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1. The Finnish Faecal Microbiota Transplantation Study (FINFMT) (FINFMT)

Author: University of Helsinki, Helsinki University Central Hospital, Turku University Hospital, Tampere University Hospital, Oulu University Hospital, Kuopio University Hospital, South Karelia, Social and Health Care District, North Karelia Central Hospital, Keski-Pohjanmaa Central Hospital, Seinajoki Central Hospital, Jyväskylä Central Hospital, Kanta-Häme Central Hospital, Mikkeli Central Hospital, Vaasa Central Hospital, Vaasa, Finland, Lapland Central Hospital, Satakunta Central Hospital, Kymenlaakso Social and Health Services, and Kainuu Social and Health Care Joint Authority
Published: 2020

2. Prevention of Gestational Diabetes Through Lifestyle Modification (RADIEL)

Author: Provincial Health Services Authority, South Karelia, Social and Health Care District, and Saila Koivusalo, MD PhD
Published: 2019

3. Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

Author: Iurilli, Maria L. C., Zhou, Bin, Bennett, James E., Carrillo-Larco, Rodrigo M., Sophiea, Marisa K., Rodriguez-Martinez, Andrea, Bixby, Honor, Solomon, Bethlehem D., Taddei, Cristina, Danaei, Goodarz, Di Cesare, Mariachiara, Stevens, Gretchen A., Riley, Leanne M., Savin, Stefan, Cowan, Melanie J., Bovet, Pascal, Damasceno, Albertino, Chirita-Emandi, Adela, Hayes, Alison J., Ikeda, Nayu, Jackson, Rod T., Khang, Young-Ho, Laxmaiah, Avula, Liu, Jing, Miranda, J. Jaime, Saidi, Olfa, Sebert, Sylvain, Soric, Maroje, Starc, Gregor, Gregg, Edward W., Abarca-Gomez, Leandra, Abdeen, Ziad A., Abdrakhmanova, Shynar, Ghaffar, Suhaila Abdul, Rahim, Hanan F. Abdul, Abu-Rmeileh, Niveen M., Garba, Jamila Abubakar, Acosta-Cazares, Benjamin, Adams, Robert J., Aekplakorn, Wichai, Afsana, Kaosar, Afzal, Shoaib, Agdeppa, Imelda A., Aghazadeh-Attari, Javad, Aguilar-Salinas, Carlos A., Agyemang, Charles, Ahmad, Mohamad Hasnan, Ahmad, Noor Ani, Ahmadi, Ali, Ahmadi, Naser, Ahmed, Soheir H., Ahrens, Wolfgang, Aitmurzaeva, Gulmira, Ajlouni, Kamel, Al-Hazzaa, Hazzaa M., Al-Lahou, Badreya, Al-Raddadi, Rajaa, Alarouj, Monira, AlBuhairan, Fadia, AlDhukair, Shahla, Ali, Mohamed M., Alkandari, Abdullah, Alkerwi, Ala'a, Allin, Kristine, Alvarez-Pedrerol, Mar, Aly, Eman, Amarapurkar, Deepak N., Amiri, Parisa, Amougou, Norbert, Amouyel, Philippe, Andersen, Lars Bo, Anderssen, Sigmund A., Angquist, Lars, Anjana, Ranjit Mohan, Ansari-Moghaddam, Alireza, Aounallah-Skhiri, Hajer, Araujo, Joana, Ariansen, Inger, Aris, Tahir, Arku, Raphael E., Arlappa, Nimmathota, Aryal, Krishna K., Aspelund, Thor, Assah, Felix K., Assuncao, Maria Cecilia F., Aung, May Soe, Auvinen, Juha, Avdicova, Maria, Avi, Shina, Azevedo, Ana, Azimi-Nezhad, Mohsen, Azizi, Fereidoun, Azmin, Mehrdad, Babu, Bontha, Jorgensen, Maja Boksgaard, Baharudin, Azli, Bahijri, Suhad, Baker, Jennifer L., Balakrishna, Nagalla, Bamoshmoosh, Mohamed, Banach, Maciej, Bandosz, Piotr, Banegas, Jose R., Baran, Joanna, Barbagallo, Carlo M., Barcelo, Alberto, Barkat, Amina, Barros, Aluisio Jd, Gomes Barros, Mauro Virgilio, Basit, Abdul, Bastos, Joao Luiz D., Bata, Iqbal, Batieha, Anwar M., Batista, Rosangela L., Battakova, Zhamilya, Batyrbek, Assembekov, Baur, Louise A., Beaglehole, Robert, Bel-Serrat, Silvia, Belavendra, Antonisamy, Ben Romdhane, Habiba, Benedics, Judith, Benet, Mikhail, Bergh, Ingunn Holden, Berkinbayev, Salim, Bernabe-Ortiz, Antonio, Bernotiene, Gailute, Bettiol, Heloisa, Bezerra, Jorge, Bhagyalaxmi, Aroor, Bharadwaj, Sumit, Bhargava, Santosh K., Bhutta, Zulfiqar A., Bi, Hongsheng, Bi, Yufang, Bia, Daniel, Lele, Elysee Claude Bika, Bikbov, Mukharram M., Bista, Bihungum, Bjelica, Dusko J., Bjerregaard, Peter, Bjertness, Espen, Bjertness, Marius B., Bjorkelund, Cecilia, Bloch, Katia, Blokstra, Anneke, Bo, Simona, Bobak, Martin, Boddy, Lynne M., Boehm, Bernhard O., Boeing, Heiner, Boggia, Jose G., Bogova, Elena, Boissonnet, Carlos P., Bojesen, Stig E., Bonaccio, Marialaura, Bongard, Vanina, Bonilla-Vargas, Alice, Bopp, Matthias, Borghs, Herman, Braeckevelt, Lien, Braeckman, Lutgart, Bragt, Marjolijn C. E., Brajkovich, Imperia, Branca, Francesco, Breckenkamp, Juergen, Breda, Joao, Brenner, Hermann, Brewster, Lizzy M., Brian, Garry R., Brinduse, Lacramioara, Brophy, Sinead, Bruno, Graziella, Bueno-de-Mesquita, H. Bas, Bugge, Anna, Buoncristiano, Marta, Burazeri, Genc, Burns, Con, Cabrera de Leon, Antonio, Cacciottolo, Joseph, Cai, Hui, Cama, Tilema, Cameron, Christine, Camolas, Jose, Can, Gunay, Candido, Ana Paula C., Canete, Felicia, Capanzana, Mario, Capkova, Nadezda, Capuano, Eduardo, Capuano, Vincenzo, Cardol, Marloes, Cardoso, Viviane C., Carlsson, Axel C., Carmuega, Esteban, Carvalho, Joana, Casajus, Jose A., Casanueva, Felipe F., Celikcan, Ertugrul, Censi, Laura, Cervantes-Loaiza, Marvin, Cesar, Juraci A., Chamukuttan, Snehalatha, Chan, Angelique W., Chan, Queenie, Chaturvedi, Himanshu K., Chaturvedi, Nish, Rahim, Norsyamlina Che Abdul, Chee, Miao Li, Chen, Chien-Jen, Chen, Fangfang, Chen, Huashuai, Chen, Shuohua, Chen, Zhengming, Cheng, Ching-Yu, Cheraghian, Bahman, Chetrit, Angela, Chikova-Iscener, Ekaterina, Chiolero, Arnaud, Chiou, Shu-Ti, Chirlaque, Maria-Dolores, Cho, Belong, Christensen, Kaare, Christofaro, Diego G. [UNESP], Chudek, Jerzy, Cifkova, Renata, Cilia, Michelle, Cinteza, Eliza, Claessens, Frank, Clarke, Janine, Clays, Els, Cohen, Emmanuel, Concin, Hans, Confortin, Susana C., Cooper, Cyrus, Coppinger, Tara C., Corpeleijn, Eva, Costanzo, Simona, Cottel, Dominique, Cowell, Chris, Craig, Cora L., Crampin, Amelia C., Crujeiras, Ana B., Csilla, Semanova, Cucu, Alexandra M., Cui, Liufu, Cureau, Felipe, Czenczek-Lewandowska, Ewelina, D'Arrigo, Graziella, D'Orsi, Eleonora, Dacica, Liliana, Dal Re Saavedra, Maria Angeles, Dallongeville, Jean, Damsgaard, Camilla T., Dankner, Rachel, Dantoft, Thomas M., Dasgupta, Parasmani, Dastgiri, Saeed, Dauchet, Luc, Davletov, Kairat, De Backer, Guy, De Bacquer, Dirk, Gaetano, Giovanni de, De Henauw, Stefaan, Oliveira, Paula Duarte de, De Ridder, David, De Ridder, Karin, Rooij, Susanne R. de, De Smedt, Delphine, Deepa, Mohan, Deev, Alexander D., DeGennaro, Vincent, Dehghan, Abbas, Delisle, Helene, Delpeuch, Francis, Demarest, Stefaan, Dennison, Elaine, Deren, Katarzyna, Deschamps, Valerie, Dhimal, Meghnath, Di Castelnuovo, Augusto F., Dias-da-Costa, Juvenal Soares, Diaz-Sanchez, Maria Elena, Diaz, Alejandro, Dika, Zivka, Djalalinia, Shirin, Djordjic, Visnja, Do, Ha T. P., Dobson, Annette J., Donati, Maria Benedetta, Donfrancesco, Chiara, Donoso, Silvana P., Doring, Angela, Dorobantu, Maria, Dorosty, Ahmad Reza, Doua, Kouamelan, Dragano, Nico, Drygas, Wojciech, Duan, Jia Li, Duante, Charmaine A., Duboz, Priscilla, Duda, Rosemary B., Duleva, Vesselka, Dulskiene, Virginija, Dumith, Samuel C., Dushpanova, Anar, Dzerve, Vilnis, Dziankowska-Zaborszczyk, Elzbieta, Eddie, Ricky, Eftekhar, Ebrahim, Egbagbe, Eruke E., Eggertsen, Robert, Eghtesad, Sareh, Eiben, Gabriele, Ekelund, Ulf, El-Khateeb, Mohammad, El Ati, Jalila, Eldemire-Shearer, Denise, Eliasen, Marie, Elliott, Paul, Engle-Stone, Reina, Enguerran, Macia, Erasmus, Rajiv T., Erbel, Raimund, Erem, Cihangir, Eriksen, Louise, Eriksson, Johan G., Escobedo-de la Pena, Jorge, Eslami, Saeid, Esmaeili, Ali, Evans, Alun, Faeh, David, Fakhretdinova, Albina A., Fall, Caroline H., Faramarzi, Elnaz, Farjam, Mojtaba, Sant'Angelo, Victoria Farrugia, Farzadfar, Farshad, Fattahi, Mohammad Reza, Fawwad, Asher, Felix-Redondo, Francisco J., Ferguson, Trevor S., Fernandes, Romulo A. [UNESP], Fernandez-Berges, Daniel, Ferrante, Daniel, Ferrao, Thomas, Ferrari, Marika, Ferrario, Marco M., Ferreccio, Catterina, Ferrer, Eldridge, Ferrieres, Jean, Figueiro, Thamara Hubler, Fijalkowska, Anna, Fink, Gunther, Fischer, Krista, Foo, Leng Huat, Forsner, Maria, Fouad, Heba M., Francis, Damian K., Franco, Maria do Carmo, Frikke-Schmidt, Ruth, Frontera, Guillermo, Fuchs, Flavio D., Fuchs, Sandra C., Fujiati, Isti I., Fujita, Yuki, Fumihiko, Matsuda, Furusawa, Takuro, Gaciong, Zbigniew, Gafencu, Mihai, Galbarczyk, Andrzej, Galenkamp, Henrike, Galeone, Daniela, Galfo, Myriam, Galvano, Fabio, Gao, Jingli, Garcia-de-la-Hera, Manoli, Garcia-Solano, Marta, Gareta, Dickman, Garnett, Sarah P., Gaspoz, Jean-Michel, Gasull, Magda, Araujo Gaya, Adroaldo Cesar, Gaya, Anelise Reis, Gazzinelli, Andrea, Gehring, Ulrike, Geiger, Harald, Geleijnse, Johanna M., Ghanbari, Ali, Ghasemi, Erfan, Gheorghe-Fronea, Oana-Florentina, Giampaoli, Simona, Gianfagna, Francesco, Gill, Tiffany K., Giovannelli, Jonathan, Gironella, Glen, Giwercman, Aleksander, Gkiouras, Konstantinos, Godos, Justyna, Gogen, Sibel, Goldberg, Marcel, Goldsmith, Rebecca A., Goltzman, David, Gomez, Santiago F., Gomula, Aleksandra, Cordeiro da Silva, Bruna Goncalves, Goncalves, Helen, Gonzalez-Chica, David A., Gonzalez-Gross, Marcela, Gonzalez-Leon, Margot, Gonzalez-Rivas, Juan P., Gonzalez-Villalpando, Clicerio, Gonzalez-Villalpando, Maria-Elena, Gonzalez, Angel R., Gottrand, Frederic, Graca, Antonio Pedro, Graff-Iversen, Sidsel, Grafnetter, Dusan, Grajda, Aneta, Grammatikopoulou, Maria G., Gregor, Ronald D., Grodzicki, Tomasz, Groholt, Else Karin, Grontved, Anders, Grosso, Giuseppe, Gruden, Gabriella, Gu, Dongfeng, Gualdi-Russo, Emanuela, Guallar-Castillon, Pilar, Gualtieri, Andrea, Gudmundsson, Elias F., Gudnason, Vilmundur, Guerrero, Ramiro, Guessous, Idris, Guimaraes, Andre L., Gulliford, Martin C., Gunnlaugsdottir, Johanna, Gunter, Marc J., Guo, Xiu-Hua, Guo, Yin, Gupta, Prakash C., Gupta, Rajeev, Gureje, Oye, Gurzkowska, Beata, Gutierrez-Gonzalez, Enrique, Gutierrez, Laura, Gutzwiller, Felix, Ha, Seongjun, Hadaegh, Farzad, Hadjigeorgiou, Charalambos A., Haghshenas, Rosa, Hakimi, Hamid, Halkjaer, Jytte, Hambleton, Ian R., Hamzeh, Behrooz, Hange, Dominique, Hanif, Abu A. M., Hantunen, Sari, Hao, Jie, Kumar, Rachakulla Hari, Hashemi-Shahri, Seyed Mohammad, Hassapidou, Maria, Hata, Jun, Haugsgjerd, Teresa, He, Jiang, He, Yuan, He, Yuna, Heidinger-Felso, Regina, Heinen, Mirjam, Hejgaard, Tatjana, Hendriks, Marleen Elisabeth, Henrique, Rafael dos Santos, Henriques, Ana, Hernandez Cadena, Leticia, Herrala, Sauli, Herrera, Victor M., Herter-Aeberli, Isabelle, Heshmat, Ramin, Hill, Allan G., Ho, Sai Yin, Ho, Suzanne C., Hobbs, Michael, Holdsworth, Michelle, Homayounfar, Reza, Homs, Clara, Hopman, Wilma M., Horimoto, Andrea R. V. R., Hormiga, Claudia M., Horta, Bernardo L., Houti, Leila, Howitt, Christina, Thein Thein Htay, Htet, Aung Soe, Htike, Maung Maung Than, Hu, Yonghua, Huerta, Jose Maria, Huhtaniemi, Ilpo Tapani, Huiart, Laetitia, Petrescu, Constanta Huidumac, Huisman, Martijn, Husseini, Abdullatif, Huu, Chinh Nguyen, Huybrechts, Inge, Hwalla, Nahla, Hyska, Jolanda, Iacoviello, Licia, Ibarluzea, Jesus M., Ibrahim, Mohsen M., Wong, Norazizah Ibrahim, Ikram, M. Arfan, Iotova, Violeta, Irazola, Vilma E., Ishida, Takafumi, Islam, Muhammad, Islam, Sheikh Mohammed Shariful, Iwasaki, Masanori, Jacobs, Jeremy M., Jaddou, Hashem Y., Jafar, Tazeen, James, Kenneth, Jamil, Kazi M., Jamrozik, Konrad, Janszky, Imre, Janus, Edward, Jarani, Juel, Jarvelin, Marjo-Riitta, Jasienska, Grazyna, Jelakovic, Ana, Jelakovic, Bojan, Jennings, Garry, Jha, Anjani Kumar, Jiang, Chao Qiang, Jimenez, Ramon O., Jockel, Karl-Heinz, Joffres, Michel, Johansson, Mattias, Jokelainen, Jari J., Jonas, Jost B., Jonnagaddala, Jitendra, Jorgensen, Torben, Joshi, Pradeep, Joukar, Farahnaz, Jovic, Dragana P., Jozwiak, Jacek J., Juolevi, Anne, Jurak, Gregor, Simina, Iulia Jurca, Juresa, Vesna, Kaaks, Rudolf, Kaducu, Felix O., Kafatos, Anthony, Kajantie, Eero O., Kalmatayeva, Zhanna, Kalter-Leibovici, Ofra, Kameli, Yves, Kampmann, Freja B., Kanala, Kodanda R., Kannan, Srinivasan, Kapantais, Efthymios, Karakosta, Argyro, Karhus, Line L., Karki, Khem B., Katibeh, Marzieh, Katz, Joanne, Katzmarzyk, Peter T., Kauhanen, Jussi, Kaur, Prabhdeep, Kavousi, Maryam, Kazakbaeva, Gyulli M., Keil, Ulrich, Boker, Lital Keinan, Keinanen-Kiukaanniemi, Sirkka, Kelishadi, Roya, Kelleher, Cecily, Kemper, Han C. G., Kengne, Andre P., Keramati, Maryam, Kerimkulova, Alina, Kersting, Mathilde, Key, Timothy, Khader, Yousef Saleh, Khalili, Davood, Khaw, Kay-Tee, Kheiri, Bahareh, Kheradmand, Motahareh, Khosravi, Alireza, Khouw, Ilse M. S. L., Kiechl-Kohlendorfer, Ursula, Kiechl, Stefan, Killewo, Japhet, Kim, Dong Wook, Kim, Hyeon Chang, Kim, Jeongseon, Kindblom, Jenny M., Klakk, Heidi, Klimek, Magdalena, Klimont, Jeannette, Klumbiene, Jurate, Knoflach, Michael, Koirala, Bhawesh, Kolle, Elin, Kolsteren, Patrick, Konig, Jurgen, Korpelainen, Raija, Korrovits, Paul, Korzycka, Magdalena, Kos, Jelena, Koskinen, Seppo, Kouda, Katsuyasu, Kovacs, Viktoria A., Kowlessur, Sudhir, Koziel, Slawomir, Kratenova, Jana, Kratzer, Wolfgang, Kriemler, Susi, Kristensen, Peter Lund, Krokstad, Steiner, Kromhout, Daan, Kruger, Herculina S., Kubinova, Ruzena, Kuciene, Renata, Kujala, Urho M., Kujundzic, Enisa, Kulaga, Zbigniew, Kumar, R. Krishna, Kunesova, Marie, Kurjata, Pawel, Kusuma, Yadlapalli S., Kuulasmaa, Kari, Kyobutungi, Catherine, Quang Ngoc La, Laamiri, Fatima Zahra, Laatikainen, Tiina, Lachat, Carl, Laid, Youcef, Lam, Tai Hing, Lambrinou, Christina-Paulina, Landais, Edwige, Lanska, Vera, Lappas, Georg, Larijani, Bagher, Latt, Tint Swe, Lauria, Laura, Lazo-Porras, Maria, Le Coroller, Gwenaelle, Khanh Le Nguyen Bao, Le Port, Agnes, Le, Tuyen D., Lee, Jeannette, Lee, Jeonghee, Lee, Paul H., Lehmann, Nils, Lehtimaki, Terho, Lemogoum, Daniel, Levitt, Naomi S., Li, Yanping, Liivak, Merike, Lilly, Christa L., Lim, Wei-Yen, Lima-Costa, M. Fernanda, Lin, Hsien-Ho, Lin, Xu, Lin, Yi-Ting, Lind, Lars, Linneberg, Allan, Lissner, Lauren, Litwin, Mieczyslaw, Liu, Lijuan, Lo, Wei-Cheng, Loit, Helle-Mai, Khuong Quynh Long, Lopes, Luis, Lopes, Oscar, Lopez-Garcia, Esther, Lopez, Tania, Lotufo, Paulo A., Eugenio Lozano, Jose, Lukrafka, Janice L., Luksiene, Dalia, Lundqvist, Annamari, Lundqvist, Robert, Lunet, Nuno, Lunogelo, Charles, Lustigova, Michala, Luszczki, Edyta, Ma, Guansheng, Ma, Jun, Ma, Xu, Machado-Coelho, George L. L., Machado-Rodrigues, Aristides M., Macieira, Luisa M., Madar, Ahmed A., Maggi, Stefania, Magliano, Dianna J., Magnacca, Sara, Magriplis, Emmanuella, Mahasampath, Gowri, Maire, Bernard, Majer, Marjeta, Makdisse, Marcia, Maki, Paivi, Malekzadeh, Fatemeh, Malekzadeh, Reza, Malhotra, Rahul, Rao, Kodavanti Mallikharjuna, Malyutina, Sofia K., Maniego, Lynell, Manios, Yannis, Mann, Jim, Mansour-Ghanaei, Fariborz, Manzato, Enzo, Margozzini, Paula, Markaki, Anastasia, Markey, Oonagh, Ioannidou, Eliza Markidou, Marques-Vidal, Pedro, Marques, Larissa Pruner, Marrugat, Jaume, Martin-Prevel, Yves, Martin, Rosemarie, Martorell, Reynaldo, Martos, Eva, Maruszczak, Katharina, Marventano, Stefano, Mascarenhas, Luis P., Masoodi, Shariq R., Mathiesen, Ellisiv B., Mathur, Prashant, Matijasevich, Alicia, Matsha, Tandi E., Mavrogianni, Christina, Mazur, Artur, Mbanya, Jean Claude N., McFarlane, Shelly R., McGarvey, Stephen T., McKee, Martin, McLachlan, Stela, McLean, Rachael