65 research outputs found

    Black list and Alert list of the Aquatic Invasive Alien Species in the Iberian Peninsula: an action of the LIFE INVASAQUA

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    Resumen del trabajo presentado en VI Congreso Nacional sobre Especies Exóticas Invasoras y I Congreso Ibérico sobre EEI (EEI 2022) celebrado en Navarra del 20 al 23 de abril de 2022.One of the objectives of LIFE INVASQUA project is to develop tools that will be more efficient the Early Warning and Rapid Response (EWRR) framework for Invasive Alien Species in the Iberian Peninsula. Horizon scanning for high-risk IAS is basic in implementing measures to reduce new invasions, developing Alert lists, and to focus effort in the species already established, for instance making a Black list. We developed a trans national horizon scanning exercise focused on inland waters of Spain and Portugal in order to provide a prioritized lists (Black list and Alert list) of aquatic IAS that may pose a threat to aquatic ecosystems and socio economic sectors in the future. We followed a step approach of existing information about IAS (Plants, Freshwater Invertebrates, Estuarine Invertebrates and Vertebrates; 127 established taxa in Black list; 90 non established taxa in Alert list) combining with an expert scoring of prioritized taxa. IAS established in the Iberian aquatic system consistently highlighted as the worst included vertebrates (e.g. Cyprinus carpio, Gambusia holbrooki, Silurus glanis), freshwater and estuarine invertebrates (e.g. Procambarus clarkii, Dreissena polymorpha, Pacifastacus leniusculus, Ficopomatus enigmaticus, Callinectes sapidus, Corbicula fluminea) and plants (e.g. Eichhornia crassipes, Azolla filiculoides, Ludwigia grandiflora). Amongst taxa not yet established (Alert list), expert pointed to Perna viridis, Hydroides dirampha, Dreissena bugensis, Procambarus fallax f. virginallis, Perccottus glenii with higher risk of invasion, ecological and socioeconomic impacts. Over 20.6% of the taxa in the preliminary black list received no votes (no prioritization) by experts, 17.8% in the innitial alert list. Our horizon scanning approach is inclusive of all-taxa, prioritizes both established and emerging biological threats across trans-national scales, and considers not only the ecological impact, but also potential direct economic consequences as well as the manageability of invasive species.This work received funds from the LIFE Programme (LIFE17 GIE/ES/000515)

    Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

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    Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

    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

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    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

    Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

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    : The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p &lt; 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

    Whole-genome sequencing reveals host factors underlying critical COVID-19

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    Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care1 or hospitalization2,3,4 after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of population controls to find underlying disease mechanisms. Here we use whole-genome sequencing in 7,491 critically ill individuals compared with 48,400 controls to discover and replicate 23 independent variants that significantly predispose to critical COVID-19. We identify 16 new independent associations, including variants within genes that are involved in interferon signalling (IL10RB and PLSCR1), leucocyte differentiation (BCL11A) and blood-type antigen secretor status (FUT2). Using transcriptome-wide association and colocalization to infer the effect of gene expression on disease severity, we find evidence that implicates multiple genes—including reduced expression of a membrane flippase (ATP11A), and increased expression of a mucin (MUC1)—in critical disease. Mendelian randomization provides evidence in support of causal roles for myeloid cell adhesion molecules (SELE, ICAM5 and CD209) and the coagulation factor F8, all of which are potentially druggable targets. Our results are broadly consistent with a multi-component model of COVID-19 pathophysiology, in which at least two distinct mechanisms can predispose to life-threatening disease: failure to control viral replication; or an enhanced tendency towards pulmonary inflammation and intravascular coagulation. We show that comparison between cases of critical illness and population controls is highly efficient for the detection of therapeutically relevant mechanisms of disease

    I. Encuentro de la Red de Asentamientos Populares : aportes teórico-metodológicos para la reflexión sobre políticas públicas de acceso al hábitat

