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
Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.5–22.7) and 16.5 cm (13.3–19.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8–144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries.DOI: http://dx.doi.org/10.7554/eLife.13410.001
ResumoForam determinadas as tendências da mortalidade de idosos brasileiros entre 1980 e 2000. Nesse período, observou-se uma importante redução das taxas de mortalidade por todas as causas, sobretudo entre mulheres e entre idosos mais velhos, assim como a redução da mortalidade por doenças do aparelho circulatório e o aumento da mortalidade por neoplasias e doenças do aparelho respiratório. Verificou-se um excesso de mortalidade sem assistência médica entre idosos, que necessita ser melhor investigado. Entre 1996 e 2000, houve redução na taxa de mortalidade por pneumonia e aumento na taxa de mortalidade por diabetes. Observou-se uma diminuição das taxas de mortalidade por doenças cerebrovasculares e por doenças isquêmicas do coração, mas as primeiras persistiram como principal causa de morte em 2000, refletindo a possibilidade de precariedade no controle da hipertensão arterial. Esse resultado indica que a redução, ainda maior, da mortalidade por doenças cerebrovasculares em idosos deveria ser uma prioridade para a Saúde Pública no Brasil.Palavras-chave: mortalidade; efeito de coorte; saúde do idoso; epidemiologia do envelhecimento. SummaryThe mortality among older adults in Brazil from 1980 to 2000 was examined. During the study period, there was an important decrease in all causes of mortality, mainly among women and among oldest old. A significant decrease of the mortality due to cardiovascular diseases was observed, but the mortality due to cancers and respiratory diseases incresead in this period. There was an excess of mortality without medical assistance among older adults which needs further investigation. From 1996 to 2000, there was a reduction in the mortality rate due to pneumonia, and an increase of the mortality rate due to diabetes. The mortality rate due to cerebral-vascular and coronary heart diseases decreased from 1996 to 2000, but the former remained as the leading cause of death in 2000, possibly due to the precariousness of blood pressure control. This result indicates that a faster decrease of cerebral-vascular diseases among older adults should be priority in Brazil.
ResumoO perfil das internações hospitalares da população idosa brasileira (60 ou mais anos de idade) foi determinado e comparado ao da população com 20-59 anos, com ênfase nas causas que justificaram a internação. Foram utilizados dados do Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH-SUS) e a estimativa populacional para 2001. O risco de hospitalizações foi acentuadamente mais alto entre idosos para a quase totalidade das causas investigadas. As doenças do aparelho circulatório, respiratório e digestivo foram responsáveis por 60% das internações entre os idosos, enquanto que entre os mais jovens essas causas representaram 38% das hospitalizações. As três causas mais freqüentes de internações entre idosos, de ambos os sexos, foram insuficiência cardíaca, bronquite/enfisema e outras doenças pulmonares obstrutivas crônicas, seguidas pelas pneumonias. Os resultados deste trabalho reforçam a necessidade do uso sistemático do SIH-SUS para o planejamento e monitoramento das ações em saúde direcionadas à população idosa do Brasil.Palavras-chave: internações hospitalares; idosos; Brasil. SummaryThe profile of hospitalized older adults (60 years or more) in Brazil was described, and compared to that of adults aged 20-59 years, with an emphasis on the cause of hospital admission. The sources of data analyzed were the national information system of hospital admissions for Brazilś Unified Health System (SIH-SUS) and the estimated population for 2001. The risk of hospitalization was higher among older adults for almost all causes investigated. Cardiovascular, respiratory and digestive diseases were responsible for 60% of hospitalizations among older adults, while for younger adults the corresponding percentage was 38%. The three leading causes of hospital admissions among the elderly (both males and females) were heart failure, bronchitis/emphysema, other chronic obstructive pulmonary diseases, and pneumonia. The results of this study demonstrate the importance of the systematic use of data available in SIH-SUS for the planning and monitoring of health actions targeting the elderly population in Brazil.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.