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

Proteolytic profile of aqueous leaf and seed extracts from Mucuna pruriens (L.) DC

Made available in DSpace on 2017-06-02T11:20:25Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 10.pdf: 672997 bytes, checksum: 6f9b1bb63c6cd9ef14a12e0995e13534 (MD5) Previous issue date: 23Fundação Oswaldo Cruz. Instituto de Tecnologia em Fármacos. Departamento de Química de Produtos Naturais. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto de Tecnologia em Fármacos. Departamento de Química de Produtos Naturais. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto de Tecnologia em Fármacos. Departamento de Química de Produtos Naturais. Rio de Janeiro, RJ, Brasil.Mucuna pruriens (L.) DC é uma planta medicinal, da família Fabaceae, usada no tratamento de diversas doenças. Extratos aquosos de folhas e sementes de M. pruriens foram preparados utilizando água, detergente Triton X-100 e tampões fosfato de sódio e Tris-HCl. Os extratos de folha exibiram os maiores teores de proteínas. Todos os extratos exibiram atividade sobre o substrato N-α-p-tosil-L-arginil-metil éster (L-TAME), principalmente nas faixas de pH ácido (4,0-5,0) e alcalino (9,0- 9,5), e atividade máxima nas temperaturas entre 40-60ºC, com exceção do extrato de semente obtido com tampão Tris-HCl (MP-ST), que apresentou pico em 80ºC. Os extratos de folhas exibiram perfis eletroforéticos semelhantes sob condições redutoras e não redutoras, sendo observada uma proteína majoritária com de cerca de 30 kDa. Na análise capacidade proteolítica, o zimograma apresentou um perfil distinto em diferentes valores de pH: em pH 9,0 os extratos obtidos com água (MP-EA) e com detergente (MP-ED) apresentaram atividade na região próxima de 170 kDa; em pH 9,5 pôde-se observar duas regiões de proteólise entre 66-90 e 200-250 kDa, com exceção do MP-EA. Os extratos de semente apresentaram perfis distintos em condições redutoras e não redutoras, com proteínas majoritárias entre 35 e 23 kDa, e atividade lítica sobre a gelatina na região de 80 kDa. Todos os extratos apresentaram atividade proteolítica contra os substratos proteicos hemoglobina, caseína e albumina e boa estabilidade na presença de agentes surfactantes e oxidantes. As proteases presentes nos extratos de M. pruriens sugerem ser da classe das serino e metaloproteases, com atividade modulada positivamente na presença íons Mn2+ e Ca2+. Essas características bioquímicas conferem aos extratos de M. Pruriens grande valor biotecnológico e possível potencial terapêutico.Mucuna pruriens is a medicinal plant, from Fabaceae family, used in the treatment of various diseases. Aqueous extracts from M. pruriens leaf and seed were prepared using water (MP-EA), detergent Triton X-100 (MP-ED), sodium phosphate and Tris-HCl buffers and leaf extracts presented the highest protein content. All extracts exhibited expressive activity against L-TAME in acid (4.0-5.0) and alkaline pH (9.0- 9.5) range and in temperatures about 40-60ºC, with exception of the seed extract prepared in Tris-HCl with maximal activity at 80ºC, besides all extracts preserved good stability in high temperatures. Leaf extracts showed similar electroforetical profiles under reducing and non-reducing conditions with a major protein of about 30 kDa. On the other hand, seed extracts presented distinctive protein profiles under reducing and non-reducing conditions, with major proteins between 35 and 23 kDa and the gelatinolytic activity in the region of 80 kDa. Leaf extracts showed distinct protease activity on gelatin in different pH values. Only MPEA e MP-ED presented gelatinolytic activity at pH 9,0 in the region about 170 kDa, on the other hand, at pH 9,5 was observed the protease activity on gelatin in two regions about 66-90 and 200-250 kDa, with the exception of MP-EA. All extracts hydrolyzed hemoglobin, casein and albumin and had good stability in the presence of surfactants and oxidizing agents. Proteases of Mucuna pruriens extracts belong to serine and metalloprotease classes, positively modulated by ions. They have biochemical features which gives them high biotechnological value and possible therapeutic potential

Qualidade da silagem de grão úmido em função da temperatura ambiente e pressão interna de armazenagem

