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

Faces da desigualdade: os efeitos da circulação de retratos de crianças desaparecidas no Brasil

In 1996, a public service specialized in missing children was created in Rio de Janeiro: “SOS Crianças Desaparecidas”. The creation of SOS met the requirements of the Brazilian federal law known as the Statute of the Child and Adolescent, and responded to the growing relevance assigned to the phenomenon of missing people in Brazil, especially through the activism of relatives of victims. Drawing from ethnographic research, the paper focuses on the multiple effects caused by one of the main actions carried out by social workers working in SOS: the systematic dissemination of portraits of missing girls and boys, carried out through agreements with NGOs, associations of relatives of missing persons, companies and other partners. I argue that the dissemination of photographs of missing persons has effects not only on the particular trajectory of each case of disappearance thus disseminated, but also on the biographies of other children and adolescents that, though not directly involved in the cases, end up being submitted to interventions by public services and agencies. More specifically, I try to unveil the subtle and determinant role of certain categories and moral judgments in the definition of which other children and adolescents other than victims of disappearance may end up suffering those interventions as a result of the circulation of missing girls and boys portraits.Em 1996 foi criado, no Rio de Janeiro, u.m serviço público especializado no desaparecimento de crianças e adolescentes: o SOS Crianças Desaparecidas. A criação do SOS atendeu a determinações da lei federal brasileira conhecida como Estatuto da Criança e do Adolescente, e respondeu à crescente importância conferida, sobretudo por meio da luta de familiares de vítimas, ao fenômeno do desaparecimento de pessoas no Brasil. A partir de pesquisa etnográfica realizada nas dependências do SOS, o artigo trata dos múltiplos efeitos provocados por uma das principais ações realizadas pelos assistentes sociais que trabalham no serviço: a divulgação sistemática de retratos de meninas e meninos desaparecidos, realizada por meio de convênios com ONGs, associações de familiares de desaparecidos, empresas e outros parceiros. Argumento que a difusão de fotografias de desaparecidos provoca efeitos não apenas na trajetória particular de cada desaparecimento assim divulgado, mas também nas biografias de outras crianças e adolescentes não diretamente envolvidos nos casos, que se tornam alvo de intervenções por parte de serviços e órgãos públicos. Mais especificamente, busco demonstrar o papel tão sutil quanto determinante de certas categorias e julgamentos morais na definição de quais outras crianças e adolescentes além das vítimas de desaparecimento podem terminar por sofrer intervenções em consequência da circulação de retratos de meninas e meninos desaparecidos.En 1996, un servicio público especializado en niños desaparecidos fue creado en Rio de Janeiro: “SOS Crianças Desaparecidas”. La creación de SOS se ajustaba a los requerimientos de la ley federal brasileña conocida como el Estatuto del Niño y el Adolescente, y respondía a la creciente relevancia otorgada al fenómeno de la desaparición de personas en Brasil, especialmente generada a través del activismo de los familiares de las víctimas. En base a una investigación etnográfica, el artículo aborda los múltiples efectos causados por una de las acciones centrales llevada a cabo por trabajadores sociales de SOS: la diseminación sistemática de fotografías de niñas y niños desaparecidos, realizada gracias al acuerdo con ONGs, asociaciones de familiares de personas desaparecidas, empresas y otros socios. Argumento que la diseminación de fotografías de personas desaparecidas tiene efectos no sólo en la trayectoria particular de cada caso de desaparición, sino también en las biografías de otros niños y adolescentes que, sin estar directamente involucrados en los casos, acabaron siendo afectados por las intervenciones de los servicios y agencias públicas. Más concretamente, busco desvelar el rol sutil y determinante de ciertas categorías y juicios morales en la definición de niños y adolescentes, además de aquellos víctimas de desaparición, que acabaron sufriendo de esas intervenciones como resultado de la circulación de fotografías de niñas y niños desaparecidos

Faces da desigualdade: os efeitos da circulação de retratos de crianças desaparecidas no Brasil

