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
Repositioning of the global epicentre of non-optimal cholesterol NCD Risk Factor Collaboration (NCD-RisC)* High blood cholesterol is typically considered a feature of wealthy western countries 1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world 3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health 4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low-and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium,
OBJECTIVE:To estimate the prevalence of childhood and adolescent obesity in Cyprus and define possible associated risk factors. STUDY DESIGN: Cross-sectional study of a representative sample of children 6 -17 y of age performed during October 1999 to June 2000. METHODS: Anthropometric data were taken using standard methods, from 2467 children. Certain diet and physical activities as well as other socioeconomic family parameters were assessed with the aid of a questionnaire. Obesity and overweight were defined using both the National Health and Nutrition Examination Survey (NHANES) I definition and the newer International Obesity Task Force (IOTF) definition. Logistic regression analyses were performed to estimate the influence of various parameters. RESULTS: The prevalence of obesity in males was 10.3% and in females 9.1% using the NHANES I definition and 6.9 and 5.7%, respectively, using the IOTF definition. The percentages presented a decreasing trend with age. There were an additional 16.9% of males and 13.1% of females defined as overweight with the NHANES I definition and 18.8 and 17.0%, respectively, using the IOTF definition. The most significant associated factor for obesity was parental obesity status. The odds ratio for offspring obesity when both parents were obese ranged from 11.34 (95% CI 1.83 -75.50) in females 6 to 11-y-old to 18.09 (95% CI 2.06 -158.81) for males 12 to 17-y-old. CONCLUSIONS: The prevalence of childhood and adolescent obesity was estimated for the first time in a representative sample from Cyprus, and this rate is comparable to that observed in North America. These results indicate the need for individual and population measures for the treatment and prevention of pediatric obesity. The rate of obesity differs significantly depending on the method of estimation.
The relationships between n-3 and n-6 fatty acids in subcutaneous fat, BMI and overweight status were investigated in eighty-eight children from Crete and Cyprus. Overweight status, BMI and serum lipid levels were similar in children at both locations, but Cretan children had higher levels of total MUFA than Cypriot children (62·2 (SD 2·8) v. 52·2 (SD 2·8) % area, respectively, P,0·001) and consequently Cypriot children had higher levels of total saturated, polyunsaturated, trans, n-3 and n-6 fatty acids. Cypriot children had also higher levels of individual n-3 and n-6 fatty acids, specifically linoleic, a-linolenic and dihomo-g-linolenic acids. The variance of BMI was better explained (38·2 %) by adipose tissue arachidonic acid content than any other n-3 and n-6 fatty acids. Mean levels of arachidonic acid, dihomo-g-linolenic acid and docosahexaenoic acid were higher in overweight and obese subjects. All obese subjects fell in the 4th quartile of arachidonic acid levels, whereas 88·9 % of overweight subjects fell in the 3rd and 4th quartile of arachidonic acid. These results indicate positive associations between adipose tissue arachidonic acid and BMI and overweight status. Further research could clarify whether this association is causal.
Objective: To pool and analyse, according to standardized criteria and using harmonized variables, the existing databases of surveys on childhood overweight and obesity carried out from 1995 to 2005 in different European countries by research groups participating in the IDEFICS project. Methods: Detailed information from seven surveys in five European countries was collected. A common database was built after harmonization of the single studies regarding sample size and age distribution. Variables were critically reviewed and harmonized according to a common protocol. On the pooled database, descriptive comparative analyses on the prevalence of overweight/obesity and association analyses of these conditions with perinatal, parental and environmental factors were performed. Results: Starting from total number of 74 871 children, data of 18 626 children were included in the common database (Belgium, n ¼ 1766; Cyprus, n ¼ 5540; Estonia, n ¼ 583; Italy, n ¼ 4480 and Sweden, n ¼ 6257). After the exclusion of children outside the defined age ranges (4-5 and 9-11 years), the analysis was conducted on 1738 younger and 12 923 older children. Relevant differences in the prevalence of overweight/obesity were observed between countries in both age groups, the highest values being observed in Italy. Age-and gender-related associations between the risk of obesity/overweight and perinatal, parental and environmental factors were observed. An increased risk of high blood pressure in overweight/obese children was consistently observed. Conclusions: The results of this collaborative work of European research centres, although providing potentially useful findings, confirmed that the validity of comparisons between communities depends critically on the comparability of the survey methods. To monitor the current epidemic of childhood obesity and develop appropriate prevention strategies, a coordinated European approach is needed to collect homogeneous sets of epidemiological data.
Objective: To estimate the prevalence of undernutrition and obesity in preschool children in Cyprus and identify possible associations. Design: Cross-sectional study. Setting: Private and public nursery schools. Subjects: A representative sample (n ¼ 1412) stratified by age, gender, district and area of residence. Interventions: Weight (kg) and height (cm) were obtained and BMI (kg/m 2 ) was calculated. Z scores for weight-for-age, height-for-age, and weight-for-height were calculated using the cutoffs from the CDC/WHO 1978 reference. Sociodemographic associations with nutritional status were examined in a logistic regression analysis. Results: The prevalence of undernutrition (WHO definition, Z-scores oÀ2) was low. Specifically the prevalence of underweight was 2.3%, wasting 2.8%, and stunting 1.1%. Undernutrition was associated with a low birth weight (LBW); odds ratio (OR) for underweight 4.1 (95% CI: 1.4, 12.2), P ¼ 0.012, stunting 5.2 (95% CI: 1.1, 23.3), P ¼ 0.033, and wasting 4.2 (95% CI: 1.3, 14.3), P ¼ 0.021.The prevalence of obesity (IOTF definition) was higher than undernutrition, and increased with age: 1.3% in 2 y olds to 10.4% in 6 y olds. Overweight and obesity prevalence were higher in rural (16.1%) than urban children (12.8%; P ¼ 0.046). Obesity in preschool children was associated with paternal obesity, OR 3.24 (95% CI: 1.59, 6.61), P ¼ 0.001, and maternal obesity 3.91 (95% CI: 1.78, 8.59), P ¼ 0.001. A birth weight (BW)Z4000 g was associated with obesity compared to a BW between 2501 and 3000 g, OR 7.63 (95% CI: 1.91, 30.52), P ¼ 0.004. Conclusions: The prevalence of undernutrition among preschool children in Cyprus was low but obesity prevalence was higher. Parental obesity and high BW were significantly associated with obesity while LBW was associated with undernutrition in preschool children.
Background: The associations between physical activity (PA), sedentary behaviour (SB) and bone health may be differentially affected by weight status during growth. This study aims to assess the cross-sectional and longitudinal associations between PA, SB and bone stiffness index (SI) in European children and adolescents, taking the weight status into consideration. Methods: Calcaneus SI was first measured by quantitative ultrasound among children aged 2-9 years old in 2007/ 08. It was measured again after 2 years in the IDEFICS study and after 6 years in the I. Family study. A sample of 2008 participants with time spent at sports clubs, watching TV and playing computer/games self-reported by questionnaire, and a subsample of 1037 participants with SB, light PA (LPA) and moderate-to-vigorous PA (MVPA) objectively measured using Actigraph accelerometers were included in the analyses. Weight status was defined as thin/normal and overweight/obese according to the extended International Obesity Task Force criteria. Linear mixed-effects models were used to estimate the cross-sectional and longitudinal associations between PA, SB and SI percentiles, stratified by weight status.
Migrants and children with unemployed parents are at risk for excessive ST and all vulnerable groups have lower odds of being sports club members.
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