Visando estabelecer a contribuição dos parâmetros físicos na qualidade final da silagem de grãos úmidos de milho, foi conduzido experimento, no interior de câmara climatizada, simulando cinco condições de temperatura ambiente (5ºC 24h-1 por dia; 25ºC 24h-1 por dia; 40ºC 24h-1 por dia; 20ºC 16h-1 por dia + 5ºC 8h-1 por dia; 30ºC 16h-1 por dia + 20ºC 8h-1 por dia) e duas condições de pressão no interior dos tambores de armazenagem (com e sem pressão interna). Para se determinar os efeitos sobre o grau de disponibilidade do amido na silagem pronta, procedeu-se a análises para avaliar a qualidade final da silagem (teor de umidade, pH, ácidos orgânicos, amido total e granulometria). O delineamento estatístico utilizado foi o inteiramente ao acaso, num fatorial 5 x 2, com três repetições. Os resultados obtidos indicaram influência significativa tanto da temperatura quanto da pressão, sendo os efeitos mais benéficos verificados nos tratamentos '30ºC 16h-1 por dia + 20ºC 8h-1 por dia', '25ºC 24h-1 por dia' e 'ausência de pressão'.In order to establish the contribution of the physical parameters in the final quality of high-moisture corn silage, an experiment was conducted in the interior of a climate-controlled chamber, simulating five conditions of room temperature (5ºC 24 hours-1 per day; 25ºC 24 hours-1 per day; 40ºC 24 hours-1 per day; 20ºC 16 hours-1 per day + 5ºC 8 hours-1 per day; 30ºC 16 hours-1 per day + 20ºC 8 hours-1 per day) and two conditions of pressure in the interior of plastic storage recipient (with and without internal pressure). To determine the effect on the degree of availability of the starch in the ready silage, analyses were carried out to evaluate the final quality of the silage (moisture content, pH, organic acid, total starch and granulometry). The experimental design was completely randomized, with 5x2 factorial schemes, with three repetitions. The obtained results indicated a significant effect of both temperature and pressure parameters, with the better quality index observed in the treatments '30ºC 16 hours-1 per day + 20ºC 8 hours-1 per day', '25ºC 24 hours-1 per day' and 'absence of internal pressure'

Qualidade da silagem de grão úmido em função da temperatura ambiente e pressão interna de armazenagem = High-moisture grain silage quality in function of room temperature and internal storage pressure

Visando estabelecer a contribuição dos parâmetros físicos na qualidade final da silagem de grãos úmidos de milho, foi conduzido experimento, no interior de câmara climatizada, simulando cinco condições de temperatura ambiente (5ºC 24h-1 por dia; 25ºC24h-1 por dia; 40ºC 24h-1 por dia; 20ºC 16h-1 por dia + 5ºC 8h-1 por dia; 30ºC 16h-1 por dia + 20ºC 8h-1 por dia) e duas condições de pressão no interior dos tambores de armazenagem (com e sem pressão interna). Para se determinar os efeitos sobre o grau de disponibilidade do amido na silagem pronta, procedeu-se a análises para avaliar a qualidade final da silagem (teor de umidade, pH, ácidos orgânicos, amido total e granulometria). O delineamentoestatístico utilizado foi o inteiramente ao acaso, num fatorial 5 x 2, com três repetições. Os resultados obtidos indicaram influência significativa tanto da temperatura quanto da pressão, sendo os efeitos mais benéficos verificados nos tratamentos ‘30ºC 16h-1 por dia + 20ºC 8h-1 por dia’, ‘25ºC 24h-1 por dia’ e ‘ausência de pressão’.In order to establish the contribution of the physical parameters in the final quality of high-moisture corn silage, an experiment was conducted in the interior of a climate-controlled chamber, simulating five conditions of room temperature (5ºC 24 hours-1 per day; 25ºC 24 hours-1 per day; 40ºC 24 hours-1 per day; 20ºC 16 hours-1 per day + 5ºC 8 hours-1 per day; 30ºC 16 hours-1 per day + 20ºC 8 hours-1per day) and two conditions of pressure in the interior of plastic storage recipient (with and without internal pressure). To determine the effect on the degree of availability of the starch in the ready silage, analyses were carried out to evaluate the final quality of the silage (moisture content, pH, organic acid, total starch and granulometry). The experimental design was completely randomized, with 5x2 factorial schemes, with three repetitions. The obtained results indicated a significant effect of both temperature and pressure parameters, with the better quality index observed in the treatments ‘30ºC 16 hours-1 per day + 20ºC 8 hours-1 per day’, ‘25ºC 24 hours-1 per day’ and ‘absence of internal pressure’

