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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