M., McLean, Scott B., McNulty, Breige A., Benchekor, Sounnia Mediene, Medzioniene, Jurate, Mehdipour, Parinaz, Mehlig, Kirsten, Mehrparvar, Amir Houshang, Meirhaeghe, Aline, Meisfjord, Jorgen, Meisinger, Christa, Menezes, Ana Maria B., Menon, Geetha R., Mensink, Gert B. M., Menzano, Maria Teresa, Mereke, Alibek, Meshram, Indrapal I., Metspalu, Andres, Meyer, Haakon E., Mi, Jie, Michaelsen, Kim F., Michels, Nathalie, Mikkel, Kairit, Milkowska, Karolina, Miller, Jody C., Minderico, Claudia S., Mini, G. K., Miquel, Juan Francisco, Mirjalili, Mohammad Reza, Mirkopoulou, Daphne, Mirrakhimov, Erkin, Misigoj-Durakovic, Marjeta, Mistretta, Antonio, Mocanu, Veronica, Modesti, Pietro A., Moghaddam, Sahar Saeedi, Mohajer, Bahram, Mohamed, Mostafa K., Mohamed, Shukri F., Mohammad, Kazem, Mohammadi, Zahra, Mohammadifard, Noushin, Mohammadpourhodki, Reza, Mohan, Viswanathan, Mohanna, Salim, Yusoff, Muhammad Fadhli Mohd, Mohebbi, Iraj, Mohebi, Farnam, Moitry, Marie, Molbo, Drude, Mollehave, Line T., Moller, Niels C., Molnar, Denes, Momenan, Amirabbas, Mondo, Charles K., Monroy-Valle, Michele, Monterrubio-Flores, Eric, Monyeki, Kotsedi Daniel K., Moon, Jin Soo, Moosazadeh, Mahmood, Moreira, Leila B., Morejon, Alain, Moreno, Luis A., Morgan, Karen, Morin, Suzanne N., Mortensen, Erik Lykke, Moschonis, George, Mossakowska, Malgorzata, Mostafa, Aya, Mota-Pinto, Anabela, Mota, Jorge, Motlagh, Mohammad Esmaeel, Motta, Jorge, Moura-dos-Santos, Marcos Andre, Mridha, Malay K., Msyamboza, Kelias P., Thet Thet Mu, Muc, Magdalena, Mugosa, Boban, Muiesan, Maria L., Mukhtorova, Parvina, Muller-Nurasyid, Martina, Murphy, Neil, Mursu, Jaakko, Murtagh, Elaine M., Musa, Kamarul Imran, Milanovic, Sanja Music, Musil, Vera, Mustafa, Norlaila, Nabipour, Iraj, Naderimagham, Shohreh, Nagel, Gabriele, Naidu, Balkish M., Najafi, Farid, Nakamura, Harunobu, Namesna, Jana, Nang, Ei Ei K., Nangia, Vinay B., Nankap, Martin, Narake, Sameer, Nardone, Paola, Nauck, Matthias, Neal, William A., Nejatizadeh, Azim, Nekkantti, Chandini, Nelis, Keiu, Nelis, Liis, Nenko, Ilona, Neovius, Martin, Nervi, Flavio, Nguyen, Chung T., Nguyen, Nguyen D., Quang Ngoc Nguyen, Nieto-Martinez, Ramfis E., Nikitin, Yury P., Ning, Guang, Ninomiya, Toshiharu, Nishtar, Sania, Noale, Marianna, Noboa, Oscar A., Nogueira, Helena, Norat, Teresa, Nordendahl, Maria, Nordestgaard, Borge G., Noto, Davide, Nowak-Szczepanska, Natalia, Al Nsour, Mohannad, Nuhoglu, Irfan, Nurk, Eha, O'Neill, Terence W., O'Reilly, Dermot, Obreja, Galina, Ochimana, Caleb, Ochoa-Aviles, Angelica M., Oda, Eiji, Oh, Kyungwon, Ohara, Kumiko, Ohlsson, Claes, Ohtsuka, Ryutaro, Olafsson, Orn, Olinto, Maria Teresa A., Oliveira, Isabel O., Omar, Mohd Azahadi, Onat, Altan, Ong, Sok King, Ono, Lariane M., Ordunez, Pedro, Ornelas, Rui, Ortiz, Ana P., Ortiz, Pedro J., Osler, Merete, Osmond, Clive, Ostojic, Sergej M., Ostovar, Afshin, Otero, Johanna A., Overvad, Kim, Owusu-Dabo, Ellis, Paccaud, Fred Michel, Padez, Cristina, Pagkalos, Ioannis, Pahomova, Elena, Paiva, Karina Mary de, Pajak, Andrzej, Palli, Domenico, Palloni, Alberto, Palmieri, Luigi, Pan, Wen-Harn, Panda-Jonas, Songhomitra, Pandey, Arvind, Panza, Francesco, Papandreou, Dimitrios, Park, Soon-Woo, Park, Suyeon, Parnell, Winsome R., Parsaeian, Mahboubeh, Pascanu, Ionela M., Pasquet, Patrick, Patel, Nikhil D., Pecin, Ivan, Pednekar, Mangesh S., Peer, Nasheeta, Pei, Gao, Peixoto, Sergio Viana, Peltonen, Markku, Pereira, Alexandre C., Peres, Marco A., Perez-Farinos, Napoleon, Perez, Cynthia M., Peterkova, Valentina, Peters, Annette, Petersmann, Astrid, Petkeviciene, Janina, Petrauskiene, Ausra, Pettenuzzo, Emanuela, Peykari, Niloofar, Pham, Son Thai, Pichardo, Rafael N., Pierannunzio, Daniela, Pigeot, Iris, Pikhart, Hynek, Pilav, Aida, Pilotto, Lorenza, Pistelli, Francesco, Pitakaka, Freda, Piwonska, Aleksandra, Pizarro, Andreia N., Plans-Rubio, Pedro, Poh, Bee Koon, Pohlabeln, Hermann, Pop, Raluca M., Popovic, Stevo R., Porta, Miquel, Posch, Georg, Poudyal, Anil, Poulimeneas, Dimitrios, Pouraram, Hamed, Pourfarzi, Farhad, Pourshams, Akram, Poustchi, Hossein, Pradeepa, Rajendra, Price, Alison J., Price, Jacqueline F., Providencia, Rui, Puder, Jardena J., Pudule, Iveta, Puhakka, Soile E., Puiu, Maria, Punab, Margus, Qasrawi, Radwan F., Qorbani, Mostafa, Tran Quoc Bao, Radic, Ivana, Radisauskas, Ricardas, Rahimikazerooni, Salar, Rahman, Mahfuzar, Rahman, Mahmudur, Raitakari, Olli, Raj, Manu, Rakhimova, Ellina, Rakhmatulloev, Sherali, Rakovac, Ivo, Rao, Sudha Ramachandra, Ramachandran, Ambady, Ramke, Jacqueline, Ramos, Elisabete, Ramos, Rafel, Rampal, Lekhraj, Rampal, Sanjay, Rarra, Vayia, Rascon-Pacheco, Ramon A., Rasmussen, Mette, Rech, Cassiano Ricardo, Redon, Josep, Reganit, Paul Ferdinand M., Regecova, Valeria, Revilla, Luis, Rezaianzadeh, Abbas, Ribas-Barba, Lourdes, Ribeiro, Robespierre, Riboli, Elio, Richter, Adrian, Rigo, Fernando, Rinaldo, Natascia, Wit, Tobias F. Rinke de, Rito, Ana, Ritti-Dias, Raphael M., Rivera, Juan A., Robitaille, Cynthia, Roccaldo, Romana, Rodrigues, Daniela, Rodriguez-Artalejo, Fernando, Rodriguez-Perez, Maria Del Cristo, Rodriguez-Villamizar, Laura A., Roggenbuck, Ulla, Rojas-Martinez, Rosalba, Rojroongwasinkul, Nipa, Romaguera, Dora, Romeo, Elisabetta L., Rosario, Rafaela, Rosengren, Annika, Rouse, Ian, Roy, Joel G. 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Univ Nove Julho, Publ Hlth Agcy Canada, Canarian Hlth Serv, Univ Ind Santander, Assoc Calabrese Epatol, Univ Minho, Fiji Natl Univ, Spanish Nutr Fdn, Publ Hlth Agcy Sweden, Inst Food Sci Natl Res Council, Sitaram Bhartia Inst Sci & Res, Kindergarten Avlonari, Natl Inst Hlth, Catalan Dept Hlth, Biodonostia Hlth Res Inst, Inst Saude Ambiental, South Karelia Social & Hlth Care Dist, McMaster Univ, Hosp Italiano Buenos Aires, Rigshosp, Acad Med Ctr Univ Amsterdam, Ctr Oral Hlth Serv & Res Midnorway, Lagos State Univ, Univ Las Palmas Gran Canaria, Comenius Univ, Natl Ctr Dis Control & Publ Hlth, Nippon Med Sch, Sungkyunkwan Univ, Finnish Inst Occupat Hlth, Publ Hlth Promot & Dev Org, St Vincents Hosp, Nes Municipal, Hlth Polytech Jakarta II Inst, Diponegoro Univ, Univ Bari, Inst Reg Sante Publ, Univ Bordeaux, Oslo Metropolitan Univ, Univ Leuven, Lamprecht & Stamm Sozialforsch & Beratung AG, Univ Bonn, Kalina Malina Kindergarten, Jikei Univ, Fu Jen Catholic Univ, Natl Stat Off, Natl Inst Publ Hlth Natl Inst Hyg, Sci Res Inst Maternal & Child Hlth, Univ Lincoln, Cent Univ Kerala, Amsterdam Publ Hlth Res Inst, Hlth Serv Murcia, Inst Invest Sanitaria Illes Balears, Univ Bologna, Hellen Hlth Fdn, Govt Med Coll, Sefako Makgatho Hlth Sci Univ, Addis Ababa Univ, Univ Ctr Occidental Lisandro Alvarado, Meharry Med Coll, Dokuz Eylul Univ, Univ Tampere, Sabiha Gokcen Ilkokulu, Polytech Inst Porto, Icahn Sch Med Mt Sinai, Univ CEU San Pablo, Univ Miguel Hernandez, Vrije Univ Amsterdam, Sunflower Nursery Sch, North Karelia Ctr Publ Hlth, Univ Witwatersrand, Med Univ Vienna, Cork Inst Technol, Inst Med Res, Xinjiang Med Univ, Shanghai Educ Dev Co Ltd, Rebro Univ, St Georges Univ London, Univ Indonesia, Minist Agr & Rural Affairs, Fudan Univ, Univ Cyprus, Niigata Univ, Int Med Univ, Iran Univ Med Sci, Ctr Diabet & Endocrine Care, Peking Univ First Hosp, Jiangsu Prov Ctr Dis Control & Prevent, Sun Yat Sen Univ, West Kazakhstan Med Univ, Inner Mongolia Med Univ, and Przedszkole 81
Subjects: Life Sciences & Biomedicine - Other Topics, Science & Technology, AUSTRALIAN ADULTS, CHINESE ADULTS, nutritional and metabolic diseases, MALNUTRITION, TRENDS, DOUBLE BURDEN, PREVALENCE, POOLED ANALYSIS, US ADULTS, SYSTEMATIC ANALYSIS, HEALTH, sense organs, skin and connective tissue diseases, Life Sciences & Biomedicine, Biology
Abstract: Made available in DSpace on 2021-06-25T15:08:19Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-03-09 Wellcome Trust From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions. 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State Of Palest, Israel Usmanu Danfodiyo Univ Teaching Hosp, Sokoto, Nigeria Inst Mexicano Seguro Social, Mexico City, DF, Mexico Flinders Univ S Australia, Adelaide, SA, Australia Mahidol Univ, Salaya, Nakhon Pathom, Thailand BRAC James P Grant Sch Publ Hlth, Dhaka, Bangladesh Univ Copenhagen, Copenhagen, Denmark Copenhagen Univ Hosp, Copenhagen, Denmark Food & Nutr Res Inst, Taguig, Philippines Urmia Univ Med Sci, Orumiyeh, Iran Inst Nacl Ciencias Med & Nut, Mexico City, DF, Mexico Univ Amsterdam, Amsterdam, Netherlands Shahrekord Univ Med Sci, Shahrekord, Iran Noncommunicable Dis Res Ctr, Tehran, Iran Univ Oslo, Oslo, Norway Univ Bremen, Bremen, Germany Republican Ctr Hlth Promot, Bishkek, Kyrgyzstan Natl Ctr Diabet Endocrinol & Genet, Amman, Jordan Princess Nourah Bint Abdulrahman Univ, Riyadh, Saudi Arabia Kuwait Inst Sci Res, Kuwait, Kuwait King Abdulaziz Univ, Jeddah, Saudi Arabia Dasman Diabet Inst, Kuwait, Kuwait Luxembourg Inst Hlth, Strassen, Luxembourg Aldara Hosp & Med Ctr, Riyadh, Saudi Arabia King Abdullah Int Med Res Ctr, Riyadh, Saudi Arabia Bispebjerg & Frederiksberg Hosp, Copenhagen, Denmark Barcelona Inst Global Hlth CIBERESP, Barcelona, Spain World Hlth Org Reg Off Eastern Mediterranean, Cairo, Egypt Bombay Hosp & Med Res Ctr, Mumbai, Maharashtra, India Res Ctr Social Determinants Hlth, Tehran, Iran UMR CNRS MNHN 7206 Ecoanthropologie, Paris, France Univ Lille, Lille, France Lille Univ Hosp, Lille, France Western Norway Univ Appl Sci, Sogndal, Norway Norwegian Sch Sport Sci, Oslo, Norway Madras Diabet Res Fdn, Chennai, Tamil Nadu, India Zahedan Univ Med Sci, Zahedan, Iran Natl Inst Publ Hlth, Tunis, Tunisia Univ Porto, Inst Publ Hlth, Porto, Portugal Norwegian Inst Publ Hlth, Oslo, Norway Univ Massachusetts, Amherst, MA 01003 USA Abt Associates Inc, Kathmandu, Nepal Univ Iceland, Reykjavik, Iceland Univ Yaounde I, Yaounde, Cameroon Univ Fed Pelotas, Pelotas, RS, Brazil Univ Med 1, Yangon, Myanmar Banska Bystrica Reg Author Publ Hlth, Banska Bystrica, Slovakia Tel Aviv Univ, Tel Aviv, Israel Hebrew Univ Jerusalem, Jerusalem, Israel Univ Porto, Med Sch, Porto, Portugal Neyshabur Univ Med Sci, Neyshabur, Iran Res Inst Endocrine Sci, Tehran, Iran Indian Council Med Res, New Delhi, India Natl Inst Publ Hlth, Copenhagen, Denmark Univ Sci & Technol, Sanaa, Yemen Med Univ Lodz, Lodz, Poland Med Univ Gdansk, Gdansk, Poland Univ Autonoma Madrid CIBERESP, Madrid, Spain Univ Rzeszow, Rzeszow, Poland Univ Palermo, Palermo, Italy Pan Amer Hlth Org, Washington, DC USA Mohammed V Univ Rabat, Rabat, Morocco Univ Pernambuco, Recife, PE, Brazil Baqai Inst Diabetol & Endocrinol, Karachi, Pakistan Univ Fed Santa Catarina, Florianopolis, SC, Brazil Dalhousie Univ, Halifax, NS, Canada Jordan Univ Sci & Technol, Irbid, Jordan Univ Fed Maranhao, Sao Luis, Brazil Farabi Kazakh Natl Univ, Alma Ata, Kazakhstan Univ Coll Dublin, Dublin, Ireland Christian Med Coll & Hosp, Vellore, Tamil Nadu, India Fed Minist Social Affairs Hlth Care & Consumer Pr, 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Potsdam, Germany Endocrinol Res Ctr, Moscow, Russia Ctr Educ Med & Invest Clin, Buenos Aires, DF, Argentina IRCCS Neuromed, Pozzilli, Italy Toulouse Univ, Sch Med, Toulouse, France Univ Zurich, Zurich, Switzerland Univ Hosp KU Leuven, Leuven, Belgium Flemish Agcy Care & Hlth, Brussels, Belgium Univ Ghent, Ghent, Belgium FrieslandCampina, Amersfoort, Netherlands Univ Cent Venezuela, Caracas, Venezuela Bielefeld Univ, Bielefeld, Germany World Hlth Org Reg Off Europe, Moscow, Russia German Canc Res Ctr, Heidelberg, Germany Fred Hollows Fdn, Auckland, New Zealand Univ Med & Pharm Bucharest, Bucharest, Romania Swansea Univ, Swansea, W Glam, Wales Univ Coll Copenhagen, Copenhagen, Denmark Inst Publ Hlth, Tirana, Albania Munster Technol Univ, Cork, Ireland Univ La Laguna, Tenerife, Spain Univ Malta, Msida, Malta Vanderbilt Univ, 221 Kirkland Hall, Nashville, TN 37235 USA Minist Hlth, Tongatapu, Tonga Canadian Fitness & Lifestyle Res Inst, Ottawa, ON, Canada Hosp Santa Maria, Lisbon, Portugal Istanbul Univ Cerrahpasa, Istanbul, Turkey Univ Fed Juiz de Fora, Juiz De Fora, Brazil Minist Publ Hlth, Asuncion, Paraguay Natl Inst Publ Hlth, Prague, Czech Republic Gaetano Fucito Hosp, Mercato San Severino, Italy Univ Groningen, Groningen, Netherlands Karolinska Inst, Huddinge, Sweden Ctr Estudios Nutr Infantil, Buenos Aires, DF, Argentina Univ Porto, Porto, Portugal Univ Zaragoza, Zaragoza, Spain Santiago de Compostela Univ, Santiago De Compostela, Spain Minist Hlth, Ankara, Turkey Council Agr Res & Econ, Rome, Italy Fed Univ Rio Grande, Rio Grande, Brazil India Diabet Res Fdn, Chennai, Tamil Nadu, India Duke NUS Med Sch, Singapore, Singapore ICMR Natl Inst Med Stat, New Delhi, India Singapore Eye Res Inst, Singapore, Singapore Acad Sinica, Taipei, Taiwan Capital Inst Pediat, Beijing, Peoples R China Duke Univ, Durham, NH USA Kailuan Gen Hosp, Tangshan, Peoples R China Univ Oxford, Oxford, England Ahvaz Jundishapur Univ Med Sci, Ahvaz, Iran Gertner Inst Epidemiol & Hlth Policy 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Madrid, Spain Indian Stat Inst, Kolkata, India Tabriz Hlth Serv Management Res Ctr, Tabriz, Iran Geneva Univ Hosp, Geneva, Switzerland Sciensano, Brussels, Belgium Univ Med Ctr Groningen, Groningen, Netherlands Natl Res Ctr Prevent Med, Moscow, Russia Innovating Hlth Int, Port Au Prince, Haiti Univ Montreal, Montreal, PQ, Canada French Natl Res Inst Sustainable Dev, Montpellier, France French Publ Hlth Agcy, St Maurice, France Mediterranea Cardioctr, Naples, Italy Univ Vale Rio dos Sinos, Sao Leopoldo, Brazil Natl Inst Hyg Epidemiol & Microbiol, Havana, Cuba Natl Council Sci & Tech Res, Buenos Aires, DF, Argentina Minist Hlth & Med Educ, Tehran, Iran Univ Novi Sad, Novi Sad, Serbia Natl Inst Nutr, Hanoi, Vietnam Univ Queensland, Brisbane, Qld, Australia Ist Super Sanita, Rome, Italy Univ Cuenca, Cuenca, Ecuador Helmholtz Zentrum Munchen, Munich, Germany Univ Tehran Med Sci, Tehran, Iran Minist Sante & Hyg Publ, Abidjan, Cote Ivoire Univ Hosp Dusseldorf, Dusseldorf, Germany Natl Inst Cardiol, Warsaw, Poland Beijing Ctr Dis Prevent & Control, Beijing, Peoples R China UMI 3189 ESS, Marseille, France Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA Scuola Super Sant Anna, Pisa, Italy Univ Latvia, Riga, Latvia Minist Hlth & Med Serv, Gizo, Solomon Islands Hormozgan Univ Med Sci, Bandar Abbas, Iran Univ Benin, Benin, Nigeria Univ Skovde, Skovde, Sweden Natl Inst Nutr & Food Technol, Tunis, Tunisia Univ West Indies, Kingston, Jamaica Univ Calif Davis, Davis, CA 95616 USA Univ Stellenbosch, Cape Town, South Africa Univ Duisburg Essen, Duisburg, Germany Karadeniz Tech Univ, Trabzon, Turkey Univ Helsinki, Helsinki, Finland Mashhad Univ Med Sci, Mashhad, Razavi Khorasan, Iran Rafsanjan Univ Med Sci, Rafsanjan, Iran Queens Univ Belfast, Belfast, Antrim, North Ireland Tabriz Univ Med Sci, Tabriz, Iran Fasa Univ Med Sci, Fasa, Iran Shiraz Univ Med Sci, Shiraz, Iran Baqai Med Univ, Karachi, Pakistan Ctr