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. MethodsWe 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

Resumo: No Brasil, a atividade física é eixo prioritário das ações de promoção da saúde no Sistema Único de Saúde (SUS). O presente estudo tem como objetivo descrever o perfil dos usuários, as barreiras e os facilitadores para participação em programas para promoção de atividades físicas na atenção básica à saúde. Trata-se de um estudo transversal com abrangência estadual realizado nos municípios de Pernambuco. Foram entrevistados de 2 a 21 indivíduos, por município, por meio de instrumento previamente testado e validado nas dimensões: sociodemográfica; estado de saúde; participação; informações sobre o programa; motivos de participação; facilitadores para a prática; barreiras para a prática e preferência de atividades. Foram realizadas análises descritivas e inferenciais (qui-quadrado). A amostra foi de 1.153 usuários, sendo 35,9% com idade entre 41-59 anos; 90,1% residentes em áreas urbanas; 58,2% dos usuários participavam das atividades há, pelo menos, um ano. A frequência semanal de 3-4 dias foi de 44,9%, e 71,1% praticavam atividades de uma hora ou mais. Observou-se que 40% das barreiras para a participação nos programas de atividade física e 77,5% dos facilitadores relatados foram de domínio intrapessoal. A barreira mais prevalente foi “condição atual de saúde”, e o facilitador foi “ter uma condição melhor de saúde”. As mulheres percebem mais barreiras do que os homens. Conclui-se que as barreiras e os facilitadores de domínio intrapessoal, relacionados com a saúde, são os fatores envolvidos na manutenção e no engajamento dos usuários dos programas e intervenções para promoção da atividade física desenvolvidos pela atenção básica à saúde do Estado de Pernambuco.

This study aims to evaluate factors associated with sleep quality (overall and by domains) in adolescents. A cross-sectional study. This study was conducted with 1,296 first-year high school students from public schools in the Northern Region of the State of Pernambuco, Brazil. Demographic, socioeconomic, and behavioral data were obtained with a questionnaire. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) Body mass index (BMI) was calculated based on the ratio of weight and height squared. Multilevel linear and logistic regressions evaluated factors associated with sleep quality. We observed 53% of adolescents reported poor sleep quality. Adolescents at higher risk of clinical depression were 3.45 times more likely to have poor sleep quality (95%CI: 2.04; 5.81), and each additional unit in the social anxiety score presented 1.03 (95%CI: 1.01; 1.05) higher odds of adolescents having poor sleep quality. Adolescents with depressive symptoms had higher sleep latency, greater sleep disturbance, and greater daytime sleep dysfunction. Social anxiety was associated with sleep latency, sleep disturbance, and daytime sleep dysfunction. Higher risk of clinical depression was associated with all domains related to sleep quality. Negative health perception was associated with sleep disturbance, and physical inactivity was associated with daytime sleep dysfunction. Social anxiety and especially higher risk of clinical depression were determinants of poor sleep quality. Changes in sleep latency, sleep disturbance and daytime sleep dysfunction seems to be relevant to poor sleep quality.

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.

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-Aim: to analyze the pattern and trends of use of screen-based devices and associated factors from two surveys conducted on public high school students in Caruaru-PE. Methods: two representative school-based crosssectional surveys conducted in 2007 (n=600) and 2012 (n=715) on high school students (15-20 years old). The time of exposure to television (TV) and computer/videogames PC/VG was obtained through a validated questionnaire, and ≥3hours/day was considered as being excessive exposure. The independent variables were socioeconomic status, school related, and physical activity. Crude and adjusted binary logistic regression were employed to examine the factors associated with screen time. The statistical significance was set at p<0.05. Results: There was a significant reduction in TV time on weekdays and total weekly, but no change in the prevalence of excessive exposure. The proportion of exposure to PC/VG of ≥3 hours/day increased 182.5% on weekdays and 69.5% on weekends (p <0.05). In 2007, being physically active was the only protection factor for excessive exposure to total screen time. In 2012, girls presented less chance of excessive exposure to all screen-based devices and total screen time. Other protective factors were studying at night and being physically active (PC/VG time), while residing in an urban area 41)] and having higher family income [OR 1.55(1.04-2.30)] were risk factors. Conclusion: Significant and important changes in the time trends and pattern of use PC/VG were observed during the interval of 5 years. This rapid increase could be associated with increased family income and improved access to these devices, driven by technological developments.

Recent systematic reviews highlighted important relationships between combinations of movement behaviors (ie. sleep, sedentary behaviour, and physical activity) and health outcomes among children and adolescents. However, it is unclear whether similar relationships occur in older adults. Therefore, the purpose of this protocol was to describe the aims and methods for a systematic review to summarize the studies examining the relationships between movement behaviors and health outcomes in older adults. A systematic review will be developed based on searches of articles in seven electronic databases and references of retrieved articles, contact with authors, and study repositories. Eligibility criteria: observational or experimental studies examining the association of at least two movement behaviours (sleep, sedentary behaviour, and physical activity) with health outcomes in older adults (≥60 years old). Selection of the studies and extraction of the data will be carried out by two reviewers independently. Characteristics of the study, participants, methods of combinations, and main results will be extracted and described. Risk of bias and level of evidence in the studies will be assessed according to the study quality tool of the US National Heart, Lung, and Blood Institute and the GRADE guidelines. The data will be synthesized using random effects meta-analysis for results that are sufficiently homogeneous in terms of statistical, clinical, and methodological characteristics. If not, then a narrative synthesis will be conducted. The results of this review may provide insights to improve current guidelines on 24-hour cycle in older adults, as well as guide future studies in this research field.

Since 2011 an educational policy promulgated that public schools from Pernambuco have had to offer physical education (PE) class in the same shift where students are enrolled. This study examined the impact of the implementation of an educational policy on PE offering and students’ participation, and whether health related behaviors could be moderated by PE participation. It was a natural experiment study performed with data obtained from two cross-sectional studies (2007 and 2012) of a sample (n = 715) of high-school students from Caruaru. PE offering was assessed by asking students if they had PE class and adapted questionnaire was used to assess health-related information. It was observed that before policy implementation, most of the students (♂: 72.4%; ♀: 69.0%) was not engaged in any PE class during the week. After policy implementation the proportion of students who had at least one PE class/week increased (♂: 68.7%; ♀: 68.9%). Having ≥1 PE classes was not associated with the amount of physical activity either before (♂: OR = 1.47 (95%CI: 0.78 – 2.76)); ♀: OR = 1.02 (95%CI: 0.61– 1.72) or after (♂: OR = 0.90 (95%CI: 0.51 – 1.58)); ♀: OR = 1.06 (95%CI: 0.63 – 1.80) policy implementation. Fruit consumption was the only health-related behavior associated to PE class (♂: OR = 1.55 (95%CI: 1.01 – 2.70); ♀: OR = 1.48 (95%CI: 1.02 – 2.10). PE offering and participation of students improved and it seems that implementation of new policies for PE might impact on students’ behaviors, although, regarding to some limitations, not sufficiently to impact on overall students’ health behaviors.