SummaryBackgroundPopulation estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods.MethodsWe estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10–54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10–14 years and 50–54 years was estimated from data on fertility in women aged 15–19 years and 45–49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories.FindingsFrom 1950 to 2017, TFRs decreased by 49·4% (95% uncertainty interval [UI] 46·4–52·0). The TFR decreased from 4·7 livebirths (4·5–4·9) to 2·4 livebirths (2·2–2·5), and the ASFR of mothers aged 10–19 years decreased from 37 livebirths (34–40) to 22 livebirths (19–24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83·8 million people per year since 1985. The global population increased by 197·2% (193·3–200·8) since 1950, from 2·6 billion (2·5–2·6) to 7·6 billion (7·4–7·9) people in 2017; much ...

Aim To determine the prevalence of undiagnosed hypertension in Croatia, and to assess its association with various demographic, socioeconomic, lifestyle, and health care usage factors. Methods We used the data from European Health Interview Survey wave 3, conducted in Croatia in 2019. The representative sample consisted of 5461 individuals aged 15 years and older. The association of undiagnosed hypertension with various factors was assessed with simple and multiple logistic regression models. The factors that contribute to undiagnosed hypertension were identified by comparing undiagnosed hypertension with normotension in the first model and with diagnosed hypertension in the second model. Results In the multiple logistic regression model, women and older age groups had lower adjusted odds ratio (OR) for undiagnosed hypertension than men and the youngest age group. Respondents living in the Adriatic region had a higher adjusted OR for undiagnosed hypertension than those living in the Continental region. Respondents who did not consult their family doctor in the previous 12 months and those who did not have their blood pressure measured by a health professional in the previous 12 months had a higher adjusted OR for undiagnosed hypertension. Conclusion Undiagnosed hypertension was significantly associated with male sex, age from 35 to 74, overweight, lack of consultation with a family doctor, and living in the Adriatic region. The results of this study should be used to inform preventive public health measures and activities.

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Uvod: Arterijska hipertenzija predstavlja globalnu epidemiju i vodeći čimbenik rizika za smrtnost i dizabilitet na globalnoj razini. U ovom radu analiziramo razlike u prevalenciji, svjesnosti, terapiji, i kontroli arterijske hipertenzije u svijetu i Hrvatskoj te trendove u prevalenciji povišenog arterijskog tlaka. Materijal i metode:Za potrebe ove analize pretraživana je literatura iz MEDLINE baze s epidemiološkim istraživanjima arterijske hipertenzije i studije globalnog opterećenja bolestima. Za graničnu vrijednost povišenog arterijskog tlaka uzimana je vrijednost 140/90 mmHg.Rezultati: Prema procjenama 18 % svih smrti na razini svijeta pripisivo je hipertenziji. Oko 40 % osoba starijih od 25 godina u svijetu ima povišeni arterijski tlak, što je oko milijardu ljudi, a prema procjenama taj broj bi se mogao povećati na 1,5 milijardu do 2025. godine. Razvijene zemlje uglavnom bilježe nižu prevalenciju, a slabije razvijene zemlje višu prevalenciju hipertenzije 1 . Gotovo 50 % osoba s hipertenzijom ne zna da ima povišeni arterijski tlak, a pola onih koji znaju za svoj povišeni tlak ne liječe se 2 . Prema studiji globalnog opterećenja bolestima iz 2010. godine arterijska hipertenzija je vodeći čimbenik rizika, odgovorna za oko 7 % DALYs-prilagođenih godina života s dizabilitetom te oko 9,4 milijuna smrti, dok je 1990. godine hipertenzija bila na 4. mjestu kao čimbenik rizika globalnog opterećenja bolestima 3 . Dobno standardizirana stopa hipertenzije opada zadnjih tridesetak godina na globalnoj razini, smanjujući se za 1 mmHg po jednom desetljeću od 1980. do 2008. Međutim, broj osoba s hipertenzijom se povećao s 605 na 978 milijuna, zbog starenja i porasta populacije 1 . Postoje značajne geografske razlike u opterećenju hipertenzijom, a oko 80 % opterećenja pripisivo hipertenziji je u zemljama niskog i srednje visokog dohotka 4 . Istraživanjima provedenim u Hrvatskoj 2003. godine hipertenzija je zabilježena u 45,6 % muškaraca i 43 % žena odrasle dobi, a svega 58,6 % osoba s hipertenzijom bilo je svjesno svoje bolesti, od njih se liječilo 48,4 %, a samo 14,8 % njih imalo je kontrolirani tlak. U studiji EH-UH provedenoj 2005. godine prevalencija je iznosila 37,5 %, a što je u razini prevalencije nekih zapadnoeuropskih zemalja. Godine 2014./2015. u Hrvatskoj je provedena EHIS anketa (European Health Interview Survey) 5 , u kojoj je prema izjavama samih ispitanika 26,8 % žena i 22,3 % muškaraca u proteklih 12 mjeseci imalo povišeni arterijski tlak.Zaključak: Arterijska hipertenzija predstavlja vodeći javnozdravstveni problem na globalnoj razini i u Hrvatskoj, zbog visoke prevalencije, nedovoljne svjesnosti, terapije i kontrole, bez obzira na dostupna znanja o mogućnosti prevencije i liječenja. Stoga je neophodno provoditi mjere primarne prevencije na populacijskoj razini, koje uključuju odgovarajuću javnozdravstvenu legislativu i strategiju te edukaciju stanovništva.

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