUS), hosted at DATASUS). The research participants were children from Espírito Santo with pneumonia, aged 0 to 9 years. RESULTS: In relation to the number of hospitalizations, black and brown race/color lead hospitalizations with a total of 65.20% of hospitalizations. In relation to hospitalizations by sex, in a total of 18,883 hospitalizations, 53.22% were male and 46.78% female. Assessing age, of the total of 18,883 hospitalizations, it was noticed that the majority were patients aged 1 to 4 years old with 54.52% of hospitalizations, under one year old 30.73% and 5 to 9 years old were 14.75%. of hospitalizations. CONCLUSION: The vast majority of cases were urgent. Of these, more than half of the hospitalizations occurred in the age group of 1 to 4 years. Furthermore, the highest number of deaths also occurred in this age group. Therefore, it is important to highlight the need for early diagnosis, identifying signs and symptoms in children, in order to reduce emergency hospitalizations and, concomitantly, the number of deaths from this disease.INTRODUÇÃO: A pneumonia é uma síndrome clínica caracterizada pela inflamação do parênquima pulmonar, sendo a principal causa infecciosa de morte em crianças no mundo. No Brasil,  a pneumonia é considerada a terceira causa de mortalidade infantil. A coordenação do cuidado da criança com pneumonia é fundamental, possibilitando o diagnóstico e o tratamento precoces, bem como a continuidade do cuidado. OBJETIVO: Identificar fatores socioeconômicos, ambientais e clínicos dos pacientes pediátricos acometidos pela pneumonia, com foco no estado do Espírito Santo. MÉTODO: Pesquisa transversal, de abordagem qualitativa e quantitativa, com dados referentes a janeiro de 2018 a agosto de 2023. A coleta dos dados foi feita através do Sistema de Informações Hospitalares do SUS (SIH/SUS), hospedado no DATASUS). Os componentes da pesquisa foram crianças capixabas com quadro de pneumonia, na faixa etária de 0 a 9 anos. RESULTADOS: Com relação ao número de internações, a raça/cor preta e parda lideram as internações com um total 65,20% das internações. Em relação às internações por sexo, em um total de 18.883 internações, 53,22% foram do sexo masculino e 46,78% do sexo feminino. Avaliando a idade, do total de 18.883 internações, percebeu-se que a maioria foram pacientes de 1 a 4 anos com 54,52% das internações, menores de um ano 30,73% e de 5 a 9 anos foram 14,75% das  internações. CONCLUSÃO: A grande maioria dos casos foi em caráter de urgência. Destes, mais da metade das internações ocorreu na faixa etária de 1-4 anos. Além disso, o maior número de óbitos também acompanhou esta faixa etária. Assim, é importante ressaltar a necessidade de diagnóstico precoce pela identificação de sinais e sintomas dos infantos, a fim de reduzir as internações em caráter de urgência e, concomitantemente, o número de óbitos por essa doença

PERFIL EPIDEMIOLÓGICO DE CRIANÇAS COM INFECÇÃO DE TRATO URINÁRIO NO ESPÍRITO SANTO ENTRE 2018 E 2023

INTRODUCTION: urinary tract infection (UTI) occurs due to the invasion and proliferation of microorganisms in the urinary system, which can compromise any segment of it, such as kidneys, ureters, bladder and urethra. UTI is a very common condition in pediatric patients and infants, considered one of the most common bacterial infections in pediatrics, which mostly affects girls. OBJECTIVE: To analyze the number of children with urinary tract infections and their respective epidemiological profile, in the last five years, focusing on the state of Espírito Santo. METHOD: Cross-sectional research, with a qualitative and quantitative approach, with data from January 2018 to August 2023. Data collection was carried out through the SUS Hospital Information System (SIH/SUS), hosted at DATASUS. The research participants were children from Espírito Santo with urinary tract infections, aged 0 to 9 years. RESULTS: Regarding the number of hospitalizations by race/color, brown ethnicities proved to be relevant with 65% of occurrences, followed by white ethnicities with 17.15%, in third place uninformed ethnicities with 16.25%, as well as to a lesser extent scale, black ethnicity with 64 cases 1.44%. Regarding the number of hospitalizations by sex, there was a greater predominance in females with 61.61% compared to males with 38.38% compared to the total. CONCLUSION: From data collection, it is concluded that UTI is a very common disease in children and breastfeeding women in Espírito Santo, with the majority of cases being female patients (61.61%), while ranges 0 to 4 years obtained the vast majority of cases (68.93%), with 98% of hospitalizations being urgent. Therefore, it is necessary to implement state prevention measures and early diagnosis of this disease, for better care for parents with their children, depending on their age, since in younger children there is a more non-specific clinical condition than in older children.INTRODUÇÃO: infecção do trato urinário (ITU) ocorre devido à invasão e a proliferação de microrganismos no sistema urinário, podendo comprometer qualquer segmento do mesmo, como rins, ureteres, bexiga e uretra. A ITU é uma condição muito comum em pacientes pediátricos e lactentes, considerada uma das infecções bacterianas mais frequentes na pediatria, na qual afeta majoritariamente as meninas. OBJETIVO: Analisar o número de crianças com infecção do trato urinário e seu respectivo perfil epidemiológico, nos últimos cinco anos, com foco no estado do Espírito Santo. MÉTODO: Pesquisa transversal, de abordagem qualitativa e quantitativa, com dados referentes a janeiro de 2018 a agosto de 2023. A coleta dos dados foi feita através do Sistema de Informações Hospitalares do SUS (SIH/SUS), hospedado no DATASUS. Os componentes da pesquisa foram crianças capixabas com quadro de infecção do trato urinário, na faixa etária de 0 a 9 anos. RESULTADOS: Com relação ao número de internações por raça/cor, etnias pardas mostrou-se relevante com 65% de ocorrências, seguido de etnia branca 17,15%, em terceiro lugar etnias não informadas com 16,25%, assim como em menor escala, etnia preta com 64 casos 1,44%. Referente ao número de internações por sexo, verificou-se maior predomínio no sexo feminino com 61,61% quando comparado ao sexo masculino de 38,38% contraposto a totalidade. CONCLUSÃO: A partir da coleta de dados, conclui-se que a ITU é uma doença muito comum em crianças e lactantes capixabas, sendo a maioria dos casos entre os pacientes de sexo feminino (61,61%), enquanto as faixas 0 a 4 anos obtiveram a grande maioria dos casos (68,93%), sendo que 98% das internações foram em caráter de urgência. Assim, faz-se necessário a implementação de medidas estatais de prevenção, e diagnóstico precoce dessa doença, para melhor atenção dos pais com seus filhos, conforme a idade, já que em crianças menores há uma clínica mais inespecífica do que a das crianças maiores

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants.

BACKGROUND: Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. METHODS: We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. FINDINGS: The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. INTERPRETATION: Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings. FUNDING: WHO

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings. Copyright (C) 2021 World Health Organization; licensee Elsevier

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions