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Background: Data for trends in blood pressure are needed to understand the effects of its dietary, lifestyle, and pharmacological determinants; set intervention priorities; and evaluate national programmes. However, few worldwide analyses of trends in blood pressure have been done. We estimated worldwide trends in population mean systolic blood pressure (SBP).
Methods: We estimated trends and their uncertainties in mean SBP for adults 25 years and older in 199 countries and territories. We obtained data from published and unpublished health examination surveys and epidemiological studies (786 country-years and 5·4 million participants). For each sex, we used a Bayesian hierarchical model to estimate mean SBP by age, country, and year, accounting for whether a study was nationally representative.
Findings: In 2008, age-standardised mean SBP worldwide was 128·1 mm Hg (95% uncertainty interval 126·7-129·4) in men and 124·4 mm Hg (123·0-125·9) in women. Globally, between 1980 and 2008, SBP decreased by 0·8 mm Hg per decade (-0·4 to 2·2, posterior probability of being a true decline=0·90) in men and 1·0 mm Hg per decade (-0·3 to 2·3, posterior probability=0·93) in women. Female SBP decreased by 3·5 mm Hg or more per decade in western Europe and Australasia (posterior probabilities ≥0·999). Male SBP fell most in high-income North America, by 2·8 mm Hg per decade (1·3-4·5, posterior probability >0·999), followed by Australasia and western Europe where it decreased by more than 2·0 mm Hg per decade (posterior probabilities >0·98). SBP rose in Oceania, east Africa, and south and southeast Asia for both sexes, and in west Africa for women, with the increases ranging 0·8-1·6 mm Hg per decade in men (posterior probabilities 0·72-0·91) and 1·0-2·7 mm Hg per decade for women (posterior probabilities 0·75-0·98). Female SBP was highest in some east and west African countries, with means of 135 mm Hg or greater. Male SBP was highest in Baltic and east and west African countries, where mean SBP reached 138 mm Hg or more. Men and women in western Europe had the highest SBP in high-income regions.
Interpretation: On average, global population SBP decreased slightly since 1980, but trends varied significantly across regions and countries. SBP is currently highest in low-income and middle-income countries. Effective population-based and personal interventions should be targeted towards low-income and middle-income countries.
Funding: Funding Bill & Melinda Gates Foundation and WHO.
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http://dx.doi.org/10.1016/S0140-6736(10)62036-3 | DOI Listing |
Mod Br Hist
December 2024
School of Historical Studies, Birkbeck College, London, United Kingdom.
Focusing on three specific organizations-The Terrence Higgins Trust (THT), Blackliners, and The NAZ Project (Naz)-this article explores the different ways in which voluntary organizations responded to Black gay men (BGM) in Britain during the AIDS crisis from the 1980s to 2000. Illustrating how the place of BGM in Britain at this time was multidimensional and often contradictory, the first section demonstrates how they required safer-sex messaging that took account of the heterogeneous ways in which they experienced the intersection of racism and homophobia. Situated in this context, the second section explores for the first time the well-documented work of THT as it applied to BGM.
View Article and Find Full Text PDFHum Reprod
December 2024
Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
Study Question: To what extent are self-reported diagnoses of food allergies associated with fecundability, the per-cycle probability of conception?
Summary Answer: Fecundability was not appreciably associated with self-reported food allergy diagnoses, number of food allergies, age at first diagnosis, or time since last allergic reaction.
What Is Known Already: Food allergies are atopic diseases that are characterized by an inappropriate immune response to a normally harmless dietary substance. While some studies have observed associations between atopic disorders and infertility, no study has examined the association between food allergies and fecundability, the per-cycle probability of conception.
Blood
December 2024
Dana-Farber Cancer Institute, BOSTON, Massachusetts, United States.
Allogeneic hematopoietic stem-cell transplantation (HCT) is one of the principal curative approaches in the treatment of acute myeloid leukemia (AML); however, relapse post-transplantation remains a catastrophic event with poor prognosis. The incidence of relapse has remained unchanged over the last three decades despite an evolving understanding of the immunobiology of the graft-versus leukemia effect and the immune escape mechanisms that lead to post-HCT relapse. The approach to post-transplant relapse is highly individualized and is dictated both by disease biology and genomics as well as the patient's clinical status at the time of relapse and the interval between relapse and transplantation.
View Article and Find Full Text PDFJ Minim Access Surg
December 2024
Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India.
Introduction: Laparoscopic transperitoneal adrenalectomy was first described by Gagner M et al. Here, we present our experience of more than two decades of laparoscopic adrenalectomy performed in a single surgical unit at a tertiary care centre.
Patients And Methods: A prospectively collected database of patients undergoing laparoscopic adrenalectomy from December 1994 to May 2020 was analysed retrospectively.
Intern Med J
December 2024
Department of Paediatrics, Fiona Stanley Hospital, Perth, Western Australia, Australia.
Background: The frequency of EoE has been increasing in Northern Hemisphere cohorts, yet there is a scarcity of data in our region. Regional climatic factors, and lifestyle habits may influence the presentation of EoE, and appropriate management is crucial to prevent complications. WIth this is mind we undertook the first comprehensive multisite study of EoE in Australasian children.
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