Salud Villanueva Norte, Badajoz, Spain Hosp Don Benito Villanueva Serena, Badajoz, Spain Minist Hlth, Buenos Aires, DF, Argentina Univ Insubria, Varese, Italy Pontificia Univ Catolica Chile, Santiago, Chile Inst Mother & Child Hlth, Warsaw, Poland Swiss Trop & Publ Hlth Inst, Basel, Switzerland Univ Tartu, Tartu, Estonia Univ Sains Malaysia, Kota Baharu, Kelantan, Malaysia Umea Univ, Umea, Sweden Univ Fed Sao Paulo, Sao Paulo, Brazil Hosp Univ Son Espases, Palma De Mallorca, Spain Hosp Clin Porto Alegre, Porto Alegre, RS, Brazil Univ Sumatera Utara, Medan, Indonesia Kindai Univ, Osaka, Japan Kyoto Univ, Kyoto, Japan Med Univ Warsaw, Warsaw, Poland Jagiellonian Univ, Med Coll, Krakow, Poland Minist Salute DG Prevenz Sanit, Rome, Italy Univ Catania, Catania, Italy CIBER Epidemiol & Salud Publ, Alicante, Spain Africa Hlth Res Inst, Mtubatuba, South Africa Univ Geneva, Med Sch, Geneva, Switzerland CIBER Epidemiol & Salud Publ, Barcelona, Spain Univ Fed Minas Gerais, Belo Horizonte, MG, Brazil Univ Utrecht, Utrecht, Netherlands Wageningen Univ, Wageningen, Netherlands Univ Adelaide, Adelaide, SA, Australia Lund Univ, Lund, Sweden Aristotle Univ Thessaloniki, Thessaloniki, Greece Inst Natl Sante & Rech Med, Villejuif, France Minist Hlth, Jerusalem, Israel McGill Univ, Montreal, PQ, Canada Gasol Fdn, Barcelona, Spain PASs Hirszfeld Inst Immunol & Expt Therapy, Wroclaw, Poland Univ Politecn Madrid, Madrid, Spain St Annes Univ Hosp, Brno, Czech Republic Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico Ctr Estudios Diabet AC, Mexico City, DF, Mexico Univ Autonoma Santo Domingo, Santo Domingo, Dominican Rep Minist Hlth, Lisbon, Portugal Inst Clin & Expt Med, Prague, Czech Republic Childrens Mem Hlth Inst, Warsaw, Poland Natl Ctr Cardiovasc Dis, Beijing, Peoples R China Univ Ferrara, Ferrara, Italy Author Sanitaria San Marino, San Marino, CA USA Iceland Heart Assoc, Kopavogur, Iceland Univ Icesi, Cali, Colombia Univ Estadual Montes Claros, Montes Claros, MG, Brazil Kings Coll London, London, England Int Agcy Res Canc, Lyon, France Capital Med Univ, Beijing, Peoples R China Capital Med Univ, Beijing Tongren Hosp, Beijing, Peoples R China Healis Sekhsaria Inst Publ Hlth, Navi Mumbai, India Eternal Heart Care Ctr & Res Inst, Jaipur, Rajasthan, India Univ Ibadan, Ibadan, Nigeria Inst Clin Effectiveness & Hlth Policy, Buenos Aires, DF, Argentina Natl Hlth Insurance Serv, Wonju, South Korea Prevent Metab Disorders Res Ctr, Tehran, Iran Res & Educ Inst Child Hlth, Nicosia, Cyprus Danish Canc Soc Res Ctr, Copenhagen, Denmark Univ West Indies, Cave Hill, Barbados Kermanshah Univ Med Sci, Kermanshah, Iran Univ Eastern Finland, Kuopio, Finland Beijing Inst Ophthalmol, Beijing, Peoples R China Int Hellen Univ, Thessaloniki, Greece Kyushu Univ, Fukuoka, Japan Univ Bergen, Bergen, Norway Tulane Univ, New Orleans, LA USA Natl Res Inst Hlth & Family Planning, Beijing, Peoples R China Chinese Ctr Dis Control & Prevent, Beijing, Peoples R China Univ Pecs, Pecs, Hungary Danish Hlth Author, Copenhagen, Denmark Joep Lange Inst, Amsterdam, Netherlands Univ Fed Pernambuco, Recife, PE, Brazil Oulu Univ Hosp, Oulu, Finland Univ Autonoma Bucaramanga, Bucaramanga, Colombia Swiss Fed Inst Technol, Zurich, Switzerland Chron Dis Res Ctr, Tehran, Iran Univ Hong Kong, Hong Kong, Peoples R China Chinese Univ Hong Kong, Hong Kong, Peoples R China Univ Western Australia, Perth, WA, Australia Kingston Hlth Sci Ctr, Kingston, ON, Canada Fdn Oftalmol Santander, Bucaramanga, Colombia Univ Oran 1, Oran, Algeria Nay Pyi Taw, Independent Publ Hlth Specialist, Nay Pyi Taw, Myanmar Minist Hlth & Sports, Nay Pyi Taw, Myanmar Peking Univ, Beijing, Peoples R China Natl Inst Publ Hlth, Bucharest, Romania Vrije Univ Amsterdam Med Ctr, Amsterdam, Netherlands Amer Univ Beirut, Beirut, Lebanon CIBER Epidemiol & Salud Publ, San Sebastian, Spain Cairo Univ, Cairo, Egypt Erasmus MC, Rotterdam, Netherlands Med Univ Varna, Varna, Bulgaria Univ Tokyo, Tokyo, Japan Deakin Univ, Geelong, Vic, Australia Tokyo Metropolitan Inst Gerontol, Tokyo, Japan Hadassah 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Estonia Kansai Med Univ, Hirakata, Osaka, Japan Hungarian Sch Sport Federat, Budapest, Hungary Minist Hlth & Qual Life, Port Louis, Mauritius Univ Hosp Ulm, Ulm, Germany North West Univ, Potchefstroom, South Africa Univ Jyvaskyla, Jyvaskyla, Finland Inst Publ Hlth, Podgorica, Montenegro Amrita Inst Med Sci, Cochin, Kerala, India Inst Endocrinol, Prague, Czech Republic All India Inst Med Sci, New Delhi, India African Populat & Hlth Res Ctr, Nairobi, Kenya Hanoi Univ Publ Hlth, Hanoi, Vietnam Hassan First Univ Settat, Settat, Morocco Minist Hlth, Algiers, Algeria Harokopio Univ, Athens, Greece Sahlgrens Acad, Gothenburg, Sweden Endocrinol & Metab Res Ctr, Tehran, Iran Univ Publ Hlth, Yangon, Myanmar Int Food Policy Res Inst, Dakar, Senegal Natl Univ Singapore, Singapore, Singapore Hong Kong Polytech Univ, Hong Kong, Peoples R China Tampere Univ Hosp, Tampere, Finland Univ Douala, Douala, Cameroon Univ Cape Town, Cape Town, South Africa Natl Inst Hlth Dev, Tallinn, Estonia West Virginia 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Stockholm, Sweden Natl Inst Hyg & Epidemiol, Hanoi, Vietnam Univ Med & Pharm Ho Chi Minh City, Ho Chi Minh City, Vietnam Hanoi Med Univ, Hanoi, Vietnam LifeDoc Hlth, Memphis, TN USA Heartfile, Islamabad, Pakistan Eastern Mediterranean Publ Hlth Network, Amman, Jordan Univ Manchester, Manchester, Lancs, England State Univ Med & Pharm, Kishinev, Moldova Tachikawa Gen Hosp, Nagaoka, Niigata, Japan Korea Ctr Dis Control & Prevent, Cheongju, South Korea Japan Wildlife Res Ctr, Tokyo, Japan Istanbul Univ, Istanbul, Turkey Minist Hlth, Bandar Seri Begawan, Brunei Univ Fed Parana, Curitiba, Parana, Brazil Univ Madeira, Funchal, Portugal Univ Puerto Rico, San Juan, PR 00936 USA Ctr Clin Res & Prevent, Glostrup, Denmark MRC Lifecourse Epidemiol Unit, Southampton, Hants, England Kwame Nkrumah Univ Sci & Technol, Kumasi, Ghana UniSante, Lausanne, Switzerland Inst Canc Res, Prevent & Clin Network, Florence, Italy Univ Wisconsin, Madison, WI USA Heidelberg Univ, Heidelberg, Germany IRCCS Ente Osped Specializzato Gastroenterol S de, Bari, Italy Zayed Univ, Abu Dhabi, U Arab Emirates Catholic Univ Daegu, Daegu, South Korea Univ Med Pharm Sci & Technol Targu Mures, Targu Mures, Romania Jivandeep Hosp, Anand, Gujarat, India South African Med Res Council, Durban, South Africa Natl Dent Care Ctr Singapore, Singapore, Singapore Univ Malaga, Malaga, Spain Univ Hosp Varese, Varese, Italy Vietnam Natl Heart Inst, Hanoi, Vietnam Clin Med Avanzada Dr Abel Gonzalez, Santo Domingo, Dominican Rep Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany Univ Sarajevo, Sarajevo, Bosnia & Herceg Cardiovasc Prevent Ctr Udine, Udine, Italy Pisa Univ Hosp, Pisa, Italy Minist Hlth & Med Serv, Honiara, Solomon Islands Publ Hlth Agcy Catalonia, Barcelona, Spain Inst Hosp del Mar Invest Med, Barcelona, Spain Ardabil Univ Med Sci, Ardebil, Iran Ctr Dis Prevent & Control, Riga, Latvia Alborz Univ Med Sci, Karaj, Iran Minist Hlth, Hanoi, Vietnam Pure Earth, Dhaka, Bangladesh Inst Epidemiol Dis Control & Res, Dhaka, Bangladesh Univ Turku, Turku, Finland Inst Univ Invest Atenc Primaria Jordi Gol, Girona, Spain Univ Putra Malaysia, Serdang, Malaysia Univ Malaya, Kuala Lumpur, Malaysia Sotiria Hosp, Athens, Greece Univ Valencia, Valencia, Spain Univ Philippines, Manila, Philippines Slovak Acad Sci, Bratislava, Slovakia Nutr Res Fdn, Barcelona, Spain Minas Gerais State Secretariat Hlth, Belo Horizonte, MG, Brazil CS S Agustin Ibsalut, Palma De Mallorca, Spain Amsterdam Inst Global Hlth & Dev, Amsterdam, Netherlands Natl Inst Hlth Doutor Ricardo Jorge, Lisbon, Portugal Univ Nove Julho, Sao Paulo, Brazil Publ Hlth Agcy Canada, Ottawa, ON, Canada Canarian Hlth Serv, Tenerife, Spain Univ Ind Santander, Bucaramanga, Colombia Assoc Calabrese Epatol, Reggio Di Calabria, Italy Univ Minho, Braga, Portugal Fiji Natl Univ, Suva, Fiji Spanish Nutr Fdn, Madrid, Spain Publ Hlth Agcy Sweden, Stockholm, Sweden Inst Food Sci Natl Res Council, Avellino, Italy Sitaram Bhartia Inst Sci & Res, New Delhi, India Kindergarten Avlonari, Evia, Greece Natl Inst Hlth, Lima, Peru Minist Hlth, Jakarta, Indonesia Catalan Dept Hlth, Barcelona, Spain Biodonostia Hlth Res Inst, San Sebastian, Spain Inst Saude Ambiental, Lisbon, Portugal South Karelia Social & Hlth Care Dist, Lappeenranta, Finland McMaster Univ, Hamilton, ON, Canada Natl Canc Ctr, Tokyo, Japan Univ Sao Paulo Clin Hosp, Sao Paulo, Brazil Hosp Italiano Buenos Aires, Buenos Aires, DF, Argentina Rigshosp, Copenhagen, Denmark Acad Med Ctr Univ Amsterdam, Amsterdam, Netherlands Ctr Oral Hlth Serv & Res Midnorway, Trondheim, Norway Lagos State Univ, Coll Med, Lagos, Nigeria Univ Las Palmas Gran Canaria, Las Palmas Gran Canaria, Spain Comenius Univ, Bratislava, Slovakia Natl Ctr Dis Control & Publ Hlth, Tbilisi, Georgia Nippon Med Sch, Tokyo, Japan Sungkyunkwan Univ, Seoul, South Korea Finnish Inst Occupat Hlth, Helsinki, Finland Publ Hlth Promot & Dev Org, Kathmandu, Nepal St Vincents Hosp, Sydney, NSW, Australia Nes Municipal, Aarnes, Norway Hlth Polytech Jakarta II Inst, Jakarta, Indonesia Diponegoro Univ, Semarang, Indonesia Univ Bari, Bari, Italy Inst Reg Sante Publ, Ouidah, Benin Univ Bordeaux, Bordeaux, France Oslo Metropolitan Univ, Oslo, Norway Inst Publ Hlth, Skopje, North Macedonia Univ Leuven, Leuven, Belgium Lamprecht & Stamm Sozialforsch & Beratung AG, Zurich, Switzerland Inst Natl Sante & Rech Med, Nancy, France Univ Bonn, Bonn, Germany Sotiria Hosp, Sotiria, Greece Kalina Malina Kindergarten, Pazardjik, Bulgaria Jikei Univ, Sch Med, Tokyo, Japan Fu Jen Catholic Univ, Taipei, Taiwan Natl Stat Off, Praia, Cape Verde Natl Inst Publ Hlth Natl Inst Hyg, Warsaw, Poland Deakin Univ, Sydney, NSW, Australia Sci Res Inst Maternal & Child Hlth, Ashkhabad, Turkmenistan Univ Lincoln, Lincoln, England Minist Hlth, Amman, Jordan UNICEF, Niamey, Niger Cent Univ Kerala, Kasaragod, India Amsterdam Publ Hlth Res Inst, Amsterdam, Netherlands Hlth Serv Murcia, Murcia, Spain Inst Invest Sanitaria Illes Balears, Menorca, Spain Univ Bologna, Bologna, Italy Hellen Hlth Fdn, Athens, Greece Govt Med Coll, Bhavnagar, Gujarat, India Sefako Makgatho Hlth Sci Univ, Ga Rankuwa, South Africa Addis Ababa Univ, Addis Ababa, Ethiopia Minist Hlth, Wellington, New Zealand Univ Ctr Occidental Lisandro Alvarado, Barquisimeto, Venezuela Meharry Med Coll, Nashville, TN 37208 USA Dokuz Eylul Univ, Izmir, Turkey Univ Tampere, Tays Eye Ctr, Tampere, Finland Sabiha Gokcen Ilkokulu, Ankara, Turkey Polytech Inst Porto, Porto, Portugal Icahn Sch Med Mt Sinai, New York, NY 10029 USA Univ CEU San Pablo, Madrid, Spain CNR, Pisa, Italy Univ Miguel Hernandez, Alicante, Spain Vrije Univ Amsterdam, Amsterdam, Netherlands Sunflower Nursery Sch, Craiova, Romania North Karelia Ctr Publ Hlth, Joensuu, Finland Univ Witwatersrand, Johannesburg, South Africa Med Univ Vienna, Vienna, Austria Cork Inst Technol, Cork, Ireland Inst Med Res, Kuala Lumpur, Malaysia Xinjiang Med Univ, Urumqi, Peoples R China Shanghai Educ Dev Co Ltd, Shanghai, Peoples R China Minist Hlth, Auckland, New Zealand Rebro Univ, Rebro, Sweden St Georges Univ London, London, England Univ Indonesia, Jakarta, Indonesia Minist Agr & Rural Affairs, Inst Food & Nutr Dev, Beijing, Peoples R China Fudan Univ, Childrens Hosp, Shanghai, Peoples R China Univ Cyprus, Nicosia, Cyprus Niigata Univ, Niigata, Japan Int Med Univ, Shah Alam, Selangor, Malaysia Hellen Mediterranean Univ, Iraklion, Greece Iran Univ Med Sci, Tehran, Iran Ctr Diabet & Endocrine Care, Srinagar, India Peking Univ First Hosp, Beijing, Peoples R China Jiangsu Prov Ctr Dis Control & Prevent, Nanjing, Peoples R China Sun Yat Sen Univ, Guangzhou, Peoples R China West Kazakhstan Med Univ, Aktobe, Kazakhstan Inner Mongolia Med Univ, Hohhot, Peoples R China Przedszkole 81, Warsaw, Poland Univ Estadual Paulista, Presidente Prudente, Brazil
Published: 2021

4. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Author: Zhou, B, Carrillo-Larco, Rm, Danaei, G, Riley, Lm, Paciorek, Cj, Stevens, Ga, Gregg, Ew, Bennett, Je, Solomon, B, Singleton, Rk, Sophiea, Mk, Iurilli, Mlc, Lhoste, Vpf, Cowan, Mj, Savin, S, Woodward, M, Balanova, Y, Cifkova, R, Damasceno, A, Elliott, P, Farzadfar, F, He, J, Ikeda, N, Kengne, Ap, Khang, Yh, Kim, Hc, Laxmaiah, A, Lin, Hh, Maira, Pm, Miranda, Jj, Neuhauser, H, Sundstrom, J, Varghese, C, Widyahening, Is, Zdrojewski, T, Ezzati, M, Abarca-Gomez, L, Abdeen, Za, Rahim, Hfa, Abu-Rmeileh, Nm, Acosta-Cazares, B, Adams, Rj, Aekplakorn, W, Afsana, K, Afzal, S, Agdeppa, Ia, Aghazadeh-Attari, J, Aguilar-Salinas, Ca, Agyemang, C, Ahmad, Na, Ahmadi, A, Ahmadi, N, Ahmadizar, F, Ahmed, Sh, Ahrens, W, Ajlouni, K, Al-Raddadi, R, Alarouj, M, Albuhairan, F, Aldhukair, S, Ali, Mm, Alkandari, A, Alkerwi, A, Allin, K, Aly, E, Amarapurkar, Dn, Amougou, N, Amouyel, P, Andersen, Lb, Anderssen, Sa, Anjana, Rm, Ansari-Moghaddam, A, Ansong, D, Aounallah-Skhiri, H, Araujo, J, Ariansen, I, Aris, T, Arku, Re, Arlappa, N, Aryal, Kk, Aspelund, T, Assah, Fk, Assuncao, Mcf, Auvinen, J, Avdicova, M, Azevedo, A, Azimi-Nezhad, M, Azizi, F, Azmin, M, Babu, Bv, Bahijri, S, Balakrishna, N, Bamoshmoosh, M, Banach, M, Banadinovic, M, Bandosz, P, Banegas, Jr, Baran, J, Barbagallo, Cm, Barcelo, A, Barkat, A, Barreto, M, Barros, Ajd, Barros, Mvg, Bartosiewicz, A, Basit, A, Bastos, Jld, Bata, I, Batieha, Am, Batyrbek, A, Baur, La, Beaglehole, R, Belavendra, A, Ben Romdhane, H, Benet, M, Benson, Ls, Berkinbayev, S, Bernabe-Ortiz, A, Bettiol, H, Bezerra, J, Bhagyalaxmi, A, Bhargava, Sk, Bia, D, Biasch, K, Lele, Ecb, Bikbov, Mm, Bista, B, Bjerregaard, P, Bjertness, E, Bjertness, Mb, Bjorkelund, C, Bloch, Kv, Blokstra, A, Bo, S, Bobak, M, Boeing, H, Boggia, Jg, Boissonnet, Cp, Bojesen, Se, Bongard, V, Bonilla-Vargas, A, Bopp, M, Borghs, H, Bovet, P, Boyer, Cb, Braeckman, L, Brajkovich, I, Branca, F, Breckenkamp, J, Brenner, H, Brewster, Lm, Briceno, Y, Brito, M, Bruno, G, Bueno-de-Mesquita, Hb, Bueno, G, Bugge, A, Burns, C, Bursztyn, M, de Leon, Ac, Cacciottolo, J, Cameron, C, Can, G, Candido, Apc, Capanzana, Mv, Capkova, N, Capuano, E, Capuano, V, Cardoso, Vc, Carlsson, Ac, Carvalho, J, Casanueva, Ff, Censi, L, Cervantes-Loaiza, M, Chadjigeorgiou, Ca, Chamukuttan, S, Chan, Aw, Chan, Q, Chaturvedi, Hk, Chaturvedi, N, Chee, Ml, Chen, Cj, Chen, Ff, Chen, Hs, Chen, Sh, Chen, Zm, Cheng, Cy, Cheraghian, B, Dekkaki, Ic, Chetrit, A, Chien, Kl, Chiolero, A, Chiou, St, Chirita-Emandi, A, Chirlaque, Md, Cho, B, Christensen, K, Christofaro, Dg, Chudek, J, Cinteza, E, Claessens, F, Clarke, J, Clays, E, Cohen, E, Concin, H, Cooper, C, Coppinger, Tc, Costanzo, S, Cottel, D, Cowell, C, Craig, Cl, Crampin, Ac, Crujeiras, Ab, Cruz, Jj, Csilla, S, Cui, Lf, Cureau, Fv, Cuschieri, S, D'Arrigo, G, D'Orsi, E, Dallongeville, J, Dankner, R, Dantoft, Tm, Dauchet, L, Davletov, K, De Backer, G, De Bacquer, D, De Curtis, A, de Gaetano, G, De Henauw, S, de Oliveira, Pd, De Ridder, D, De Smedt, D, Deepa, M, Deev, Ad, Degennaro, V, Delisle, H, Demarest, S, Dennison, E, Deschamps, V, Dhimal, M, Di Castelnuovo, Af, Dias-da-Costa, Js, Diaz, A, Dickerson, Tt, Dika, Z, Djalalinia, S, Htp, Do, Dobson, Aj, Donfrancesco, C, Donoso, Sp, Doring, A, Dorobantu, M, Dorr, M, Doua, K, Dragano, N, Drygas, W, Duante, Ca, Duboz, P, Duda, Rb, Dulskiene, V, Dushpanova, A, Dzakula, A, Dzerve, V, Dziankowska-Zaborszczyk, E, Eddie, R, Eftekhar, E, Eggertsen, R, Eghtesad, S, Eiben, G, Ekelund, U, El-Khateeb, M, El Ati, J, Eldemire-Shearer, D, Eliasen, M, Elosua, R, Erasmus, Rt, Erbel, R, Erem, C, Eriksen, L, Eriksson, Jg, Escobedo-de la Pena, J, Eslami, S, Esmaeili, A, Evans, A, Faeh, D, Fakhretdinova, Aa, Fall, Ch, Faramarzi, E, Farjam, M, Fattahi, Mr, Fawwad, A, Felix-Redondo, Fj, Felix, Sb, Ferguson, Ts, Fernandes, Ra, Fernandez-Berges, D, Ferrante, D, Ferrao, T, Ferrari, M, Ferrario, Mm, Ferreccio, C, Ferreira, Hs, Ferrer, E, Ferrieres, J, Figueiro, Th, Fink, G, Fischer, K, Foo, Lh, Forsner, M, Fouad, Hm, Francis, Dk, Grego, Franco, Frikke-Schmidt, R, Frontera, G, Fuchs, Fd, Fuchs, Sc, Fujita, Y, Fumihiko, M, Furdela, V, Furer, A, Furusawa, T, Gaciong, Z, Galbarczyk, A, Galenkamp, H, Galvano, F, Gao, Jl, Gao, P, Garcia-de-la-Hera, M, Garcia, P, Gareta, D, Garnett, Sp, Gaspoz, Jm, Gasull, M, Gazzinelli, A, Gehring, U, Geleijnse, Jm, George, R, Ghanbari, A, Ghasemi, E, Gheorghe-Fronea, Of, Ghimire, A, Gialluisi, A, Giampaoli, S, Gieger, C, Gill, Tk, Giovannelli, J, Gironella, G, Giwercman, A, Gkiouras, K, Goldberg, M, Goldsmith, Ra, Gomez, Lf, Gomula, A, da Silva, Bgc, Goncalves, H, Goncalves, M, Gonzalez-Chica, Da, Gonzalez-Gross, M, Gonzalez-Rivas, Jp, Gonzalez-Villalpando, C, Gonzalez-Villalpando, Me, Gonzalez, Ar, Gorbea, Mb, Gottrand, F, Graff-Iversen, S, Grafnetter, D, Grajda, A, Grammatikopoulou, Mg, Gregor, Rd, Grodzicki, T, Grosso, G, Gruden, G, Df, Gu, Guan, Op, Gudmundsson, Ef, Gudnason, V, Guerrero, R, Guessous, I, Guimaraes, Al, Gulliford, Mc, Gunnlaugsdottir, J, 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Jockel, Kh, Joffres, M, Johansson, M, Jokelainen, Jj, Jonas, Jb, Jorgensen, T, Joshi, P, Joukar, F, Jozwiak, J, Juolevi, A, Jurak, G, Juresa, V, Kaaks, R, Kafatos, A, Kajantie, Eo, Kalmatayeva, Z, Kalpourtzi, N, Kalter-Leibovici, O, Kampmann, Fb, Kannan, S, Karaglani, E, Karhus, Ll, Karki, Kb, Katibeh, M, Katz, J, Kauhanen, J, Kaur, P, Kavousi, M, Kazakbaeva, Gm, Keil, U, Boker, Lk, Keinanen-Kiukaanniemi, S, Kelishadi, R, Kemper, Hcg, Keramati, M, Kerimkulova, A, Kersting, M, Key, T, Khader, Ys, Khalili, D, Khaw, Kt, Kheiri, B, Kheradmand, M, Khosravi, A, Kiechl-Kohlendorfer, U, Kiechl, S, Killewo, J, Kim, Dw, Kim, J, Klakk, H, Klimek, M, Klumbiene, J, Knoflach, M, Kolle, E, Kolsteren, P, Kontto, Jp, Korpelainen, R, Korrovits, P, Kos, J, Koskinen, S, Kouda, K, Kowlessur, S, Koziel, S, Kratenova, J, Kriaucioniene, V, Kristensen, Pl, Krokstad, S, Kromhout, D, Kruger, Hs, Kubinova, R, Kuciene, R, Kujala, Um, Kulaga, Z, Kumar, Rk, Kurjata, P, Kusuma, Ys, Kutsenko, V, Kuulasmaa, K, Kyobutungi, C, Laatikainen, T, Lachat, C, Laid, Y, Lam, Th, Landrove, O, Lanska, V, Lappas, G, Larijani, B, Latt, Ts, Le Coroller, G, Bao, Kln, Le, THUY DUNG, Lee, J, Lehmann, N, Lehtimaki, T, Lemogoum, D, Levitt, Ns, Yp, Li, Lilly, Cl, Lim, Wy, Lima-Costa, Mf, Lin, X, Lin, Yt, Lind, L, Lingam, V, Linneberg, A, Lissner, L, Litwin, M, Wc, Lo, Loit, Hm, Lopez-Garcia, E, Lopez, T, Lotufo, Pa, Lozano, Je, Lovrencic, Il, Lukrafka, Jl, Luksiene, D, Lundqvist, A, Lundqvist, R, Lunet, N, Lustigova, M, Luszczki, E, Gs, Ma, Ma, J, Machado-Coelho, Gll, Machado-Rodrigues, Am, Macia, E, Macieira, Lm, Madar, Aa, Maggi, S, Magliano, Dj, Magriplis, E, Mahasampath, G, Maire, B, Majer, M, Makdisse, M, Malekzadeh, F, Malekzadeh, R, Malhotra, R, Mallikharjuna, K, Malyutina, Sk, Maniego, Lv, Manios, Y, Mann, Ji, Mansour-Ghanaei, F, Manzato, E, Marcil, A, Margozzini, P, Marild, Sb, Glavic, Mm, Marques-Vidal, P, Marques, Lp, Marrugat, J, Martorell, R, Mascarenhas, Lp, Matasin, M, Mathiesen, Eb, Mathur, P, Matijasevich, A, Matlosz, P, Matsha, Te, Mavrogianni, C, Mbanya, Jcn, Posso, Ajm, Mcfarlane, Sr, Mcgarvey, St, Mclachlan, S, Mclean, Rm, Mclean, Sb, Mcnulty, Ba, Benchekor, Sm, Medzioniene, J, Mehdipour, P, Mehlig, K, Mehrparvar, Ah, Meirhaeghe, A, Meisinger, C, Montano, Cm, Menezes, Amb, Menon, Gr, Mereke, A, Meshram, Ii, Metspalu, A, Meyer, He, Mi, J, Michels, N, Mikkel, K, Milkowska, K, Miller, Jc, Minderico, Cs, Mini, Gk, Mirjalili, Mr, Mirrakhimov, E, Misigoj-Durakovic, M, Modesti, Pa, Moghaddam, Ss, Mohajer, B, Mohamed, Mk, Mohamed, Sf, Mohammad, K, Mohammadi, Mr, Mohammadi, Z, Mohammadifard, N, Mohammadpourhodki, R, Mohan, V, Mohanna, S, Yusoff, Mfm, Mohebbi, I, Mohebi, F, Moitry, M, Mollehave, Lt, Molnar, D, Momenan, A, Mondo, Ck, Monterrubio-Flores, E, Monyeki, Kdk, Moon, Js, Moosazadeh, M, Moreira, Lb, Morejon, A, Moreno, La, Morgan, K, Moschonis, G, Mossakowska, M, Mostafa, A, Mostafavi, Sa, Mota, J, Motlagh, Me, Motta, J, Moura-dos-Santos, Ma, Mridha, Mk, Msyamboza, Kp, Tt, 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Aluisio Jd Barros, Mauro Virgílio Gomes Barros, Anna Bartosiewicz, Abdul Basit, Joao Luiz D Bastos, Iqbal Bata, Anwar M Batieha, Assembekov Batyrbek, Louise A Baur, Robert Beaglehole, Antonisamy Belavendra, Habiba Ben Romdhane, Mikhail Benet, Lowell S Benson, Salim Berkinbayev, Antonio Bernabe-Ortiz, Gailute Bernotiene, Heloísa Bettiol, Jorge Bezerra, Aroor Bhagyalaxmi, Santosh K Bhargava, Daniel Bia, Katia Biasch, Elysée Claude Bika Lele, Mukharram M Bikbov, Bihungum Bista, Peter Bjerregaard, Espen Bjertness, Marius B Bjertness, Cecilia Björkelund, Katia V Bloch, Anneke Blokstra, Simona Bo, Martin Bobak, Heiner Boeing, Jose G Boggia, Carlos P Boissonnet, Stig E Bojesen, Vanina Bongard, Alice Bonilla-Vargas, Matthias Bopp, Herman Borghs, Pascal Bovet, Christopher B Boyer, Lutgart Braeckman, Imperia Brajkovich, Francesco Branca, Juergen Breckenkamp, Hermann Brenner, Lizzy M Brewster, Yajaira Briceño, Miguel Brito, Graziella Bruno, H Bas Bueno-de-Mesquita, Gloria Bueno, Anna Bugge, Con Burns, Michael Bursztyn, Antonio Cabrera de León, Joseph Cacciottolo, Christine Cameron, Günay Can, Ana Paula C Cândido, Mario V Capanzana, Naděžda Čapková, Eduardo Capuano, Vincenzo Capuano, Viviane C Cardoso, Axel C Carlsson, Joana Carvalho, Felipe F Casanueva, Laura Censi, Marvin Cervantes-Loaiza, Charalambos A Chadjigeorgiou, Snehalatha Chamukuttan, Angelique W Chan, Queenie Chan, Himanshu K Chaturvedi, Nish Chaturvedi, Miao Li Chee, Chien-Jen Chen, Fangfang Chen, Huashuai Chen, Shuohua Chen, Zhengming Chen, Ching-Yu Cheng, Bahman Cheraghian, Imane Cherkaoui Dekkaki, Angela Chetrit, Kuo-Liong Chien, Arnaud Chiolero, Shu-Ti Chiou, Adela Chirita-Emandi, María-Dolores Chirlaque, Belong Cho, Kaare Christensen, Diego G Christofaro, Jerzy Chudek, Eliza Cinteza, Frank Claessens, Janine Clarke, Els Clays, Emmanuel Cohen, Hans Concin, Cyrus Cooper, Tara C Coppinger, Simona Costanzo, Dominique Cottel, Chris Cowell, Cora L Craig, Amelia C Crampin, Ana B Crujeiras, Juan J Cruz, Semánová Csilla, Liufu Cui, Felipe V Cureau, Sarah Cuschieri, Graziella D'Arrigo, Eleonora d'Orsi, Jean Dallongeville, Rachel Dankner, Thomas M Dantoft, Luc Dauchet, Kairat Davletov, Guy De Backer, Dirk De Bacquer, Amalia De Curtis, Giovanni de Gaetano, Stefaan De Henauw, Paula Duarte de Oliveira, David De Ridder, Delphine De Smedt, Mohan Deepa, Alexander D Deev, Vincent Jr DeGennaro, Hélène Delisle, Stefaan Demarest, Elaine Dennison, Valérie Deschamps, Meghnath Dhimal, Augusto F Di Castelnuovo, Juvenal Soares Dias-da-Costa, Alejandro Diaz, Ty T Dickerson, Zivka Dika, Shirin Djalalinia, Ha Tp Do, Annette J Dobson, Chiara Donfrancesco, Silvana P Donoso, Angela Döring, Maria Dorobantu, Marcus Dörr, Kouamelan Doua, Nico Dragano, Wojciech Drygas, Charmaine A Duante, Priscilla Duboz, Rosemary B Duda, Virginija Dulskiene, Anar Dushpanova, Aleksandar Džakula, Vilnis Dzerve, Elzbieta Dziankowska-Zaborszczyk, Ricky Eddie, Ebrahim Eftekhar, Robert Eggertsen, Sareh Eghtesad, Gabriele Eiben, Ulf Ekelund, Mohammad El-Khateeb, Jalila El Ati, Denise Eldemire-Shearer, Marie Eliasen, Roberto Elosua, Rajiv T Erasmus, Raimund Erbel, Cihangir Erem, Louise Eriksen, Johan G Eriksson, Jorge Escobedo-de la Peña, Saeid Eslami, Ali Esmaeili, Alun Evans, David Faeh, Albina A Fakhretdinova, Caroline H Fall, Elnaz Faramarzi, Mojtaba Farjam, Mohammad Reza Fattahi, Asher Fawwad, Francisco J Felix-Redondo, Stephan B Felix, Trevor S Ferguson, Romulo A Fernandes, Daniel Fernández-Bergés, Daniel Ferrante, Thomas Ferrao, Marika Ferrari, Marco M Ferrario, Catterina Ferreccio, Haroldo S Ferreira, Eldridge Ferrer, Jean Ferrieres, Thamara Hubler Figueiró, Günther Fink, Krista Fischer, Leng Huat Foo, Maria Forsner, Heba M Fouad, Damian K Francis, Maria do Carmo Franco, Ruth Frikke-Schmidt, Guillermo Frontera, Flavio D Fuchs, Sandra C Fuchs, Yuki Fujita, Matsuda Fumihiko, Viktoriya Furdela, Ariel Furer, Takuro Furusawa, Zbigniew Gaciong, Andrzej Galbarczyk, Henrike Galenkamp, Fabio Galvano, Jingli Gao, Pei Gao, Manoli Garcia-de-la-Hera, Pablo Garcia, Dickman Gareta, Sarah P Garnett, Jean-Michel Gaspoz, Magda Gasull, Andrea Gazzinelli, Ulrike Gehring, Johanna M Geleijnse, Ronnie George, Ali Ghanbari, Erfan Ghasemi, Oana-Florentina Gheorghe-Fronea, Anup Ghimire, Alessandro Gialluisi, Simona Giampaoli, Christian Gieger, Tiffany K Gill, Jonathan Giovannelli, Glen Gironella, Aleksander Giwercman, Konstantinos Gkiouras, Marcel Goldberg, Rebecca A Goldsmith, Luis F Gomez, Aleksandra Gomula, Helen Gonçalves, Mauer Gonçalves, Bruna Gonçalves Cordeiro da Silva, David A Gonzalez-Chica, Marcela Gonzalez-Gross, Juan P González-Rivas, Clicerio González-Villalpando, María-Elena González-Villalpando, Angel R Gonzalez, Mariano Bonet Gorbea, Frederic Gottrand, Sidsel Graff-Iversen, Dušan Grafnetter, Aneta Grajda, Maria G Grammatikopoulou, Ronald D Gregor, Tomasz Grodzicki, Giuseppe Grosso, Gabriella Gruden, Dongfeng Gu, Ong Peng Guan, Elias F Gudmundsson, Vilmundur Gudnason, Ramiro Guerrero, Idris Guessous, Andre L Guimaraes, Martin C Gulliford, Johanna Gunnlaugsdottir, Marc J Gunter, Prakash C Gupta, Rajeev Gupta, Oye Gureje, Beata Gurzkowska, Laura Gutierrez, Felix Gutzwiller, Seongjun Ha, Farzad Hadaegh, Rosa Haghshenas, Hamid Hakimi, Jytte Halkjær, Ian R Hambleton, Behrooz Hamzeh, Dominique Hange, Abu Am Hanif, Sari Hantunen, Jie Hao, Carla Menêses Hardman, Rachakulla Hari Kumar, Seyed Mohammad Hashemi-Shahri, Jun Hata, Teresa Haugsgjerd, Alison J Hayes, Yuna He, Margit Heier, Marleen Elisabeth Hendriks, Rafael Dos Santos Henrique, Ana Henriques, Leticia Hernandez Cadena, Herqutanto, Sauli Herrala, Ramin Heshmat, Allan G Hill, Sai Yin Ho, Suzanne C Ho, Michael Hobbs, Michelle Holdsworth, Reza Homayounfar, Gonul Horasan Dinc, Andrea Rvr Horimoto, Claudia M Hormiga, Bernardo L Horta, Leila Houti, Christina Howitt, Thein Thein Htay, Aung Soe Htet, Maung Maung Than Htike, Yonghua Hu, José María Huerta, Ilpo Tapani Huhtaniemi, Laetitia Huiart, Martijn Huisman, Abdullatif S Husseini, Inge Huybrechts, Nahla Hwalla, Licia Iacoviello, Anna G Iannone, Mohsen M Ibrahim, Norazizah Ibrahim Wong, M Arfan Ikram, Violeta Iotova, Vilma E Irazola, Takafumi Ishida, Godsent C Isiguzo, Muhammad Islam, Sheikh Mohammed Shariful Islam, Masanori Iwasaki, Rod T Jackson, Jeremy M Jacobs, Hashem Y Jaddou, Tazeen Jafar, Kenneth James, Konrad Jamrozik, Imre Janszky, Edward Janus, Marjo-Riitta Jarvelin, Grazyna Jasienska, Ana Jelaković, Bojan Jelaković, Garry Jennings, Anjani Kumar Jha, Chao Qiang Jiang, Ramon O Jimenez, Karl-Heinz Jöckel, Michel Joffres, Mattias Johansson, Jari J Jokelainen, Jost B Jonas, Torben Jørgensen, Pradeep Joshi, Farahnaz Joukar, Jacek Jóżwiak, Anne Juolevi, Gregor Jurak, Vesna Jureša, Rudolf Kaaks, Anthony Kafatos, Eero O Kajantie, Zhanna Kalmatayeva, Natasa Kalpourtzi, Ofra Kalter-Leibovici, Freja B Kampmann, Srinivasan Kannan, Eva Karaglani, Line L Kårhus, Khem B Karki, Marzieh Katibeh, Joanne Katz, Jussi Kauhanen, Prabhdeep Kaur, Maryam Kavousi, Gyulli M Kazakbaeva, Ulrich Keil, Lital Keinan Boker, Sirkka Keinänen-Kiukaanniemi, Roya Kelishadi, Han Cg Kemper, Maryam Keramati, Alina Kerimkulova, Mathilde Kersting, Timothy Key, Yousef Saleh Khader, Davood Khalili, Kay-Tee Khaw, Bahareh Kheiri, Motahareh Kheradmand, Alireza Khosravi, Ursula Kiechl-Kohlendorfer, Stefan Kiechl, Japhet Killewo, Dong Wook Kim, Jeongseon Kim, Heidi Klakk, Magdalena Klimek, Jurate Klumbiene, Michael Knoflach, Elin Kolle, Patrick Kolsteren, Jukka P Kontto, Raija Korpelainen, Paul Korrovits, Jelena Kos, Seppo Koskinen, Katsuyasu Kouda, Sudhir Kowlessur, Slawomir Koziel, Jana Kratenova, Vilma Kriaucioniene, Peter Lund Kristensen, Steiner Krokstad, Daan Kromhout, Herculina S Kruger, Ruzena Kubinova, Renata Kuciene, Urho M Kujala, Zbigniew Kulaga, R Krishna Kumar, Pawel Kurjata, Yadlapalli S Kusuma, Vladimir Kutsenko, Kari Kuulasmaa, Catherine Kyobutungi, Tiina Laatikainen, Carl Lachat, Youcef Laid, Tai Hing Lam, Orlando Landrove, Vera Lanska, Georg Lappas, Bagher Larijani, Tint Swe Latt, Gwenaëlle Le Coroller, Khanh Le Nguyen Bao, Tuyen D Le, Jeannette Lee, Jeonghee Lee, Nils Lehmann, Terho Lehtimäki, Daniel Lemogoum, Naomi S Levitt, Yanping Li, Christa L Lilly, Wei-Yen Lim, M Fernanda Lima-Costa, Xu Lin, Yi-Ting Lin, Lars Lind, Vijaya Lingam, Allan Linneberg, Lauren Lissner, Mieczyslaw Litwin, Wei-Cheng Lo, Helle-Mai Loit, Esther Lopez-Garcia, Tania Lopez, Paulo A Lotufo, José Eugenio Lozano, Iva Lukačević Lovrenčić, Janice L Lukrafka, Dalia Luksiene, Annamari Lundqvist, Robert Lundqvist, Nuno Lunet, Michala Lustigová, Edyta Luszczki, Guansheng Ma, Jun Ma, George Ll Machado-Coelho, Aristides M Machado-Rodrigues, Enguerran Macia, Luisa M Macieira, Ahmed A Madar, Stefania Maggi, Dianna J Magliano, Emmanuella Magriplis, Gowri Mahasampath, Bernard Maire, Marjeta Majer, Marcia Makdisse, Fatemeh Malekzadeh, Reza Malekzadeh, Rahul Malhotra, Kodavanti Mallikharjuna Rao, Sofia K Malyutina, Lynell V Maniego, Yannis Manios, Jim I Mann, Fariborz Mansour-Ghanaei, Enzo Manzato, Anie Marcil, Staffan B Mårild, Mihalea Marinović Glavić, Pedro Marques-Vidal, Larissa Pruner Marques, Jaume Marrugat, Reynaldo Martorell, Luis P Mascarenhas, Marija Matasin, Ellisiv B Mathiesen, Prashant Mathur, Alicia Matijasevich, Piotr Matlosz, Tandi E Matsha, Christina Mavrogianni, Jean Claude N Mbanya, Anselmo J Mc Donald Posso, Shelly R McFarlane, Stephen T McGarvey, Stela McLachlan, Rachael M McLean, Scott B McLean, Breige A McNulty, Sounnia Mediene Benchekor, Jurate Medzioniene, Parinaz Mehdipour, Kirsten Mehlig, Amir Houshang Mehrparvar, Aline Meirhaeghe, Christa Meisinger, Carlos Mendoza Montano, Ana Maria B Menezes, Geetha R Menon, Alibek Mereke, Indrapal I Meshram, Andres Metspalu, Haakon E Meyer, Jie Mi, Nathalie Michels, Kairit Mikkel, Karolina Milkowska, Jody C Miller, Cláudia S Minderico, G K Mini, Mohammad Reza Mirjalili, Erkin Mirrakhimov, Marjeta Mišigoj-Duraković, Pietro A Modesti, Sahar Saeedi Moghaddam, Bahram Mohajer, Mostafa K 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William A Neal, Azim Nejatizadeh, Ilona Nenko, Martin Neovius, Chung T Nguyen, Nguyen D Nguyen, Quang V Nguyen, Quang Ngoc Nguyen, Ramfis E Nieto-Martínez, Teemu J Niiranen, Yury P Nikitin, Toshiharu Ninomiya, Sania Nishtar, Marina A Njelekela, Marianna Noale, Oscar A Noboa, Ahmad Ali Noorbala, Teresa Norat, Maria Nordendahl, Børge G Nordestgaard, Noto Davide, Natalia Nowak-Szczepanska, Mohannad Al Nsour, Baltazar Nunes, Terence W O'Neill, Dermot O'Reilly, Caleb Ochimana, Eiji Oda, Augustine N Odili, Kyungwon Oh, Kumiko Ohara, Ryutaro Ohtsuka, Valérie Olié, Maria Teresa A Olinto, Isabel O Oliveira, Mohd Azahadi Omar, Altan Onat, Sok King Ong, Lariane M Ono, Pedro Ordunez, Rui Ornelas, Pedro J Ortiz, Clive Osmond, Sergej M Ostojic, Afshin Ostovar, Johanna A Otero, Kim Overvad, Ellis Owusu-Dabo, Fred Michel Paccaud, Cristina Padez, Elena Pahomova, Karina Mary de Paiva, Andrzej Pająk, Domenico Palli, Luigi Palmieri, Wen-Harn Pan, Songhomitra Panda-Jonas, Francesco Panza, Mariela Paoli, 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Bas, Bueno, Gloria, Bugge, Anna, Burns, Con, Bursztyn, Michael, Cabrera de Leon, Antonio, Cacciottolo, Joseph, Cameron, Christine, Can, Gunay, Candido, Ana Paula C., Capanzana, Mario V., Capkova, Nadezda, Capuano, Eduardo, Capuano, Vincenzo, Cardoso, Viviane C., Carlsson, Axel C., Carvalho, Joana, Casanueva, Felipe F., Censi, Laura, Cervantes-Loaiza, Marvin, Chadjigeorgiou, Charalambos A., Chamukuttan, Snehalatha, Chan, Angelique W., Chan, Queenie, Chaturvedi, Himanshu K., Chaturvedi, Nish, Chee, Miao Li, Chen, Chien-Jen, Chen, Fangfang, Chen, Huashuai, Chen, Shuohua, Chen, Zhengming, Cheng, Ching-Yu, Cheraghian, Bahman, Dekkaki, Imane Cherkaoui, Chetrit, Angela, Chien, Kuo-Liong, Chiolero, Arnaud, Chiou, Shu-Ti, Chirita-Emandi, Adela, Chirlaque, Maria-Dolores, Cho, Belong, Christensen, Kaare, Christofaro, Diego G., Chudek, Jerzy, Cinteza, Eliza, Clarke, Janine, Clays, Els, Cohen, Emmanuel, Concin, Hans, Cooper, Cyrus, Coppinger, Tara C., Costanzo, Simona, Cottel, Dominique, Cowell, Chris, Craig, Cora L., Crampin, Amelia C., Crujeiras, Ana B., Cruz, Juan J., Csilla, Semanova, Cui, Liufu, Cureau, Felipe V., Cuschieri, Sarah, D'Arrigo, Graziella, d'Orsi, Eleonora, Dallongeville, Jean, Dankner, Rachel, Dantoft, Thomas M., Dauchet, Luc, Davletov, Kairat, De Backer, Guy, De Bacquer, Dirk, De Curtis, Amalia, de Gaetano, Giovanni, De Henauw, Stefaan, de Oliveira, Paula Duarte, De Ridder, David, De Smedt, Delphine, Deepa, Mohan, Deev, Alexander D., DeGennaro, Vincent Jr, Delisle, Helene, Demarest, Stefaan, Dennison, Elaine, Deschamps, Valerie, Dhimal, Meghnath, Di Castelnuovo, Augusto F., Dias-da-Costa, Juvenal Soares, Diaz, Alejandro, Dickerson, Ty T., Dika, Zivka, Djalalinia, Shirin, Do, Ha T. P., Dobson, Annette J., Donfrancesco, Chiara, Donoso, Silvana P., Doering, Angela, Dorobantu, Maria, Doerr, Marcus, Doua, Kouamelan, Dragano, Nico, Drygas, Wojciech, Duante, Charmaine A., Duboz, Priscilla, Duda, Rosemary B., Dulskiene, Virginija, Dushpanova, Anar, Dzakula, Aleksandar, Dzerve, Vilnis, Dziankowska-Zaborszczyk, Elzbieta, Eddie, Ricky, Eftekhar, Ebrahim, Eggertsen, Robert, Eghtesad, Sareh, Eiben, Gabriele, Ekelund, Ulf, El-Khateeb, Mohammad, El Ati, Jalila, Eldemire-Shearer, Denise, Eliasen, Marie, Elosua, Roberto, Erasmus, Rajiv T., Erbel, Raimund, Erem, Cihangir, Eriksen, Louise, Eriksson, Johan G., Escobedo-de la Pena, Jorge, Eslami, Saeid, Esmaeili, Ali, Evans, Alun, Faeh, David, Fakhretdinova, Albina A., Fall, Caroline H., Faramarzi, Elnaz, Farjam, Mojtaba, Fattahi, Mohammad Reza, Fawwad, Asher, Felix-Redondo, Francisco J., Felix, Stephan B., Ferguson, Trevor S., Fernandes, Romulo A., Fernandez-Berges, Daniel, Ferrante, Daniel, Ferrao, Thomas, Ferrari, Marika, Ferrario, Marco M., Ferreccio, Catterina, Ferreira, Haroldo S., Ferrer, Eldridge, Ferrieres, Jean, Figueiro, Thamara Hubler, Fink, Gunther, Fischer, Krista, Foo, Leng Huat, Forsner, Maria, Fouad, Heba M., Francis, Damian K., Franco, Maria do Carmo, Frikke-Schmidt, Ruth, Frontera, Guillermo, Fuchs, Flavio D., Fuchs, Sandra C., Fujita, Yuki, Fumihiko, Matsuda, Furdela, Viktoriya, Furer, Ariel, Furusawa, Takuro, Gaciong, Zbigniew, Galbarczyk, Andrzej, Galenkamp, Henrike, Galvano, Fabio, Gao, Jingli, Gao, Pei, Garcia-de-la-Hera, Manoli, Garcia, Pablo, Gareta, Dickman, Garnett, Sarah P., Gaspoz, Jean-Michel, Gasull, Magda, Gazzinelli, Andrea, Gehring, Ulrike, Geleijnse, Johanna M., George, Ronnie, Ghanbari, Ali, Ghasemi, Erfan, Gheorghe-Fronea, Oana-Florentina, Ghimire, Anup, Gialluisi, Alessandro, Giampaoli, Simona, Gieger, Christian, Gill, Tiffany K., Giovannelli, Jonathan, Gironella, Glen, Giwercman, Aleksander, Gkiouras, Konstantinos, Goldberg, Marcel, Goldsmith, Rebecca A., Gomez, Luis F., Gomula, Aleksandra, Cordeiro da Silva, Bruna Goncalves, Goncalves, Helen, Goncalves, Mauer, Gonzalez-Chica, David A., Gonzalez-Gross, Marcela, Gonzalez-Rivas, Juan P., Gonzalez-Villalpando, Clicerio, Gonzalez-Villalpando, Maria-Elena, Gonzalez, Angel R., Bonet Gorbea, Mariano, Gottrand, Frederic, Graff-Iversen, Sidsel, Grafnetter, Dusan, Grajda, Aneta, Grammatikopoulou, Maria G., Gregor, Ronald D., Grodzicki, Tomasz, Grosso, Giuseppe, Gruden, Gabriella, Gu, Dongfeng, Guan, Ong Peng, Gudmundsson, Elias F., Gudnason, Vilmundur, Guerrero, Ramiro, Guessous, Idris, Guimaraes, Andre L., Gulliford, Martin C., Gunnlaugsdottir, Johanna, Gunter, Marc J., Gupta, Prakash C., Gupta, Rajeev, Gureje, Oye, Gurzkowska, Beata, Gutierrez, Laura, Gutzwiller, Felix, Ha, Seongjun, Hadaegh, Farzad, Haghshenas, Rosa, Hakimi, Hamid, Halkjaer, Jytte, Hambleton, Ian R., Hamzeh, Behrooz, Hange, Dominique, Hanif, Abu A. M., Hantunen, Sari, Hao, Jie, Hardman, Carla Meneses, Kumar, Rachakulla Hari, Hashemi-Shahri, Seyed Mohammad, Hata, Jun, Haugsgjerd, Teresa, Hayes, Alison J., He, Yuna, Heier, Margit, Hendriks, Marleen Elisabeth, Henrique, Rafael dos Santos, Henriques, Ana, Cadena, Leticia Hernandez, Herrala, Sauli, Heshmat, Ramin, Hill, Allan G., Ho, Sai Yin, Ho, Suzanne C., Hobbs, Michael, Holdsworth, Michelle, Homayounfar, Reza, Dinc, Gonul Horasan, Horimoto, Andrea R. V. R., Hormiga, Claudia M., Horta, Bernardo L., Houti, Leila, Howitt, Christina, Htay, Thein Thein, Htet, Aung Soe, Htike, Maung Maung Than, Hu, Yonghua, Huerta, Jose Maria, Huhtaniemi, Ilpo Tapani, Huiart, Laetitia, Huisman, Martijn, Husseini, Abdullatif S., Huybrechts, Inge, Hwalla, Nahla, Iacoviello, Licia, Iannone, Anna G., Ibrahim, Mohsen M., Wong, Norazizah Ibrahim, Ikram, M. Arfan, Iotova, Violeta, Irazola, Vilma E., Ishida, Takafumi, Isiguzo, Godsent C., Islam, Muhammad, Islam, Sheikh Mohammed Shariful, Iwasaki, Masanori, Jackson, Rod T., Jacobs, Jeremy M., Jaddou, Hashem Y., Jafar, Tazeen, James, Kenneth, Jamrozik, Konrad, Janszky, Imre, Janus, Edward, Jarvelin, Marjo-Riitta, Jasienska, Grazyna, Jelakovic, Ana, Jelakovic, Bojan, Jennings, Garry, Jha, Anjani Kumar, Jiang, Chao Qiang, Jimenez, Ramon O., Joeckel, Karl-Heinz, Joffres, Michel, Johansson, Mattias, Jokelainen, Jari J., Jonas, Jost B., Jorgensen, Torben, Joshi, Pradeep, Joukar, Farahnaz, Jozwiak, Jacek, Juolevi, Anne, Jurak, Gregor, Juresa, Vesna, Kaaks, Rudolf, Kafatos, Anthony, Kajantie, Eero O., Kalmatayeva, Zhanna, Kalpourtzi, Natasa, Kalter-Leibovici, Ofra, Kampmann, Freja B., Kannan, Srinivasan, Karaglani, Eva, Karhus, Line L., Karki, Khem B., Katibeh, Marzieh, Katz, Joanne, Kauhanen, Jussi, Kaur, Prabhdeep, Kavousi, Maryam, Kazakbaeva, Gyulli M., Keil, Ulrich, Boker, Lital Keinan, Keinanen-Kiukaanniemi, Sirkka, Kelishadi, Roya, Kemper, Han C. 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L., Machado-Rodrigues, Aristides M., Macia, Enguerran, Macieira, Luisa M., Madar, Ahmed A., Maggi, Stefania, Magliano, Dianna J., Magriplis, Emmanuella, Mahasampath, Gowri, Maire, Bernard, Majer, Marjeta, Makdisse, Marcia, Malekzadeh, Fatemeh, Malekzadeh, Reza, Malhotra, Rahul, Mallikharjuna, Kodavanti, Malyutina, Sofia K., Maniego, Lynell V., Manios, Yannis, Mann, Jim I., Mansour-Ghanaei, Fariborz, Manzato, Enzo, Marcil, Anie, Margozzini, Paula, Marild, Staffan B., Glavic, Mihalea Marinovic, Marques-Vidal, Pedro, Marques, Larissa Pruner, Marrugat, Jaume, Martorell, Reynaldo, Mascarenhas, Luis P., Matasin, Marija, Mathiesen, Ellisiv B., Mathur, Prashant, Matijasevich, Alicia, Matlosz, Piotr, Matsha, Tandi E., Mavrogianni, Christina, Mbanya, Jean Claude N., Mc Donald Posso, Anselmo J., McFarlane, Shelly R., McGarvey, Stephen T., McLachlan, Stela, McLean, Rachael M., McLean, Scott B., McNulty, Breige A., Benchekor, Sounnia Mediene, Medzioniene, Jurate, Mehdipour, Parinaz, Mehlig, Kirsten, Mehrparvar, Amir Houshang, Meirhaeghe, Aline, Meisinger, Christa, Mendoza Montano, Carlos, Menezes, Ana Maria B., Menon, Geetha R., Mereke, Alibek, Meshram, Indrapal I., Metspalu, Andres, Meyer, Haakon E., Mi, Jie, Michels, Nathalie, Mikkel, Kairit, Milkowska, Karolina, Miller, Jody C., Minderico, Claudia S., Mini, G. K., Mirjalili, Mohammad Reza, Mirrakhimov, Erkin, Misigoj-Durakovic, Marjeta, Modesti, Pietro A., Moghaddam, Sahar Saeedi, Mohajer, Bahram, Mohamed, Mostafa K., Mohamed, Shukri F., Mohammad, Kazem, Mohammadi, Mohammad Reza, Mohammadi, Zahra, Mohammadifard, Noushin, Mohammadpourhodki, Reza, Mohan, Viswanathan, Mohanna, Salim, Yusoff, Muhammad Fadhli Mohd, Mohebbi, Iraj, Mohebi, Farnam, Moitry, Marie, Mollehave, Line T., Molnar, Denes, Momenan, Amirabbas, Mondo, Charles K., Monterrubio-Flores, Eric, Monyeki, Kotsedi Daniel K., Moon, Jin Soo, Moosazadeh, Mahmood, Moreira, Leila B., Morejon, Alain, Moreno, Luis A., Morgan, Karen, Moschonis, George, Mossakowska, Malgorzata, Mostafa, Aya, Mostafavi, Seyed-Ali, Mota, Jorge, Motlagh, Mohammad Esmaeel, Motta, Jorge, Andre Moura-dos-Santos, Marcos, Mridha, Malay K., Msyamboza, Kelias P., Mu, Thet Thet, Muhihi, Alfa J., Muiesan, Maria L., Muller-Nurasyid, Martina, Murphy, Neil, Mursu, Jaakko, Musa, Kamarul Imran, Milanovic, Sanja Music, Musil, Vera, Mustafa, Norlaila, Nabipour, Iraj, Naderimagham, Shohreh, Nagel, Gabriele, Naidu, Balkish M., Najafi, Farid, Nakamura, Harunobu, Namesna, Jana, Nang, Ei Ei K., Nangia, Vinay B., Narake, Sameer, Ndiaye, Ndeye Coumba, Neal, William A., Nejatizadeh, Azim, Nenko, Ilona, Neovius, Martin, Neuhauser, Hannelore K., Nguyen, Chung T., Nguyen, Nguyen D., Nguyen, Quang V., Quang Ngoc Nguyen, Nieto-Martinez, Ramfis E., Niiranen, Teemu J., Nikitin, Yury P., Ninomiya, Toshiharu, Nishtar, Sania, Njelekela, Marina A., Noale, Marianna, Noboa, Oscar A., Noorbala, Ahmad Ali, Norat, Teresa, Nordendahl, Maria, Nordestgaard, Borge G., Noto, Davide, Nowak-Szczepanska, Natalia, Al Nsour, Mohannad, Nunes, Baltazar, O'Neill, Terence W., O'Reilly, Dermot, Ochimana, Caleb, Oda, Eiji, Odili, Augustine N., Oh, Kyungwon, Ohara, Kumiko, Ohtsuka, Ryutaro, Olie, Valerie, Olinto, Maria Teresa A., Oliveira, Isabel O., Omar, Mohd Azahadi, Onat, Altan, Ong, Sok King, Ono, Lariane M., Ordunez, Pedro, Ornelas, Rui, Ortiz, Pedro J., Osmond, Clive, Ostojic, Sergej M., Ostovar, Afshin, Otero, Johanna A., Overvad, Kim, Owusu-Dabo, Ellis, Paccaud, Fred Michel, Padez, Cristina, Pahomova, Elena, de Paiva, Karina Mary, Pajak, Andrzej, Palli, Domenico, Palmieri, Luigi, Pan, Wen-Harn, Panda-Jonas, Songhomitra, Panza, Francesco, Paoli, Mariela, Papandreou, Dimitrios, Park, Soon-Woo, Park, Suyeon, Parnell, Winsome R., Parsaeian, Mahboubeh, Pasquet, Patrick, Patel, Nikhil D., Pavlyshyn, Halyna, Pecin, Ivan, Pednekar, Mangesh S., Pedro, Joao M., Peer, Nasheeta, Peixoto, Sergio Viana, Peltonen, Markku, Pereira, Alexandre C., Peres, Karen G. D. A., Peres, Marco A., Peters, Annette, Petkeviciene, Janina, Peykari, Niloofar, Son Thai Pham, Pichardo, Rafael N., Pigeot, Iris, Pikhart, Hynek, Pilav, Aida, Pilotto, Lorenza, Pitakaka, Freda, Piwonska, Aleksandra, Pizarro, Andreia N., Plans-Rubio, Pedro, Polasek, Ozren, Porta, Miquel, Poudyal, Anil, Pourfarzi, Farhad, Pourshams, Akram, Poustchi, Hossein, Pradeepa, Rajendra, Price, Alison J., Price, Jacqueline F., Providencia, Rui, Puhakka, Soile E., Puiu, Maria, Punab, Margus, Qasrawi, Radwan F., Qorbani, Mostafa, Queiroz, Daniel, Tran Quoc Bao, Radic, Ivana, Radisauskas, Ricardas, Rahimikazerooni, Salar, Rahman, Mahfuzar, Raitakari, Olli, Raj, Manu, Rakhimova, Ellina M., Rao, Sudha Ramachandra, Ramachandran, Ambady, Ramos, Elisabete, Rampal, Lekhraj, Rampal, Sanjay, Rangel Reina, Daniel A., Rarra, Vayia, Rech, Cassiano Ricardo, Redon, Josep, Reganit, Paul Ferdinand M., Regecova, Valeria, Revilla, Luis, Rezaianzadeh, Abbas, Ribeiro, Robespierre, Riboli, Elio, Richter, Adrian, Rigo, Fernando, de Wit, Tobias F. 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M., van Zutphen, Elisabeth M., Vanuzzo, Diego, Varbo, Anette, Vasan, Senthil K., Vega, Tomas, Veidebaum, Toomas, Velasquez-Melendez, Gustavo, Veronesi, Giovanni, Verschuren, W. M. Monique, Verstraeten, Roosmarijn, Victora, Cesar G., Viet, Lucie, Villalpando, Salvador, Vineis, Paolo, Vioque, Jesus, Virtanen, Jyrki K., Visvikis-Siest, Sophie, Viswanathan, Bharathi, Vlasoff, Tiina, Vollenweider, Peter, Voutilainen, Ari, Wade, Alisha N., Walton, Janette, Wambiya, Elvis O. A., Bebakar, Wan Mohamad Wan, Mohamud, Wan Nazaimoon Wan, Wanderley Junior, Rildo de Souza, Wang, Ming-Dong, Wang, Ningli, Wang, Qian, Wang, Xiangjun, Wang, Ya Xing, Wang, Ying-Wei, Wannamethee, S. Goya, Wareham, Nicholas, Wei, Wenbin, Weres, Aneta, Werner, Bo, Whincup, Peter H., Widhalm, Kurt, Wiecek, Andrzej, Wilks, Rainford J., Willeit, Johann, Willeit, Peter, Williams, Emmanuel A., Wilsgaard, Tom, Wojtyniak, Bogdan, Wong-McClure, Roy A., Wong, Andrew, Wong, Tien Yin, Woo, Jean, Wu, Frederick C., Wu, Shouling, Wyszynska, Justyna, Xu, Haiquan, Xu, Liang, Yaacob, Nor Azwany, Yan, Weili, Yang, Ling, Yang, Xiaoguang, Yang, Yang, Yasuharu, Tabara, Ye, Xingwang, Yiallouros, Panayiotis K., Yoosefi, Moein, Yoshihara, Akihiro, You, San-Lin, Younger-Coleman, Novie O., Yusoff, Ahmad Faudzi, Zainuddin, Ahmad A., Zakavi, Seyed Rasoul, Zamani, Farhad, Zambon, Sabina, Zampelas, Antonis, Elisa Zapata, Maria, Zaw, Ko Ko, Zejglicova, Kristyna, Vrkic, Tajana Zeljkovic, Zeng, Yi, Zhang, Luxia, Zhao, Dong, Zhao, Ming-Hui, Zhen, Shiqi, Zheng, Yingfeng, Zholdin, Bekbolat, Zhu, Dan, Zins, Marie, Zitt, Emanuel, Zocalo, Yanina, Zoghlami, Nada, Zuniga Cisneros, Julio., School of Medicine, ACS - Diabetes & metabolism, APH - Global Health, Pulmonology, Medical Informatics, Adult Psychiatry, Global Health, APH - Quality of Care, APH - Methodology, Vascular Medicine, ACS - Atherosclerosis & ischemic syndromes, Anesthesiology, Graduate School, and ACS - Heart failure & arrhythmias
Subjects: Male, Latin Americans, Nutrition and Disease, Epidemiology, [SDV]Life Sciences [q-bio], Medizin, BLOOD-PRESSURE, 030204 cardiovascular system & hematology, Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants, Hypertension, Prevalence, Control, Tretament, GUIDELINES, Global Health, Worldwide trends, 0302 clinical medicine, Hypertension prevalence, Voeding en Ziekte, Medicine and Health Sciences, kohonnut verenpaine, Medicine, 030212 general & internal medicine, Prevention and Control, 11 Medical and Health Sciences, ComputingMilieux_MISCELLANEOUS, education.field_of_study, food and beverages, Public Health, Global Health, Social Medicine and Epidemiology, General Medicine, Noncommunicable diseases, Period prevalence, Middle Aged, kansainvälinen vertailu, 3142 Public health care science, environmental and occupational health, 3. Good health, MIDDLE-INCOME, Pooled analysis, SYSTEMATIC ANALYSIS, INCOME COUNTRIES, ADULTS, PREVENTION, MANAGEMENT, ADHERENCE, DIAGNOSIS, Western europe, [SDE]Environmental Sciences, Hypertension/diagnosis, NCD Risk Factor Collaboration (NCD-RisC), Female, B990 Subjects Allied to Medicine not elsewhere classified, Life Sciences & Biomedicine, Adult, health-care, esiintyvyys, Central asia, Population, Nursing, 3121 Internal medicine, 03 medical and health sciences, Medicine, General & Internal, Drug Therapy, General & Internal Medicine, Life Science, Humans, ddc:610, education, Antihypertensive Agents, VLAG, Aged, Science & Technology, Antihypertensive Agents/therapeutic use, business.industry, Omvårdnad, fungi, General and internal medicine, Estados de Saúde e de Doença, Taking medication, Treatment, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Blood pressure, Faculdade de Ciências Sociais, 3121 General medicine, internal medicine and other clinical medicine, lääkehoito, 1182 Biochemistry, cell and molecular biology, business, Demography
Abstract: 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. Methods: we 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 Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings., British Heart Foundation Centre of Research Excellence Grant; World Health Organization (WHO); Abdul Latif Jameel Institute for Disease and Emergency Analytics Fellowship
Published: 2021
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5. Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

Author: Maryam Sharafkhah, Emanuel Zitt, Majid Ezzati, Luxia Zhang, Young-Ho Khang, Ellina Rakhimova, Kairit Mikkel, Tiina Vlasoff, Eruke E. Egbagbe, Sidsel Graff-Iversen, Ilona Nenko, Magdalena Klimek, Mathilde Savy, Sanjib Kumar Sharma, Alfonso Siani, Luís Lopes, Vanina Bongard, Gregor Jurak, Jacqueline F. Price, Christina-Paulina Lambrinou, Maria Lc Iurilli, Rainford J. Wilks, Bontha V. Babu, Fereidoun Azizi, Harunobu Nakamura, Marialaura Bonaccio, Angela Döring, Zhenyu Zhang, Naser Ahmadi, Jolanta Słowikowska-Hilczer, Ana Paula Carlos Cândido, Clive Osmond, Thirunavukkarasu Sathish, Robert J. Adams, Themistoklis Tzotzas, Reina Engle-Stone, Atul Trivedi, Shoichiro Tsugane, Niels Møller, Jorge Bezerra, Dénes Molnár, Muhammad Fadhli Mohd Yusoff, Badreya Al-Lahou, J. Jaime Miranda, Bahram Mohajer, Sigmund A. Anderssen, Lital Keinan Boker, Eero Kajantie, Martin Gulliford, Maties Torrent, Sumit Bharadwaj, Toshiharu Ninomiya, Zbigniew Gaciong, Nayu Ikeda, Li Juan Wu, Adrian Richter, Licia Iacoviello, Marc J. Gunter, Wenbin Wei, Norsyamlina Che Abdul Rahim, Eman Aly, Ambady Ramachandran, Nils Lehmann, Soile E. Puhakka, Giovanni Veronesi, Hongsheng Bi, Eiji Oda, Jia Li Duan, Per Tynelius, José María Huerta, Janne Schurmann Tolstrup, Rodrigo M. Carrillo-Larco, Rosangela Fernandes Lucena Batista, Victoria E Soto-Rojas, Hanno Ulmer, Shukri F. Mohamed, Anthony Kafatos, Suyeon Park, Mohsen Ibrahim, Hamed Pouraram, Bin Zhou, May Soe Aung, Lars Bo Andersen, Erfan Ghasemi, René Charles Sylva, Himanshu K. Chaturvedi, Luc Dauchet, Ahmad Ali Zainuddin, Angela Chetrit, Dan Zhu, Valérie Deschamps, Ko Ko Zaw, Peter Vollenweider, Tomas Vega, Yves Martin-Prével, Mahfuzar Rahman, Dorja Vočanec, Roman Topor-Madry, Vinay Nangia, Herculina S. 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Gonzalez, Ying-Wei Wang, Rob M. van Dam, Ryutaro Ohtsuka, Ludmila Sevcikova, Suhaila Abdul Ghaffar, Lynell V Maniego, Fariborz Mansour-Ghanaei, Maria Dorobantu, Giovanni Viegi, Xiaoguang Yang, Honor Bixby, Prakash C. Gupta, Ofra Kalter-Leibovici, Eugene Sobngwi, Ričardas Radišauskas, Jurate Medzioniene, Roy A Wong-McClure, Kim F. Michaelsen, Antonia Trichopoulou, Tania Tello, Francesco Branca, Johanna Gunnlaugsdottir, Els Clays, Wei-Yen Lim, Suzanne C. Ho, Toomas Veidebaum, Rebecca Goldsmith, Margot González-León, Matthias Nauck, Alibek Mereke, Marta Buoncristiano, Jakob Tarp, Rosalba Rojas-Martínez, Maya Tanrygulyyeva, Reza Malekzadeh, Abdonas Tamosiunas, Dimitrios Poulimeneas, Pedro Ordunez, Isabelle Herter-Aeberli, Khanh Le Nguyen Bao, Anne Juolevi, Vassilis Zafiropulos, Emanuela Gualdi-Russo, Jordi Sunyer, Manu Raj, Chaoqiang Jiang, Sofia Malyutina, Efthymios Kapantais, Maria Lazo-Porras, Maung Maung Than Htike, Michael Hobbs, Ranjit Mohan Anjana, Merike Liivak, Johan G. Eriksson, Margarita Samoutian, Andreia N. Pizarro, Mohammed Rasoul Tarawneh, Jean Woo, Kaspar Staub, Maria Teresa Menzano, Mojtaba Farjam, Adroaldo Cesar Araujo Gaya, Mohammad El-khateeb, Zulfiqar A Bhutta, Mukharram M. Bikbov, Hsien-Ho Lin, Oscar Noboa, Thomas Waldhör, Garry Brian, Simona Costanzo, Frank Tanser, Nor Azwany Yaacob, Michelle Cilia, Ivo Rakovac, Bill Stavreski, Ioannis Pagkalos, Ivan Pećin, Carlo M. Barbagallo, Abla M. Sibai, Yuna He, Matsuda Fumihiko, Bharathi Viswanathan, Ali Reza Safarpour, Wei Cheng Lo, Abdullatif Husseini, Jiang He, Liv Elin Torheim, Nipa Rojroongwasinkul, Aicha Soumare, Astrid Petersmann, Tomasz Grodzicki, Davide Noto, Panayiotis K. Yiallouros, Kelias P. Msyamboza, William R. Tebar, Yingfeng Zheng, Eha Nurk, Bhawesh Koirala, Ana Jelakovic, Suhad Bahijri, Freja B Kampmann, Qi Sheng You, Marika Ferrari, María-Elena González-Villalpando, Aline Wagner, Olfa Saidi, Anwar Batieha, Eduardo Capuano, Coimbatore Subramaniam Shanthirani, Dong Wook Kim, Albina A Fakhretdinova, Tom Wilsgaard, Maria Avdicova, Moesijanti Soekatri, Chiara Donfrancesco, Salim Mohanna, Paola Russo, Uruwan Yamborisut, Rafael dos Santos Henrique, Martin Nankap, Allan Linneberg, Khairil Si-Ramlee, Kirsten Mehlig, Christina Mavrogianni, Raluca Pop, Lèlita Santos, Graziella Bruno, Valentina Peterkova, Iná S. Santos, Georg Lappas, Alberto Palloni, Malay K. Mridha, Andrzej Pajak, Marta García-Solano, Stefaan De Henauw, Daniel Ferrante, Rute Santos, Anders Grøntved, Lucjan Szponar, Mihaela Vladulescu, Chien-An Sun, Jan A. Staessen, Paula Duarte de Oliveira, Norazizah Ibrahim Wong, Maria Nordendahl, Elaine M. Dennison, Jeonghee Lee, Diego Salmerón, Ida Maria Schmidt, Gao Pei, Noushin Mohammadifard, Igor Spiroski, Fernando Rodríguez-Artalejo, Xu Ma, Elin Pettersen Sørgjerd, Valéria Regecová, Cláudia S. Minderico, Johanna A. Otero, Jamila Abubakar Garba, Vesselka Duleva, Rui Ornelas, Ilpo Huhtaniemi, Cesar G. Victora, Lijuan Liu, Rody G. Sy, Mahmood Moosazadeh, Ali Ahmadi, Antonio Pedro Graça, Natalia Nowak-Szczepanska, Miao Li Chee, Michael Sjöström, Charles Agyemang, Shiqi Zhen, Xiu-Hua Guo, Pawel Kurjata, Jardena J. Puder, Mehrdad Azmin, Neil Murphy, Kaosar Afsana, Alireza Sadjadi, Johanna M. Geleijnse, Prashant Mathur, Elysée Claude Bika Lele, Raphael Mendes Ritti-Dias, Yannis Manios, Majid Shirani, Rosemary B. Duda, Liis Nelis, Jurate Klumbiene, Zhengming Chen, Wichai Aekplakorn, Alun Evans, Andrzej Wiecek, Lars Lind, Denise Eldemire-Shearer, Bernardo L. Horta, Macia Enguerran, Seyed Rasoul Zakavi, Daniel Fernández-Bergés, Kumiko Ohara, Ursula Kiechl-Kohlendorfer, Hermann Brenner, Przemyslaw Slusarczyk, Espen Bjertness, Jutta Stieber, Augusto Di Castelnuovo, Joel G. R. Roy, Aryeh D. Stein, Ruth Frikke-Schmidt, Vera Musil, Amaneh Shayanrad, Marcel Goldberg, Ramon O. Jimenez, Mohammad Reza Fattahi, Jolanda Hyska, Amir Houshang Mehrparvar, Elin Kolle, Mohamed Bamoshmoosh, Michelle Holdsworth, Felipe F. Casanueva, Børge G. Nordestgaard, Niels Wedderkopp, Eva Corpeleijn, Elias F. Gudmundsson, Antonio Mistretta, Daniel Lemogoum, Larissa Pruner Marques, Slavica Sović, Olli T. Raitakari, Marco Aurélio Peres, Alexandra Cucu, Gregorio Varela-Moreiras, Janine Clarke, Andrea Gazzinelli, Mieczysław Litwin, Sara Schramm, Xenophon Theodoridis, Harshpal Singh Sachdev, Mohammad Reza Mirjalili, Dimitrios Papandreou, Peter T. Katzmarzyk, Benjamin Acosta-Cazares, Ben Schöttker, Prabhdeep Kaur, Norlaila Mustafa, Shariq Rashid Masoodi, Sadaf G. Sepanlou, Adolfo Rubinstein, Francis Delpeuch, Julianne Williams, Abbas Dehghan, Leanne M. Riley, Heloisa Bettiol, Gabriele Nagel, Ellisiv B. Mathiesen, Ekaterina Stoyanova, Alisha N. Wade, Zhamyila Usupova, Arnaud Chiolero, Oonagh Markey, Jacqueline Ramke, Elena Bogova, Niveen M E Abu-Rmeileh, Nguyen D Nguyen, Tomasz Zdrojewski, Marjo-Riitta Järvelin, Jose Sanchez-Abanto, Rômulo Araújo Fernandes, Lourdes Ribas-Barba, Nalan Uysal, Mohamad Hasnan Ahmad, Krista Fischer, Maria Wany Louzada Strufaldi, Ramiro Guerrero, Farnam Mohebi, Tran Quoc Bao, Flávio Danni Fuchs, Salim Berkinbayev, Enisa Kujundzic, Sari Voutilainen, Farzad Hadaegh, Robert Lundqvist, Saeid Safiri, Iraj Mohebbi, George Luiz Lins Machado-Coelho, Annette Peters, Gonzalo Valdivia, Magdalena Korzycka, Rajiv T Erasmus, Masanori Iwasaki, Charmaine A. Duante, Sheikh Mohammed Shariful Islam, Quang Ngoc La, Ricky Eddie, Petra Rust, Daniela Rodrigues, Dirk De Bacquer, Karen Sparrenberger, Agneta Sjöberg, Thet Thet Mu, Katarzyna Dereń, Cora L. Craig, Jorge Motta, Janina Petkeviciene, Boyd Swinburn, Paibul Suriyawongpaisal, Visnja Djordjic, Ramón Alberto Rascón-Pacheco, Pradeep Joshi, Daan Kromhout, Marius B. Bjertness, Stefano Marventano, Juel Jarani, Alireza Khosravi, Eva Martos, David De Ridder, Lizzy M. Brewster, Nico Dragano, Liam Smeeth, Kenji Shibuya, Emma Ruiz Moreno, Hashem Jaddou, Grzegorz Sobek, Dimitrios Trichopoulos, Marvin Cervantes-Loaiza, Abu Am Hanif, Elaine M. Murtagh, Carlos A. Aguilar-Salinas, Graziella D'Arrigo, Kyungwon Oh, Heiner Boeing, Regina Heidinger-Felso, André Luiz Sena Guimarães, Balkish M. Naidu, Avula Laxmaiah, Ana M. B. Menezes, Marie Eliasen, Francesco Pistelli, Yuan He, Dusko Bjelica, José A. Casajús, Guang Ning, Lutgart Braeckman, Dirk Vanderschueren, Jochanan Stessman, Ivana Radic, Yi Zeng, Hans Concin, Damaskini Valvi, Sari Hantunen, Catherine Kyobutungi, Diego Augusto Santos Silva, Wenhua Zhao, Sok King Ong, Anne W. Taylor, Iraj Nabipour, Justyna Godos, Cyrus Cooper, Mattias Johansson, Samuel C. Dumith, Magdalena Muc, Sabine Schipf, Idowu O Senbanjo, Jim Mann, Rajaa Al-Raddadi, Yih Chung Tham, Kay-Tee Khaw, Joseph Cacciottolo, Ana Henriques, Sahar Saeedi Moghaddam, Reza Mohammadpourhodki, Bernhard O. Boehm, Songhomitra Panda-Jonas, Iveta Pudule, Elisabete Ramos, Lacramioara Aurelia Brinduse, Paul H. Lee, Terence W O'Neill, Javad Aghazadeh-Attari, Margus Punab, Bojan Jelaković, Camilla T. Damsgaard, Takafumi Ishida, Ekaterina Chikova-Iscener, Mirjam M. Heinen, Tazeen H. Jafar, Semánová Csilla, Constance Schultsz, Santiago F. Gomez, Raija Korpelainen, Edward W. Gregg, Laura Gutierrez, Pierre Traissac, Victor M. Herrera, Aristides M. Machado-Rodrigues, Fatemeh Malekzadeh, Shouling Wu, Jennifer L. Baker, Clicerio González-Villalpando, Eleonora d'Orsi, Irene G. M. van Valkengoed, Anna Fijałkowska, Wen-Harn Pan, Gregor Starc, Meghnath Dhimal, Murat Topbaş, George Moschonis, Robert Eggertsen, Abdullah Alkandari, Quang Ngoc Nguyen, Janette Walton, Elnaz Faramarzi, Saeed Dastgiri, Lien Braeckevelt, Nasheeta Peer, Radka Taxová Braunerová, Mohamed M. Ali, Steiner Krokstad, Harald Geiger, Morteza Shamshirgaran, Lela Shengelia, María Ángeles Dal Re Saavedra, Silvana Donoso, Khem Bahadur Karki, Timothy J. Key, Maria G. Grammatikopoulou, Susana Vale, Felix K. Assah, Juan A Rivera, Peter H. Whincup, Oana-Florentina Gheorghe-Fronea, Cassiano Ricardo Rech, Paul Ferdinand M. Reganit, Rachakulla Hari Kumar, Jaakko Mursu, Luis A. Moreno, Glen Gironella, Jelena Kos, Tilema Cama, Haakon E. Meyer, Jun Ma, Raphael E. Arku, Ziad Abdeen, Dianna J. Magliano, Jitendra Jonnagaddala, Konstantinos Gkiouras, Paola Nardone, Alberto Barceló, Tomi-Pekka Tuomainen, Francesco Gianfagna, Stefania Maggi, Mohammad Hossein Somi, Behrooz Hamzeh, Miquel Porta, Vesna Jureša, Alexander D. Deev, David Faeh, Antonio Bernabe-Ortiz, Sirkka Keinänen-Kiukaanniemi, Ian Hambleton, Stefan Savin, Andre Pascal Kengne, R. Krishna Kumar, Kurt Widhalm, Marco M Ferrario, Parisa Amiri, Anjani Kumar Jha, Thamara Hubler Figueiró, Jana Kratenova, Claudia M. Hormiga, Maria Tsigga, Zivka Dika, Indrapal I. Meshram, Ei Ei K. Nang, Ian Rouse, Rusidah Selamat, Paul Korrovits, Grethe S. Tell, Julie Taylor, Anabela Mota-Pinto, Paolo Vineis, Kotsedi D Monyeki, Khuong Quynh Long, Frank J Rühli, Shelly R. McFarlane, Sara Santos Sanz, Edyta Łuszczki, Maria G. Stathopoulou, Tara Coppinger, Karin De Ridder, Lucie Viet, Anna Bugge, Mehdi Yaseri, Safiah Md Yusof, Sandra C. 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Patel, Reynaldo Martorell, Ching-Yu Cheng, Stine Schramm, Hana Shimizu-Furusawa, Jacek Jóźwiak, Radwan Qasrawi, Herman Borghs, Zhanna Kalmatayeva, Heidi Klakk, Akram Pourshams, Naomi S. Levitt, Son Thai Pham, Simona Giampaoli, Dong Zhao, Indah Suci Widyahening, Merete Osler, Paula Margozzini, Silvia Bel-Serrat, Dora Romaguera, Monira Alarouj, Winsome R. Parnell, Marloes Cardol, Giota Touloumi, Janice Luisa Lukrafka, Adela Chirita-Emandi, Maryam Kavousi, Sanja Musić Milanović, Jean-Michel Gaspoz, Jalila El Ati, Sauli Herrala, Liang Xu, Pilar Guallar-Castillón, Bee Koon Poh, Luis Serra-Majem, Jonathan E. Shaw, Belong Cho, Daphne Mirkopoulou, Salvador Villalpando, Yuki Fujita, Tiffany K. Gill, Nish Chaturvedi, Erkin M. Mirrakhimov, Günay Can, Mark Woodward, Esther Lopez-Garcia, Mauro Virgílio Gomes de Barros, Ahmed A. Madar, Shoaib Afzal, Melanie J. Cowan, Gareth Stratton, Eduardo Salazar Martinez, Sameer Narake, Norie Sawada, Deepak Amarapurkar, Deepa Weerasekera, Diana A. 