Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

© The Author(s) 2018. Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probittransformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the highincome Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups

Características clínico-epidemiológicas de pacientes hipertensos en un Consultorio Médico de Santa Clara

High blood pressure is a chronic non-transmittable disease, which is also a risk factor for the development of other clinical conditions. The incidence of arterial hypertension in the Cuban population is high.Aim: to characterize the evolution of arterial hypertension in a Family Doctor's Office.Methods: an observational, descriptive and cross-sectional study was carried out at the Family Doctor's Office 17-19 in the municipality of Santa Clara. The study covered the months of January to March 2020. Of the 256 hypertensive patients, a sample of 52 was selected by a simple random method.Results: Males predominated (53.84 %), together with the age group between 40 and 49 years (28.84 %). A total of 63.46 % of the patients were white-skinned. 51.61% presented risk factors. The risk factors with the highest incidence were smoking, followed by obesity and sedentary lifestyle.Conclusions: the most affected hypertensive patients are male. Most patients have a family history of high blood pressure. Smoking is a high incidence risk factor in the hypertensive population.Introducción: la hipertensión arterial es una enfermedad crónica no transmisible, que a la vez constituye un factor de riesgo para el desarrollo de otras enfermedades. La incidencia de la hipertensión arterial en la población de Cuba es alta.Objetivo: caracterizar el comportamiento de la hipertensión arterial en un Consultorio Médico de Familia.Métodos: se realizó un estudio observacional, descriptivo y transversal en el Consultorio Médico de Familia 17-19 del municipio Santa Clara. El período de estudio comprendió los meses de enero a marzo del 2020. La población fue de 256 hipertensos y se escogió una muestra de 52 hipertensos por muestreo aleatorio simple.Resultados: predominó el sexo masculino (53,84 %), y el grupo de edad entre 40 y 49 años (28,84 %). El 63,46 % de los pacientes fueron de color de la piel blanca. El 51,61 % presentaron factores de riesgo. Los factores de riesgo de mayor incidencia fueron el tabaquismo, seguido por la obesidad y el sedentarismo.Conclusiones: los pacientes hipertensos más afectados son los del sexo masculino. La mayor parte de los pacientes tienen antecedentes familiares de hipertensión arterial. El tabaquismo es un factor de riesgo de alta incidencia en la población hipertensa

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

Modelo funcional de un decodificador H.264/AVC

Terrestrial Digital Television. (DTV-T) is a constantly evolving technology with current update according to the State of the Art. Its adoption, as well as replacing the traditional analog transmission chain is a fact in many countries, because of its many advantages and synergy with other modern technologies. Cuba, like others, is already in deployment phase, following scripts defined by entities in charge of its proper implementation, where the assimilation of technologies is crucial for a real and independent development in this field. Among the basic blocks that make up the Digital TV chain, the compression and decompression of video are an essential element in a scenario where the bandwidth for transmission is finite and quoted. H.264/MPEG-4 Part 10 is currently the video compression standard widely used for digital television broadcasting. Receptors that fulfill H.264 must be able to decode the format. This paper described the use of software in C language to model the performance of an H.264 decoder. FPGA Virtex 5 from Xilinx is used to embed a system with PowerPC as the main element that will support the proposed model. Through the ML507 Development Board is realized the system operation. H.264 video format files are used, which in turn are decoded to obtain uncompressed video files using YCbCr format. These become the result of the experiment.La Televisión Digital Terrestre (TVD-T) es una tecnología en constante desarrollo, con elevada actualidad de acuerdo al Estado del Arte. Su adopción, así como sustitución de la tradicional cadena de transmisión analógica es un hecho en muchos países del mundo, debido a sus múltiples ventajas y correspondencia con otras tecnologías modernas. Cuba, como otros, se encuentra en franco despliegue de la misma, con programas definidos por cada una de las entidades responsables de su apropiada implementación, donde la asimilación de tecnología resulta decisivo para un desarrollo real e independiente en este campo. Entre los bloques básicos que conforman la cadena de Televisión Digital, la compresión y descompresión de video constituyen un elemento esencial, en un escenario donde el ancho de banda para la transmisión es finito y cotizado. H.264/MPEG-4 Parte 10 es actualmente el estándar de compresión de video mayormente empleado para la radiodifusión de Televisión Digital. Los receptores que cumplan con H.264 deben tener la capacidad de decodificar su formato. En este trabajo se describe la utilización de software descrito en lenguaje C para modelar el funcionamiento de un decodificador H.264. Se utiliza un FPGA Virtex 5, de Xilinx, para empotrar un sistema con PowerPC como elemento principal que soportará el modelo propuesto. A través de la Tarjeta de Desarrollo ML507 se demuestra el funcionamiento del sistema. Para esto se utilizan ficheros de video comprimidos con el formato H.264 que a su vez son decodificados obteniéndose ficheros de video en formato descomprimido YCbCr. Estos constituyen el resultado del experimento