The genomic history of the Iberian Peninsula over the past 8000 years

We assembled genome-wide data from 271 ancient Iberians, of whom 176 are from the largely unsampled period after 2000 BCE, thereby providing a high-resolution time transect of the Iberian Peninsula. We document high genetic substructure between northwestern and southeastern hunter-gatherers before the spread of farming. We reveal sporadic contacts between Iberia and North Africa by ~2500 BCE and, by ~2000 BCE, the replacement of 40% of Iberia’s ancestry and nearly 100% of its Y-chromosomes by people with Steppe ancestry. We show that, in the Iron Age, Steppe ancestry had spread not only into Indo-European–speaking regions but also into non-Indo-European–speaking ones, and we reveal that present-day Basques are best described as a typical Iron Age population without the admixture events that later affected the rest of Iberia. Additionally, we document how, beginning at least in the Roman period, the ancestry of the peninsula was transformed by gene flow from North Africa and the eastern Mediterranean.J.M.F., F.J.L.-C., J.I.M., F.X.O., J.D., and M.S.B. were supported by HAR2017-86509-P, HAR2017-87695-P, and SGR2017-11 from the Generalitat de Catalunya, AGAUR agency. C.L.-F. was supported by Obra Social La Caixa and by FEDER-MINECO (BFU2015- 64699-P). L.B.d.L.E. was supported by REDISCO-HAR2017-88035-P (Plan Nacional I+D+I, MINECO). C.L., P.R., and C.Bl. were supported by MINECO (HAR2016-77600-P). A.Esp., J.V.-V., G.D., and D.C.S.-G. were supported by MINECO (HAR2009-10105 and HAR2013-43851-P). D.J.K. and B.J.C. were supported by NSF BCS-1460367. K.T.L., A.W., and J.M. were supported by NSF BCS-1153568. J.F.-E. and J.A.M.-A. were supported by IT622-13 Gobierno Vasco, Diputación Foral de Álava, and Diputación Foral de Gipuzkoa. We acknowledge support from the Portuguese Foundation for Science and Technology (PTDC/EPH-ARQ/4164/2014) and the FEDER-COMPETE 2020 project 016899. P.S. was supported by the FCT Investigator Program (IF/01641/2013), FCT IP, and ERDF (COMPETE2020 – POCI). M.Si. and K.D. were supported by a Leverhulme Trust Doctoral Scholarship awarded to M.B.R. and M.P. D.R. was supported by an Allen Discovery Center grant from the Paul Allen Foundation, NIH grant GM100233, and the Howard Hughes Medical Institute. V.V.-M. and W.H. were supported by the Max Planck Society

The genomic history of the Iberian Peninsula over the past 8000 years

We assembled genome-wide data from 271 ancient Iberians, of whom 176 are from the largely unsampled period after 2000 BCE, thereby providing a high-resolution time transect of the Iberian Peninsula. We document high genetic substructure between northwestern and southeastern hunter-gatherers before the spread of farming. We reveal sporadic contacts between Iberia and North Africa by ~2500 BCE and, by ~2000 BCE, the replacement of 40% of Iberia's ancestry and nearly 100% of its Y-chromosomes by people with Steppe ancestry. We show that, in the Iron Age, Steppe ancestry had spread not only into Indo-European-speaking regions but also into non-Indo-European-speaking ones, and we reveal that present-day Basques are best described as a typical Iron Age population without the admixture events that later affected the rest of Iberia. Additionally, we document how, beginning at least in the Roman period, the ancestry of the peninsula was transformed by gene flow from North Africa and the eastern Mediterranean.J.M.F., F.J.L.-C., J.I.M., F.X.O., J.D., and M.S.B. were supported by HAR2017-86509-P, HAR2017-87695-P, and SGR2017-11 from the Generalitat de Catalunya, AGAUR agency. C.L.-F. was supported by Obra Social La Caixa and by FEDER-MINECO (BFU2015- 64699-P). L.B.d.L.E. was supported by REDISCO-HAR2017-88035-P (Plan Nacional I+D+I, MINECO). C.L., P.R., and C.Bl. were supported by MINECO (HAR2016-77600-P). A.Esp., J.V.-V., G.D., and D.C.S.-G. were supported by MINECO (HAR2009-10105 and HAR2013-43851-P). D.J.K. and B.J.C. were supported by NSF BCS-1460367. K.T.L., A.W., and J.M. were supported by NSF BCS-1153568. J.F.-E. and J.A.M.-A. were supported by IT622-13 Gobierno Vasco, Diputación Foral de Álava, and Diputación Foral de Gipuzkoa. We acknowledge support from the Portuguese Foundation for Science and Technology (PTDC/EPH-ARQ/4164/2014) and the FEDER-COMPETE 2020 project 016899. P.S. was supported by the FCT Investigator Program (IF/01641/2013), FCT IP, and ERDF (COMPETE2020 – POCI). M.Si. and K.D. were supported by a Leverhulme Trust Doctoral Scholarship awarded to M.B.R. and M.P. D.R. was supported by an Allen Discovery Center grant from the Paul Allen Foundation, NIH grant GM100233, and the Howard Hughes Medical Institute. V.V.-M. and W.H. were supported by the Max Planck Society