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Chan School of Public Health, Middlesex University [London], Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Montpellier Interdisciplinary center on Sustainable Agri-food systems (Social and nutritional sciences) (UMR MoISA), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut de Recherche pour le Développement (IRD)-Centre International de Hautes Etudes Agronomiques Méditerranéennes - Institut Agronomique Méditerranéen de Montpellier (CIHEAM-IAMM), Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut 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Ltd, Orebro University, University of London, Universitas Indonesia, Institute of Food and Nutrition Development of Ministry of Agriculture and Rural Affairs, Children’s Hospital of Fudan University, University of Cyprus, Niigata University, International Medical University, Iran University of Medical Sciences, Center for Diabetes and Endocrine Care, Peking University First Hospital, Jiangsu Provincial Center for Disease Control and Prevention, Sun Yat-sen University, West Kazakhstan Medical University, Inner Mongolia Medical University, University of Ghana, Maria Lc Iurilli , Bin Zhou , James E Bennett , Rodrigo M Carrillo-Larco , Marisa K Sophiea , Andrea Rodriguez-Martinez , Honor Bixby , Bethlehem D Solomon , Cristina Taddei , Goodarz Danaei , Mariachiara Di Cesare , Gretchen A Stevens , Leanne M Riley , Stefan Savin , Melanie J Cowan , Pascal Bovet , Albertino Damasceno , Adela Chirita-Emandi , Alison J Hayes , Nayu Ikeda , Rod T Jackson , Young-Ho Khang , Avula Laxmaiah , Jing 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Mišigoj-Durakovic , Antonio Mistretta , Veronica Mocanu , Pietro A Modesti , Sahar Saeedi Moghaddam , Bahram Mohajer , Mostafa K Mohamed , Shukri F Mohamed , Kazem Mohammad , Zahra Mohammadi , Noushin Mohammadifard , Reza Mohammadpourhodki , Viswanathan Mohan , Salim Mohanna , Muhammad Fadhli Mohd Yusoff , Iraj Mohebbi , Farnam Mohebi , Marie Moitry , Drude Molbo , Line T Møllehave , Niels C Møller , Dénes Molnár , Amirabbas Momenan , Charles K Mondo , Michele Monroy-Valle , Eric Monterrubio-Flores , Kotsedi Daniel K Monyeki , Jin Soo Moon , Mahmood Moosazadeh , Leila B Moreira , Alain Morejon , Luis A Moreno , Karen Morgan , Suzanne N Morin , Erik Lykke Mortensen , George Moschonis , Malgorzata Mossakowska , Aya Mostafa , Anabela Mota-Pinto , Jorge Mota , Mohammad Esmaeel Motlagh , Jorge Motta , Marcos André Moura-Dos-Santos , Malay K Mridha , Kelias P Msyamboza , Thet Thet Mu , Magdalena Muc , Boban Mugoša , Maria L Muiesan , Parvina Mukhtorova , Martina Müller-Nurasyid , Neil Murphy 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Thai Pham , Rafael N Pichardo , Daniela Pierannunzio , Iris Pigeot , Hynek Pikhart , Aida Pilav , Lorenza Pilotto , Francesco Pistelli , Freda Pitakaka , Aleksandra Piwonska , Andreia N Pizarro , Pedro Plans-Rubió , Bee Koon Poh , Hermann Pohlabeln , Raluca M Pop , Stevo R Popovic , Miquel Porta , Georg Posch , Anil Poudyal , Dimitrios Poulimeneas , Hamed Pouraram , Farhad Pourfarzi , Akram Pourshams , Hossein Poustchi , Rajendra Pradeepa , Alison J Price , Jacqueline F Price , Rui Providencia , Jardena J Puder , Iveta Pudule , Soile E Puhakka , Maria Puiu , Margus Punab , Radwan F Qasrawi , Mostafa Qorbani , Tran Quoc Bao , Ivana Radic , Ricardas Radisauskas , Salar Rahimikazerooni , Mahfuzar Rahman , Mahmudur Rahman , Olli Raitakari , Manu Raj , Ellina Rakhimova , Sherali Rakhmatulloev , Ivo Rakovac , Sudha Ramachandra Rao , Ambady Ramachandran , Jacqueline Ramke , Elisabete Ramos , Rafel Ramos , Lekhraj Rampal , Sanjay Rampal , Vayia Rarra , Ramon A Rascon-Pacheco , Mette Rasmussen , Cassiano Ricardo Rech , Josep Redon , Paul Ferdinand M Reganit , Valéria Regecová , Luis Revilla , Abbas Rezaianzadeh , Lourdes Ribas-Barba , Robespierre Ribeiro , Elio Riboli , Adrian Richter , Fernando Rigo , Natascia Rinaldo , Tobias F Rinke de Wit , Ana Rito , Raphael M Ritti-Dias , Juan A Rivera , Cynthia Robitaille , Romana Roccaldo , Daniela Rodrigues , Fernando Rodríguez-Artalejo , María Del Cristo Rodriguez-Perez , Laura A Rodríguez-Villamizar , Ulla Roggenbuck , Rosalba Rojas-Martinez , Nipa Rojroongwasinkul , Dora Romaguera , Elisabetta L Romeo , Rafaela V Rosario , Annika Rosengren , Ian Rouse , Joel Gr Roy , Adolfo Rubinstein , Frank J Rühli , Jean-Bernard Ruidavets , Blanca Sandra Ruiz-Betancourt , Maria Ruiz-Castell , Emma Ruiz Moreno , Iuliia A Rusakova , Kenisha Russell Jonsson , Paola Russo , Petra Rust , Marcin Rutkowski , Charumathi Sabanayagam , Elena Sacchini , Harshpal S Sachdev , Alireza Sadjadi , Ali Reza Safarpour , Saeid Safiri , Nader Saki , Benoit Salanave , Eduardo Salazar Martinez , Diego Salmerón , Veikko Salomaa , Jukka T Salonen , Massimo Salvetti , Margarita Samoutian , Jose Sánchez-Abanto , Sandjaja , Susana Sans , Loreto Santa Marina , Diana A Santos , Ina S Santos , Lèlita C Santos , Maria Paula Santos , Osvaldo Santos , Rute Santos , Sara Santos Sanz , Jouko L Saramies , Luis B Sardinha , Nizal Sarrafzadegan , Thirunavukkarasu Sathish , Kai-Uwe Saum , Savvas Savva , Mathilde Savy , Norie Sawada , Mariana Sbaraini , Marcia Scazufca , Beatriz D Schaan , Angelika Schaffrath Rosario , Herman Schargrodsky , Anja Schienkiewitz , Sabine Schipf , Carsten O Schmidt , Ida Maria Schmidt , Peter Schnohr , Ben Schöttker , Sara Schramm , Stine Schramm , Helmut Schröder , Constance Schultsz , Aletta E Schutte , Aye Aye Sein , Rusidah Selamat , Vedrana Sember , Abhijit Sen , Idowu O Senbanjo , Sadaf G Sepanlou , Victor Sequera , Luis Serra-Majem , Jennifer Servais , Ludmila Ševcíková , Svetlana A Shalnova , Teresa Shamah-Levy , 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Paola, Nauck, Matthia, Neal, William A, Nejatizadeh, Azim, Nekkantti, Chandini, Nelis, Keiu, Nelis, Lii, Nenko, Ilona, Neovius, Martin, Nervi, Flavio, Nguyen, Chung T, Nguyen, Nguyen D, Nguyen, Quang Ngoc, Nieto-Martínez, Ramfis E, Nikitin, Yury P, Ning, Guang, Ninomiya, Toshiharu, Nishtar, Sania, Noale, Marianna, Noboa, Oscar A, Nogueira, Helena, Norat, Teresa, Nordendahl, Maria, Nordestgaard, Børge G, Noto, Davide, Nowak-Szczepanska, Natalia, Al Nsour, Mohannad, Nuhoglu, Irfan, Nurk, Eha, O'Neill, Terence W, O'Reilly, Dermot, Obreja, Galina, Ochimana, Caleb, Ochoa-Avilés, Angélica M, Oda, Eiji, Oh, Kyungwon, Ohara, Kumiko, Ohlsson, Clae, Ohtsuka, Ryutaro, Olafsson, Örn, Olinto, Maria Teresa A, Oliveira, Isabel O, Omar, Mohd Azahadi, Onat, Altan, Ong, Sok King, Ono, Lariane M, Ordunez, Pedro, Ornelas, Rui, Ortiz, Ana P, Ortiz, Pedro J, Osler, Merete, Osmond, Clive, Ostojic, Sergej M, Ostovar, Afshin, Otero, Johanna A, Overvad, Kim, Owusu-Dabo, Elli, Paccaud, Fred Michel, Padez, 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Salvador, Vineis, Paolo, Vioque, Jesu, Virtanen, Jyrki K, Visser, Marjolein, Visvikis-Siest, Sophie, Viswanathan, Bharathi, Vladulescu, Mihaela, Vlasoff, Tiina, Vocanec, Dorja, Vollenweider, Peter, Völzke, Henry, Voutilainen, Ari, Voutilainen, Sari, Vrijheid, Martine, Vrijkotte, Tanja GM, Wade, Alisha N, Wagner, Aline, Waldhör, Thoma, Walton, Janette, Wambiya, Elvis OA, Bebakar, Wan Mohamad Wan, Mohamud, Wan Nazaimoon Wan, de Souza Wanderley Júnior, Rildo, Wang, Ming-Dong, Wang, Ningli, Wang, Qian, Wang, Xiangjun, Wang, Ya Xing, Wang, Ying-Wei, Wannamethee, S Goya, Wareham, Nichola, Weber, Adelheid, Wedderkopp, Niel, Weerasekera, Deepa, Weghuber, Daniel, Wei, Wenbin, Weres, Aneta, Werner, Bo, Whincup, Peter H, Widhalm, Kurt, Widyahening, Indah S, Wiecek, Andrzej, Wilks, Rainford J, Willeit, Johann, Willeit, Peter, Williams, Julianne, Wilsgaard, Tom, Wojtyniak, Bogdan, Wong-McClure, Roy A, Wong, Andrew, Wong, Jyh Eiin, Wong, Tien Yin, Woo, Jean, Woodward, Mark, Wu, Frederick C, Wu, Jianfeng, Wu, Li Juan, Wu, Shouling, Xu, Haiquan, Xu, Liang, Yaacob, Nor Azwany, Yamborisut, Uruwan, Yan, Weili, Yang, Ling, Yang, Xiaoguang, Yang, Yang, Yardim, Nazan, Yaseri, Mehdi, Yasuharu, Tabara, Ye, Xingwang, Yiallouros, Panayiotis K, Yoosefi, Moein, Yoshihara, Akihiro, You, Qi Sheng, You, San-Lin, Younger-Coleman, Novie O, Md Yusof, Safiah, Yusoff, Ahmad Faudzi, Zaccagni, Luciana, Zafiropulos, Vassili, Zainuddin, Ahmad A, Zakavi, Seyed Rasoul, Zamani, Farhad, Zambon, Sabina, Zampelas, Antoni, Zamrazilová, Hana, Zapata, Maria Elisa, Zargar, Abdul Hamid, Ko Zaw, Ko, Zdrojewski, Tomasz, Zejglicova, Kristyna, Vrkic, Tajana Zeljkovic, Zeng, Yi, Zhang, Luxia, Zhang, Zhen-Yu, Zhao, Dong, Zhao, Ming-Hui, Zhao, Wenhua, Zhen, Shiqi, Zheng, Wei, Zheng, Yingfeng, Zholdin, Bekbolat, Zhou, Maigeng, Zhu, Dan, Zins, Marie, Zitt, Emanuel, Zocalo, Yanina, Cisneros, Julio Zuñiga, Zuziak, Monika, Ezzati, Majid, Filippi, Sarah, Cohortes épidémiologiques en population (CONSTANCES), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université Paris Cité (UPCité), Université Paris Cité (UPCité), Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut Agro - Montpellier SupAgro, and Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)
Subjects: Population -- Health aspects, Leanness, Baixo peso/Underweight, none, Double burden, alipainoisuus, tulotaso, global health, systematic analysis, Sedentary behaviors, RC1200, Prospective associations, 0302 clinical medicine, underweight, nälänhätä, Biology (General), skin and connective tissue diseases, Children, ComputingMilieux_MISCELLANEOUS, Body mass index, Human Nutrition & Health, education.field_of_study, Humane Voeding & Gezondheid, ylipaino, General Medicine, kansainvälinen vertailu, 3. Good health, World health, Medicine, A100 Pre-clinical Medicine, Population distribution, medicine.medical_specialty, QH301-705.5, Science, Socio-culturale, Nursing, Social sciences, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, Thinness, SDG 3 - Good Health and Well-being, BMI, epidemiology, obesity, None, Humans, Obesidade/Obesity, SDG 2 - Zero Hunger, education, VLAG, US adults, Omvårdnad, body mass index, malnutrition, obesity, underweight, nutritional and metabolic diseases, medicine.disease, terveellisyys, Obesity, Faculdade de Ciências Sociais, Body Mass Index, Prevalence, Risk Factors, General Biochemistry, WIAS, lihavuus, RA, Demography, N.A, double burden, Settore MED/09 - Medicina Interna, alueelliset erot, Nutrition and Disease, Animal Nutrition, [SDV]Life Sciences [q-bio], Medizin, 030204 cardiovascular system & hematology, 0601 Biochemistry and Cell Biology, Change distribution of body mass index, RA0421, Voeding en Ziekte, Epidemiology, Medicine and Health Sciences, Global health, Índice de massa corporal/Body Mass Index, 030212 general & internal medicine, Underweight, painoindeksi, 2. Zero hunger, General Neuroscience, aliravitsemus, elintarvikkeet, health, Public Health, Global Health, Social Medicine and Epidemiology, Diervoeding, 3142 Public health care science, environmental and occupational health, purl.org/pe-repo/ocde/ford#3.01.03 [https], Chinese adults, pooled analysis, medicine.symptom, Diet quality, B120 Physiology, Research Article, trends, purl.org/pe-repo/ocde/ford#1.06.03 [https], prevalence, Population, Mothers, Genetics and Molecular Biology, 3121 Internal medicine, medicine, Life Science, ddc:610, 3125 Otorhinolaryngology, ophthalmology, kehonkoostumus, Nutrition, Australian adults, General Immunology and Microbiology, purl.org/pe-repo/ocde/ford#3.01.04 [https], Ciências sociais, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Malnutrition, Epidemiology and Global Health, sense organs, Estilos de Vida e Impacto na Saúde
Abstract: From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions., Wellcome Trust, Medical Research Council, peer-reviewed
Published: 2021
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6. Effectiveness of three interventions for secondary prevention of low back pain in the occupational health setting - A randomised controlled trial with a natural course control

Author: Markku Hupli, Aki Vehtari, Simo Taimela, Eira Viikari-Juntura, Antti Malmivaara, Jaro Karppinen, Jarmo Rantonen, S Luoto, University of Helsinki, University of Oulu, Helsinki Institute for Information Technology (HIIT), South Karelia Social and Health Care District, Finnish Institute of Occupational Health, National Institute for Health and Welfare, Department of Computer Science, Aalto-yliopisto, Aalto University, HYKS erva, FICEBO, Clinicum, I kirurgian klinikka (Töölö), Department of Surgery, and HUS Musculoskeletal and Plastic Surgery
Subjects: Male, Cost effectiveness, Graded activity, Psychological intervention, law.invention, COST-EFFECTIVENESS, Cohort Studies, 0302 clinical medicine, Quasi-randomised design, Quality of life, Randomized controlled trial, law, Surveys and Questionnaires, LBP, Secondary Prevention, Medicine, MORRIS DISABILITY QUESTIONNAIRE, 030212 general & internal medicine, FEAR-AVOIDANCE BELIEFS, Population based, Multidisciplinary, lcsh:Public aspects of medicine, Rehabilitation, Usual care, PRIMARY-CARE, Middle Aged, Low back pain, 3142 Public health care science, environmental and occupational health, 3. Good health, Natural course of LBP, Treatment Outcome, Cohort, Female, medicine.symptom, Sick Leave, RCT, Cohort study, Research Article, Adult, medicine.medical_specialty, Adolescent, Visual analogue scale, WHITEHALL-II, Sickness absence, 03 medical and health sciences, MULTIPLE IMPUTATION, Young Adult, Early management, Humans, Occupational Health, Disability, business.industry, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, GLOBAL BURDEN, Physical therapy, Quality of Life, business, FOLLOW-UP, Low Back Pain, 030217 neurology & neurosurgery
Abstract: Background: We assessed the effectiveness of three interventions that were aimed to reduce non-acute low back pain (LBP) related symptoms in the occupational health setting. Methods: Based on a survey (n = 2480; response rate 71%) on LBP, we selected a cohort of 193 employees who reported moderate LBP (Visual Analogue Scale VAS > 34 mm) and fulfilled at least one of the following criteria during the past 12 months: sciatica, recurrence of LBP ≥ 2 times, LBP ≥ 2 weeks, or previous sickness absence. A random sample was extracted from the cohort as a control group (Control, n = 50), representing the natural course of LBP. The remaining 143 employees were invited to participate in a randomised controlled trial (RCT) of three 1:1:1 allocated parallel intervention arms: multidisciplinary rehabilitation (Rehab, n = 43); progressive exercises (Physio, n = 43) and self-care advice (Advice, n = 40). Seventeen employees declined participation in the intervention. The primary outcome measures were physical impairment (PHI), LBP intensity (Visual Analogue Scale), health related quality of life (QoL), and accumulated sickness absence days. We imputed missing values with multiple imputation procedure. We assessed all comparisons between the intervention groups and the Control group by analysing questionnaire outcomes at 2 years with ANOVA and sickness absence at 4 years by using negative binomial model with a logarithmic link function. Results: Mean differences between the Rehab and Control groups were - 3 [95% CI -5 to - 1] for PHI, - 13 [- 24 to - 1] for pain intensity, and 0.06 [0.00 to 0.12] for QoL. Mean differences between the Physio and Control groups were - 3 [95% CI -5 to - 1] for PHI, - 13 [- 29 to 2] for pain intensity, and 0.07 [0.01 to 0.13] for QoL. The main effects sizes were from 0.4 to 0.6. The interventions were not effective in reducing sickness absence. Conclusions: Rehab and Physio interventions improved health related quality of life, decreased low back pain and physical impairment in non-acute, moderate LBP, but we found no differences between the Advice and Control group results. No effectiveness on sickness absence was observed. Trial registration: Number NCT00908102 Clinicaltrials.gov.