Diseño e implementación de una plataforma para Voz sobre IP basado en FPGA

The development of systems with embedded microprocessors within a FPGA chip, Field Programmable Gate Array, becomes important because it allows hybrid designs between hardware modules that provide processing speed, and intelligence through high-level applications on a microprocessor, all in one device. Many of them use operating systems with multitasking applications that achieve efficient processing of modern telecommunications protocols. Also noteworthy is the growth of applications of Voice over IP (VoIP) over multiple networks telecommunication standards, due to its flexibility, high capacity and upgrade design that contribute to increasingly comprehensive services. This paper describes the use of the MicroBlaze microprocessor embedded on a Virtex5, one of the Xilinx FPGA families. Hardware modules are presented to host operating system with Linux 2.6 kernel, using the Xilinx ML507 Development Board. Aplication of VoIP protocols are used, compiled and inserted into Linux files, supported in turn by the MicroBlaze embedded system within the FPGA. VoIP client is obtained so able to communicate and register with the VoIP server and other IP network clients, like IP phones, VoIP software. SIP protocol performance is achieved, as well as the preparation of the RTP protocol to use it as a carrier of voice packets.El desarrollo de sistemas con microprocesadores embebidos dentro de un chip FPGA toma importancia pues permite diseños híbridos entre módulos hardware que ofrecen velocidad de procesamiento, e inteligencia a través de aplicaciones de alto nivel sobre un microprocesador, todo dentro de un mismo dispositivo. Muchos de ellos se sirven de sistemas operativos con aplicaciones multitareas que logran el procesamiento eficiente de protocolos modernos para las telecomunicaciones. Asimismo es notable el crecimiento de aplicaciones de voz sobre IP (VoIP) sobre las múltiples redes estándares de telecomunicaciones, debido a su flexibilidad, gran capacidad de diseño y actualización que tributa a servicios cada vez más completos. En este trabajo se describe la utilización del microprocesador MicroBlaze embebido sobre un Virtex5, una de las familias de FPGA de Xilinx. Se presentan sus módulos hardwares para albergar un sistema operativo con el kernel 2.6 de Linux, probándose con la Tarjeta de Desarrollo ML507 de Xilinx. Se utilizan aplicaciones sobre protocolos que se compilan e introducen dentro de los ficheros del Linux, soportado a su vez por el sistema MicroBlaze embebido dentro del FPGA. Se obtiene un cliente VoIP capaz de establecer comunicación y registro con el servidor VoIP y demás clientes de la red IP, llámese teléfonos IP, software VoIP. Se logra el funcionamiento del protocolo SIP, así como la preparación del protocolo RTP para su utilización como transportador de paquetes de voz

Calidad de vida e indicadores de salud: Cuba, 2001-2002 Quality of life and health indicators. Cuba, 2001-2002

En Cuba se han desarrollado instrumentos de medición con el objetivo de evaluar el estado de salud y su relación con la calidad de vida. El 30 de octubre del año 2000 se aprobó el acuerdo 3790 del Comité Ejecutivo del Consejo de Ministros, que crea el programa nacional de salud y calidad de vida y la comisión nacional de salud y calidad de vida. El presente trabajo, con un diseño descriptivo, expone los indicadores de evaluación que se construyeron a partir de un enfoque intersectorial y por organismos como coordinadores por áreas de intervención: sedentarismo-INDER (Instituto Nacional de Educación Física y Recreación), alimentación saludable-MINAL (Ministerio de la Industria Alimenticia), tabaquismo-MINCIN (Ministerio del Comercio Interior), accidentes-MITRANS (Ministerio del Transporte), calidad atmosférica-CITMA (Centro de Investigaciones y Tecnologías del Medio Ambiente), ambiente laboral-MTSS (Ministerio del Trabajo y Seguridad Social), calidad del agua, residuales líquidos-INRH (Instituto de Recursos Hidráulicos), residuales sólidos-MEP (Ministerio de Economía y Planificación) y se evaluó además la mortalidad y la calidad de vida relacionada con la salud, así como el comportamiento en el 2001-2002, lo que permitió ofrecer información a los organismos de la administración central del Estado, miembros de la comisión nacional de salud y calidad de vida, y lograr información de calidad para facilitar la toma de decisiones por esta comisión. Se trabajó con propuestas de indicadores mediante el análisis de la especificidad, la sensibilidad y la mensurabilidad del indicador, y se obtuvo un total de 83 indicadores (proceso 41 y resultados 42), los que se sometieron a la consideración de la comisión nacional para su aprobación final. Se muestran algunos resultados obtenidos con estos indicadores. Es una respuesta avanzada en el contexto mundial que incorpora Cuba para nuevos enfoques en la prevención y el control de estos problemas.Measurement instruments have been developed in Cuba aimed at evaluating the health status and its relation with the quality of life. On October 30, 2000, it was aproved the agreement 3790 of the Executive Committee of the Council of Ministers that creates the National Program of Health and Quality of Life and the National Commission of Health and Quality of Life. The present paper, with a descriptive design, exposes the evaluation indicators that were established starting from an intersectorial approach and with bodies as coordinators by intervention areas: sedentarism-INDER (National Institute of Sports, Physical Education and Recreation), healthy nutrition-MINAL (Ministry of Food Industry), smoking-MINCIN (Ministry of Domestic Trade), accidents-MITRANS (Ministry of Transportation), atmospheric quality-CITMA (Center of Environmental Research and Technologies), working environment-MTSS (Ministry of Work and Social Security), quality of water, liquid wastes-INRH (Institute of Hydraulic Resources), solid wastes-MEP (Ministry of Economy and Planning). Mortality and quality of life related to health, as well as the behavior in 2001-2002, were evaluated, which allowed to give information to the State central management organizations, members of the Health and Quality of Life National Commission, and to attain information of quality to make easy the decision-making for this commission. Proposals of indicators were used by the analysis of specificity, sensitivity and mensurability of the indicator. A total of 83 indicators (41 process and 42 results) was obtained. They were put ot the consideration of the national commission for their final approval. Some results obtained with these indicators are shown. It is an advanced response in the world context that Cuba introduces itself for new approaches in the prevention and control of these problems