In 1996, a public service specialized in missing children was created in Rio de Janeiro: “SOS Crianças Desaparecidas”. The creation of SOS met the requirements of the Brazilian federal law known as the Statute of the Child and Adolescent, and responded to the growing relevance assigned to the phenomenon of missing people in Brazil, especially through the activism of relatives of victims. Drawing from ethnographic research, the paper focuses on the multiple effects caused by one of the main actions carried out by social workers working in SOS: the systematic dissemination of portraits of missing girls and boys, carried out through agreements with NGOs, associations of relatives of missing persons, companies and other partners. I argue that the dissemination of photographs of missing persons has effects not only on the particular trajectory of each case of disappearance thus disseminated, but also on the biographies of other children and adolescents that, though not directly involved in the cases, end up being submitted to interventions by public services and agencies. More specifically, I try to unveil the subtle and determinant role of certain categories and moral judgments in the definition of which other children and adolescents other than victims of disappearance may end up suffering those interventions as a result of the circulation of missing girls and boys portraits

Faces da desigualdade: Os efeitos da circulação de retratos de crianças desaparecidas no Brasil

In 1996, a public service specialized in missing children was created in Rio de Janeiro: “SOS Crianças Desaparecidas”. The creation of SOS met the requirements of the Brazilian federal law known as the Statute of the Child and Adolescent, and responded to the growing relevance assigned to the phenomenon of missing people in Brazil, especially through the activism of relatives of victims. Drawing from ethnographic research, the paper focuses on the multiple effects caused by one of the main actions carried out by social workers working in SOS: the systematic dissemination of portraits of missing girls and boys, carried out through agreements with NGOs, associations of relatives of missing persons, companies and other partners. I argue that the dissemination of photographs of missing persons has effects not only on the particular trajectory of each case of disappearance thus disseminated, but also on the biographies of other children and adolescents that, though not directly involved in the cases, end up being submitted to interventions by public services and agencies. More specifically, I try to unveil the subtle and determinant role of certain categories and moral judgments in the definition of which other children and adolescents other than victims of disappearance may end up suffering those interventions as a result of the circulation of missing girls and boys portraits.; En 1996, un servicio público especializado en niños desaparecidos fue creado en Rio de Janeiro: “SOS Crianças Desaparecidas”. La creación de SOS se ajustaba a los requerimientos de la ley federal brasileña conocida como el Estatuto del Niño y el Adolescente, y respondía a la creciente relevancia otorgada al fenómeno de la desaparición de personas en Brasil, especialmente generada a través del activismo de los familiares de las víctimas. En base a una investigación etnográfica, el artículo aborda los múltiples efectos causados por una de las acciones centrales llevada a cabo por trabajadores sociales de SOS: la diseminación sistemática de fotografías de niñas y niños desaparecidos, realizada gracias al acuerdo con ONGs, asociaciones de familiares de personas desaparecidas, empresas y otros socios. Argumento que la diseminación de fotografías de personas desaparecidas tiene efectos no sólo en la trayectoria particular de cada caso de desaparición, sino también en las biografías de otros niños y adolescentes que, sin estar directamente involucrados en los casos, acabaron siendo afectados por las intervenciones de los servicios y agencias públicas. Más concretamente, busco desvelar el rol sutil y determinante de ciertas categorías y juicios morales en la definición de niños y adolescentes, además de aquellos víctimas de desaparición, que acabaron sufriendo de esas intervenciones como resultado de la circulación de fotografías de niñas y niños desaparecidos.; Em 1996 foi criado, no Rio de Janeiro, u.m serviço público especializado no desaparecimento de crianças e adolescentes: o SOS Crianças Desaparecidas. A criação do SOS atendeu a determinações da lei federal brasileira conhecida como Estatuto da Criança e do Adolescente, e respondeu à crescente importância conferida, sobretudo por meio da luta de familiares de vítimas, ao fenômeno do desaparecimento de pessoas no Brasil. A partir de pesquisa etnográfica realizada nas dependências do SOS, o artigo trata dos múltiplos efeitos provocados por uma das principais ações realizadas pelos assistentes sociais que trabalham no serviço: a divulgação sistemática de retratos de meninas e meninos desaparecidos, realizada por meio de convênios com ONGs, associações de familiares de desaparecidos, empresas e outros parceiros. Argumento que a difusão de fotografias de desaparecidos provoca efeitos não apenas na trajetória particular de cada desaparecimento assim divulgado, mas também nas biografias de outras crianças e adolescentes não diretamente envolvidos nos casos, que se tornam alvo de intervenções por parte de serviços e órgãos públicos. Mais especificamente, busco demonstrar o papel tão sutil quanto determinante de certas categorias e julgamentos morais na definição de quais outras crianças e adolescentes além das vítimas de desaparecimento podem terminar por sofrer intervenções em consequência da circulação de retratos de meninas e meninos desaparecidos