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

Reaction of melon genotypes to the gummy stem blight and the downy mildew Reação de genótipos de melão ao crestamento gomoso e ao míldio

The gummy stem blight (Didymella bryoniae) and the downy mildew (Pseudoperonospora cubensis) are two foremost melon (Cucumis melo) diseases, considering their effects on yield and fruit quality. Despite the importance of such diseases, relatively few studies have been done so far on the identification of resistance sources to D. bryoniae and P. cubensis in Brazil. This work aimed at evaluating the resistance of commercial melon genotypes to the gummy stem blight and the downy mildew. Firstly, the most aggressive and representative D. bryoniae isolate was selected. Subsequently, the resistance of 86 melon genotypes to stem infection was studied upon greenhouse conditions by inoculating with the previously selected isolate. Afterwards, the resistance to mildew and leaf infection by D. bryoniae of 28 melon genotypes was evaluated in the field, under natural infection. In the greenhouse, all 86 melon genotypes were infected and showed stem infection symptoms caused by D. bryoniae four days after inoculation. Nevertheless, a significant variation on the resistance levels of the melon genotypes was found. Under field conditions and natural inoculation, genotypes Taslaki and Sary Juliabi were the most susceptible to leaf infection by D. bryoniae, significantly differing from the other genotypes. The lowest levels of susceptibility were identified in genotypes Perlita Busle S1, Valenciano Elíptico, Glaver, MR1, and 2526. All genotypes were susceptible to the downy mildew, albeit differing in susceptibility levels.<br>O crestamento gomoso do caule (Didymella bryoniae) e o míldio (Pseudoperonospora cubensis) estão entre as principais doenças do meloeiro (Cucumis melo) ocasionando redução da produtividade e da qualidade dos frutos. Apesar da importância dessas doenças, são poucos os trabalhos envolvendo a identificação de fontes de resistência a D. bryoniae e a P. cubensis no Brasil. O objetivo deste trabalho foi avaliar a resistência de genótipos comerciais de melão a essas doenças. A partir da seleção de um isolado mais agressivo, foi estudada, em condições de casa de vegetação, a resistência de 86 genótipos de meloeiro à infecção por D. bryoniae no caule. Posteriormente, em condições de campo, foi avaliada a resistência conjunta de 28 genótipos ao crestamento gomoso e ao míldio. Em casa de vegetação, todos os 86 genótipos de meloeiro avaliados foram infectados e mostraram sintomas de crestamento no caule, quatro dias após a inoculação. Houve variação significativa nos níveis de resistência entre os genótipos avaliados. No campo, sob inóculo natural, os genótipos Taslaki e Sary Juliabi mostraram-se mais suscetíveis à infecção por D. bryoniae nas folhas, diferindo significativamente dos demais genótipos. Os menores níveis de suscetibilidade foram verificados nos genótipos Perlita Busle S1, Valenciano Elíptico, Glaver, MR1 e 2526. Na avaliação da resistência ao míldio, todos os genótipos foram considerados suscetíveis, embora tenham sido encontradas diferenças nos níveis de suscetibilidade

Salinity-tolerant dwarf cashew rootstock has better ionic homeostasis and morphophysiological performance of seedlings

ABSTRACT Considering the cashew tree’s relevance and the limitations imposed by salinity stress in semi-arid regions, the use of alternatives capable of mitigating the harmful effects due to salinity is of great importance to the production sector. The use of grafted plants, especially with rootstock made of tolerant materials, influences the accumulation of toxic ions in leaves of grafted seedlings. Thus, the objective of this work was to evaluate morphophysiological characteristics and leaf concentrations of Na+, K+ and Ca+2 of combinations of scion and rootstock of early dwarf cashew, contrasting in terms of salinity tolerance. The experiment was carried out in a completely randomized design with five replicates, in a 4 × 3 factorial arrangement, corresponding to four dwarf cashew scion/rootstock combinations (self-graft CCP 09, CCP 09/CCP 76, self-graft CCP 76, and CCP 76/CCP 09) and three NaCl concentrations (0, 50, and 100 mM L-1). Height, number of leaves, leaf area, dry matter, tolerance index and leaf concentrations of Na+, K+ and Ca+2 were evaluated after 30 days of application of NaCl concentrations. The scion/rootstock combination CCP 76/09 showed tolerance to 50 mM L-1, due to the increase of leaf area and number of leaves. The scion/rootstock combination CCP 76/09 was more suitable, as it kept the leaf K+ concentration and had the lowest Na+ concentration.</div