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    Contenidos Introducción / M. Cecilia Marengo, Ana Laura Elorza, Virginia Monayar ; Eje 1. Acceso al hábitat y urbanizaciones informales; Asentamientos (in)formales en pequeñas metrópolis del Cono Sur. Estado de situación y debate actual / Ricardo Apaolaza, Elizabeth Zenteno Torres, Marco Sumiza; Un análisis comparativo sobre la expansión de asentamientos populares en las ciudades patagónicas / Santiago Bachiller, Mariana Giaretto, Pablo Marigo, Natalia Usach ; Acceso al Hábitat para los ¨sin techo¨: la lucha por la tierra en la Ciudad de Posadas-Misiones / Myriam Elena Barone, Jonas Dumas, Mariela Dachary, Celia Draganchuk; El mercado informal de suelo y vivienda en resistencia. El caso del asentamiento en "La Rubita" Resistencia, Argentina / María Andrea Benitez, María Victoria Cazorla; Brazos Unidos un realojo en construcción colectiva / Borelli, Lily, Halich, Verónica; Transformaciones en el hábitat de asentamientos informales y políticas públicas sociales. El caso de barrio nuestro hogar III / Renzo Cáceres; Discursividad mediática sobre el acceso y producción del hábitat popular en el barrio Costanera / Debora Leticia Decima; Trayectorias residenciales y usos de la ciudad como clave de lectura de la lucha por el acceso a la ciudad / María Mercedes Di Virgilio, Natalia Cosacov, Denise Brikman, Mercedes Najman; Asentamientos en el borde metropolitano. Avances de investigación, reflexiones y preguntas / Lucas Jordán Dombroski; Repensando el acceso al hábitat en ciudades medias. La problemática habitacional de Tandil / Agustina Girado; Narrativas de un asentamiento de comienzos de siglo: más allá de la épica y la mafia / María Maneiro; Informalidad y periferia urbana. Derivas de la política habitacional / M. Cecilia Marengo, Virginia Monayar, Florencia Sosa; Sobre las ¿nuevas? ocupaciones de tierras. Notas para una periodización de las tomas en San Francisco Solano, 1981-2002 / Santiago Nardin Memorias villeras en disputa sobre las intervenciones estatales de erradicación en Villa 20 (1976-1983) / Julieta Oxman; El Centro para Erradicación de Villas de Emergencia. Planificación, censo y viviendas, Rosario (1964-1983) / Anahí G. Pagnoni; Ensayo de una cartografía de asentamientos informales en la Ciudad de Córdoba / German Gustavo Rebord, Andrea Karina Stiefkens; Urbanización y prácticas estatales en asentamientos populares en Comodoro Rivadavia. El caso del “Barrio las Américas” / Letizia Vázquez; Eje 2: Derecho a la ciudad: conflictos y disputas por el territorio urbano; La ciudad contra el barrio. El caso de los Barrios del Sur en San José de Costa Rica / Pablo Acuña Quiel; Procesos autogestionarios de hábitat popular y políticas urbanas en la ciudad de Ushuaia. Tierra del Fuego. Argentina / Alicia Delia Alcaráz; Conflictos y tensiones en la ocupación del suelo en Posadas. Misiones, Argentina: procesos de diferenciación / Lucia Mariana Andrujovich, Laura Josefa Krujoski,Myriam Elena Barone; Políticas públicas, exclusión y conformación de identidades colectivas / Sandra Raquel Ávalos; La reurbanización del Playón de Chacarita como problema público. Arenas, actores y políticas públicas / Joaquín Benítez; Relocalización, organización y derecho a la ciudad. El caso de Barrio Nuevo (La Plata) / María Sofía Bernat; Resistencias y disputas político-judiciales en casos de desalojos de asentamientos en Buenos Aires / María Cristina Cravino; Análisis de las herramientas territoriales de la organización ArqCom (LP) en el periodo 2012-2018 / Andrea Di Croce Garay, Nahir Meline Cantar, Ángeles Belén Carrizo Romero, Tamara Dileo; Planificación y urbanización del Barrio 31 y 31 bis / Rosana Karina Espejo; Mercado de suelo: tensiones y ambigüedades. El caso de la zona Norte de Resistencia, Chaco, Argentina / Sebastián Galvaliz, María del Rosario Olmedo; Marta Graciela Giró; Experiencias de urbanización y ciudadanización en La Carbonilla. Una propuesta de análisis en escalas / María Belén Garibotti, Luciana Boroccioni, María Florencia Girola ¿Integración? A la trama formal. De complejidades a desafíos / Carolain Izaguirre, Marion Tejera y Carolina Leiva; ¿Urbanizar o aniquilar? Disyuntivas ontológicas en los procesos de urbanización de las sierras de Córdoba / Denise Mattioli; Conflicto y construcción de resistencias en el asentamiento Barrio Flores / Emilia Elisa Molina; Conflictos territoriales y recualificación de la ribera. Los pescadores artesanales y los espacios públicos / Diego Roldán; El Bajo Belgrano: del Barrio de las Latas a la Villa 30 / Valeria Laura Snitcofsky; Líneas de fuga en un barrio de resistencia. Visualización de una lucha / Rafael Ramón Franco Spatuzza; Nuevas legalidades para la reurbanización de villas en CABA. Un desafío para los derechos / Agustín Territoriale, María Julia López; Los Vacíos Urbanos. Dinámicas Urbanas y Respuestas Innovadoras frente al Derecho a la Ciudad / Ezequiel Zeitune, Silvia A Politi, Natalia Czytajlo; Eje 3: Políticas públicas para atender la informalidad y de gestión en el hábitat popular; Tolerancia y precariedad. Advertencias de la política de regularización del Gran Resistencia al RENABAP / Miguel Ángel Barreto, Evelyn Roxana Abildgaard, María Laura Puntel; Adicciones y narcomenudeo, barreras (in) franqueables para los asentamientos informales en Tucumán, Argentina / Paula Boldrini; Políticas de relocalización de villas: ¿qué pasa después? La organización consorcial como práctica comunitaria / María Florencia Bruno, Belén Demoy, Natalia Fainburg, Romina Olejarczyk; La disputa por la participación y la noción de participación en disputa: una reflexión desde el proceso de urbanización de la Villa 31 (2015-2019) / Tomás Capalbo; Economía popular en asentamientos informales del Gran San Miguel de Tucumán / Corina María Cattáneo; La producción de territorialidades en el habitar un asentamiento: procesos de intervención estatal y disociaciones socio espaciales / Magali Chanampa; Estrategias de gestión territorial desde las políticas públicas: replicando el “modelo Medellín” con acento Cordobés / Ana Laura Elorza, Mónica Alvarado Rodríguez, Fani Balcazar, Ernesto Morillo, Mariana Gamboa; Discusiones sobre la conceptualización e identificación de asentamientos informales. Análisis de la realidad en Chubut / María Paula Ferrari, Sergio Andrés Kaminker, Roxana Yanina Velásquez; Barrios autoproducidos en ciudades intermedias. El caso de Río Grande, Tierra del Fuego AIAS / Nadia B. Finck; Luces y sombras del Programa Compra de Vivienda Usada / Elena Inés Gabriel Hernández; Programas de Inclusión Socio-Urbana: ¿Producto de última generación de la Nueva Agenda Urbana? / Fernando Murillo, Gabriel Artese, Andrés Mage; Los dispositivos de espera en las políticas habitacionales / Romina Olejarczyk; Tres debates recurrentes acerca de la vivienda para la población urbana de menores ingresos / Juan Santiago Palero; Nuevos asentamientos precarios: un desafío a la Política Habitacional y Urbana Chilena / Rubén Sepúlveda Ocampo, Felipe Núñez Orrego; Irrumpir con las recetas. Reflexiones en torno a desarrollo, políticas públicas y hábitat popular / Carla Eleonora Pedrazzani, María Inés Sesma.Esta publicación presenta los trabajos del I. Encuentro de la Red de Asentamientos Populares: aportes teórico -metodológicos para la reflexión sobre políticas públicas de acceso al hábitat, desarrollado los días 23 y 24 de mayo de 2019 en la Facultad de Arquitectura, Urbanismo y Diseño de la Universidad Nacional de Córdoba. En las últimas dos décadas, el INVIHAB (Instituto de Investigación de Vivienda y Hábitat) se ha conformado como un espacio de referencia en la investigación, transferencia y formación en temáticas relativas a las políticas de vivienda, territorio, informalidad urbana, ambiente y ciudadanía. Experiencia que ha llevado a la articulación con otros espacios académicos, organizaciones socio-territoriales, gobiernos locales, en el sentido de confluir en la comprensión, reflexión y formulación de propuestas para mitigar las desigualdades socioterritoriales. En este escenario, se viene construyendo una red de investigadores que estudian la informalidad urbana desde diversos enfoques -territoriales, físico-espaciales, sociales, urbanos, laborales, entre otros- tendientes a superar las miradas parciales y locales desde los abordajes teórico metodológicos y propiciar la comprensión del fenómeno desde una perspectiva que abarque la multiplicidad de campos y su complejidad.FIL: Marengo, María Cecilia. Universidad Nacional de Córdoba. Facultad de Arquitectura, Urbanismo y Diseño; Argentina.FIL: Elorza, Ana Laura. Universidad Nacional de Córdoba. Facultad de Arquitectura, Urbanismo y Diseño; Argentina.FIL: Monayar, Virginia. Universidad Nacional de Córdoba. Facultad de Arquitectura, Urbanismo y Diseño; Argentina

    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.

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    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

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    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

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    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
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