Published: 2018

7. Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

Author: Yiallouros, Panayiotis K., Escobedo-de la Peña, Jorge, Zhou, Bin, Bentham, James, Di Cesare, Mariachiara, Bixby, Honor, Danaei, Goodarz, Hajifathalian, Kaveh, Taddei, Cristina, Carrillo-Larco, Rodrigo M., Djalalinia, Shirin, Khatibzadeh, Shahab, Lugero, Charles, Peykari, Niloofar, Zhang, Wan Zhu, Bennett, James, Bilano, Ver, Stevens, Gretchen A., Cowan, Melanie J., Riley, Leanne M., Chen, Zhengming, Hambleton, Ian R., Jackson, Rod T., Kengne, Andre Pascal, Khang, Young-Ho, Laxmaiah, Avula, Liu, Jing, Malekzadeh, Reza, Neuhauser, Hannelore K., Sorić, Maroje, Starc, Gregor, Sundström, Johan, Woodward, Mark, Ezzati, Majid, Abarca-Gómez, Leandra, Abdeen, Ziad A., Abu-Rmeileh, Niveen M., Acosta-Cazares, Benjamin, Adams, Robert J., Aekplakorn, Wichai, Afsana, Kaosar, Aguilar-Salinas, Carlos A., Agyemang, Charles, Ahmad, Noor Ani, Ahmadvand, Alireza, Ahrens, Wolfgang, Ajlouni, Kamel, Akhtaeva, Nazgul, Al-Raddadi, Rajaa, Ali, Mohamed M., Ali, Osman, Alkerwi, Ala'a, Aly, Eman, Amarapurkar, Deepak N., Amouyel, Philippe, Amuzu, Antoinette, Andersen, Lars Bo, Anderssen, Sigmund A., Ängquist, Lars H., Anjana, Ranjit Mohan, Ansong, Daniel, Aounallah-Skhiri, Hajer, Araújo, Joana, Ariansen, Inger, Aris, Tahir, Arlappa, Nimmathota, Arveiler, Dominique, Aryal, Krishna K., Aspelund, Thor, Assah, Felix K., Assunção, Maria Cecília F., Avdicová, Mária, Azevedo, Ana, Azizi, Fereidoun, Babu, Bontha V., Bahijri, Suhad, Balakrishna, Nagalla, Bamoshmoosh, Mohamed, Banach, Maciej, Bandosz, Piotr, Banegas, José R., Barbagallo, Carlo M., Barceló, Alberto, Barkat, Amina, Barros, Aluisio J. D., Barros, Mauro V., Bata, Iqbal, Batieha, Anwar M., Batyrbek, Assembekov, Baur, Louise A., Beaglehole, Robert, Romdhane, Habiba Ben, Benet, Mikhail, Benson, Lowell S., Bernabe-Ortiz, Antonio, Bernotiene, Gailute, Bettiol, Heloisa, Bhagyalaxmi, Aroor, Bharadwaj, Sumit, Bhargava, Santosh K., Bi, Yufang, Bikbov, Mukharram, Bista, Bihungum, Bjerregaard, Peter, Bjertness, Espen, Bjertness, Marius B., Björkelund, Cecilia, Blokstra, Anneke, Bo, Simona, Bobak, Martin, Boeing, Heiner, Boggia, Jose G., Boissonnet, Carlos P., Bongard, Vanina, Borchini, Rossana, Bovet, Pascal, Braeckman, Lutgart, Brajkovich, Imperia, Branca, Francesco, Breckenkamp, Juergen, Brenner, Hermann, Brewster, Lizzy M., Bruno, Graziella, Bueno-de-Mesquita, H. B(as), Bugge, Anna, Burns, Con, Bursztyn, Michael, de León, Antonio Cabrera, Cacciottolo, Joseph, Cai, Hui, Cameron, Christine, Can, Günay, Cândido, Ana Paula C., Capuano, Vincenzo, Cardoso, Viviane C., Carlsson, Axel C., Carvalho, Maria J., Casanueva, Felipe F., Casas, Juan-Pablo, Caserta, Carmelo A., Chamukuttan, Snehalatha, Chan, Angelique W., Chan, Queenie, Chaturvedi, Himanshu K., Chaturvedi, Nishi, Chen, Chien-Jen, Chen, Fangfang, Chen, Huashuai, Chen, Shuohua, Cheng, Ching-Yu, Dekkaki, Imane Cherkaoui, Chetrit, Angela, Chiolero, Arnaud, Chiou, Shu-Ti, Chirita-Emandi, Adela, Chirlaque, María-Dolores, Cho, Belong, Cho, Yumi, Christofaro, Diego G., Chudek, Jerzy, Cifkova, Renata, Cinteza, Eliza, Claessens, Frank, Clays, Els, Concin, Hans, Cooper, Cyrus, Cooper, Rachel, Coppinger, Tara C., Costanzo, Simona, Cottel, Dominique, Cowell, Chris, Craig, Cora L., Crujeiras, Ana B., Cruz, Juan J., D'Arrigo, Graziella, d'Orsi, Eleonora, Dallongeville, Jean, Damasceno, Albertino, Dankner, Rachel, Dantoft, Thomas M., Dauchet, Luc, Davletov, Kairat, De Backer, Guy, De Bacquer, Dirk, de Gaetano, Giovanni, De Henauw, Stefaan, de Oliveira, Paula Duarte, De Smedt, Delphine, Deepa, Mohan, Dehghan, Abbas, Delisle, Hélène, Deschamps, Valérie, Dhana, Klodian, Di Castelnuovo, Augusto F., Dias-da-Costa, Juvenal Soares, Diaz, Alejandro, Dickerson, Ty T., Do, Ha T. P., Donfrancesco, Chiara, Donoso, Silvana P., Döring, Angela, Dorobantu, Maria, Doua, Kouamelan, Drygas, Wojciech, Dulskiene, Virginija, Džakula, Aleksandar, Dzerve, Vilnis, Dziankowska-Zaborszczyk, Elzbieta, Eggertsen, Robert, Ekelund, Ulf, El Ati, Jalila, Elliott, Paul, Elosua, Roberto, Erasmus, Rajiv T., Erem, Cihangir, Eriksen, Louise, Eriksson, Johan G., Evans, Alun, Faeh, David, Fall, Caroline H., Farzadfar, Farshad, Felix-Redondo, Francisco J., Ferguson, Trevor S., Fernandes, Romulo A., Fernández-Bergés, Daniel, Ferrante, Daniel, Ferrari, Marika, Ferreccio, Catterina, Ferrieres, Jean, Finn, Joseph D., Fischer, Krista, Föger, Bernhard, Foo, Leng Huat, Forslund, Ann-Sofie, Forsner, Maria, Fouad, Heba M., Francis, Damian K., do Carmo Franco, Maria, Franco, Oscar H., Frontera, Guillermo, Fuchs, Flavio D., Fuchs, Sandra C., Fujita, Yuki, Furusawa, Takuro, Gaciong, Zbigniew, Galvano, Fabio, Garcia-de-la-Hera, Manoli, Gareta, Dickman, Garnett, Sarah P., Gaspoz, Jean-Michel, Gasull, Magda, Gates, Louise, Geleijnse, Johanna M., Ghasemian, Anoosheh, Ghimire, Anup, Giampaoli, Simona, Gianfagna, Francesco, Gill, Tiffany K., Giovannelli, Jonathan, Goldsmith, Rebecca A., Gonçalves, Helen, Gonzalez-Gross, Marcela, González-Rivas, Juan P., Gorbea, Mariano Bonet, Gottrand, Frederic, Graff-Iversen, Sidsel, Grafnetter, Dušan, Grajda, Aneta, Grammatikopoulou, Maria G., Gregor, Ronald D., Grodzicki, Tomasz, Grøntved, Anders, Grosso, Giuseppe, Gruden, Gabriella, Grujic, Vera, Gu, Dongfeng, Guan, Ong Peng, Gudmundsson, Elias F., Gudnason, Vilmundur, Guerrero, Ramiro, Guessous, Idris, Guimaraes, Andre L., Gulliford, Martin C., Gunnlaugsdottir, Johanna, Gunter, Marc, Gupta, Prakash C., Gupta, Rajeev, Gureje, Oye, Gurzkowska, Beata, Gutierrez, Laura, Gutzwiller, Felix, Hadaegh, Farzad, Halkjær, Jytte, Hardy, Rebecca, Hari Kumar, Rachakulla, Hata, Jun, Hayes, Alison J., He, Jiang, He, Yuna, Elisabeth, Marleen, Henriques, Ana, Cadena, Leticia Hernandez, Herrala, Sauli, Heshmat, Ramin, Hihtaniemi, Ilpo Tapani, Ho, Sai Yin, Ho, Suzanne C., Hobbs, Michael, Hofman, Albert, Dinc, Gonul Horasan, Horimoto, Andrea R. V. R., Hormiga, Claudia M., Horta, Bernardo L., Houti, Leila, Howitt, Christina, Htay, Thein Thein, Htet, Aung Soe, Than Htike, Maung Maung, Hu, Yonghua, Huerta, José María, Huisman, Martijn, Husseini, Abdullatif S., Huybrechts, Inge, Hwalla, Nahla, Iacoviello, Licia, Iannone, Anna G., Ibrahim, Mohsen M., Wong, Norazizah Ibrahim, Ikeda, Nayu, Ikram, M. Arfan, Irazola, Vilma E., Islam, Muhammad, al-Safi Ismail, Aziz, Ivkovic, Vanja, Iwasaki, Masanori, Jacobs, Jeremy M., Jaddou, Hashem, Jafar, Tazeen, Jamrozik, Konrad, Janszky, Imre, Jasienska, Grazyna, Jelaković, Ana, Jelaković, Bojan, Jennings, Garry, Jeong, Seung-lyeal, Jiang, Chao Qiang, Joffres, Michel, Johansson, Mattias, Jokelainen, Jari J., Jonas, Jost B., Jørgensen, Torben, Joshi, Pradeep, Jóźwiak, Jacek, Juolevi, Anne, Jurak, Gregor, Jureša, Vesna, Kaaks, Rudolf, Kafatos, Anthony, Kajantie, Eero O., Kalter-Leibovici, Ofra, Kamaruddin, Nor Azmi, Karki, Khem B., Kasaeian, Amir, Katz, Joanne, Kauhanen, Jussi, Kaur, Prabhdeep, Kavousi, Maryam, Kazakbaeva, Gyulli, Keil, Ulrich, Boker, Lital Keinan, Keinänen-Kiukaanniemi, Sirkka, Kelishadi, Roya, Kemper, Han C. G., Kengne, Andre P., Kerimkulova, Alina, Kersting, Mathilde, Key, Timothy, Khader, Yousef Saleh, Khalili, Davood, Khateeb, Mohammad, Khaw, Kay-Tee, Kiechl-Kohlendorfer, Ursula, Kiechl, Stefan, Killewo, Japhet, Kim, Jeongseon, Kim, Yeon-Yong, Klumbiene, Jurate, Knoflach, Michael, Kolle, Elin, Kolsteren, Patrick, Korrovits, Paul, Koskinen, Seppo, Kouda, Katsuyasu, Kowlessur, Sudhir, Koziel, Slawomir, Kriemler, Susi, Kristensen, Peter Lund, Krokstad, Steinar, Kromhout, Daan, Kruger, Herculina S., Kubinova, Ruzena, Kuciene, Renata, Kuh, Diana, Kujala, Urho M., Kulaga, Zbigniew, Krishna Kumar, R., Kurjata, Pawel, Kusuma, Yadlapalli S., Kuulasmaa, Kari, Kyobutungi, Catherine, Laatikainen, Tiina, Lachat, Carl, Lam, Tai Hing, Landrove, Orlando, Lanska, Vera, Lappas, Georg, Larijani, Bagher, Laugsand, Lars E., Le Nguyen Bao, Khanh, Le, Tuyen D., Leclercq, Catherine, Lee, Jeannette, Lee, Jeonghee, Lehtimäki, Terho, León-Muñoz, Luz M., Levitt, Naomi S., Li, Yanping, Lilly, Christa L., Lim, Wei-Yen, Lima-Costa, M. Fernanda, Lin, Hsien-Ho, Lin, Xu, Lind, Lars, Linneberg, Allan, Lissner, Lauren, Litwin, Mieczyslaw, Lorbeer, Roberto, Lotufo, Paulo A., Lozano, José Eugenio, Luksiene, Dalia, Lundqvist, Annamari, Lunet, Nuno, Lytsy, Per, Ma, Guansheng, Ma, Jun, Machado-Coelho, George L. L., Machi, Suka, Maggi, Stefania, Magliano, Dianna J., Magriplis, Emmanuella, Majer, Marjeta, Makdisse, Marcia, Malhotra, Rahul, Mallikharjuna Rao, Kodavanti, Malyutina, Sofia, Manios, Yannis, Mann, Jim I., Manzato, Enzo, Margozzini, Paula, Marques-Vidal, Pedro, Marques, Larissa Pruner, Marrugat, Jaume, Martorell, Reynaldo, Mathiesen, Ellisiv B., Matijasevich, Alicia, Matsha, Tandi E., Mbanya, Jean Claude N., Mc Donald Posso, Anselmo J., McFarlane, Shelly R., McGarvey, Stephen T., McLachlan, Stela, McLean, Rachael M., McLean, Scott B., McNulty, Breige A., Mediene-Benchekor, Sounnia, Medzioniene, Jurate, Meirhaeghe, Aline, Meisinger, Christa, Menezes, Ana Maria B., Menon, Geetha R., Meshram, Indrapal I., Metspalu, Andres, Meyer, Haakon E., Mi, Jie, Mikkel, Kairit, Miller, Jody C., Minderico, Cláudia S., Francisco, Juan, Miranda, J. Jaime, Mirrakhimov, Erkin, Mišigoj-Durakovic, Marjeta, Modesti, Pietro A., Mohamed, Mostafa K., Mohammad, Kazem, Mohammadifard, Noushin, Mohan, Viswanathan, Mohanna, Salim, Mohd Yusoff, Muhammad Fadhli, Møllehave, Line T., Møller, Niels C., Molnár, Dénes, Momenan, Amirabbas, Mondo, Charles K., Monyeki, Kotsedi Daniel K., Moon, Jin Soo, Moreira, Leila B., Morejon, Alain, Moreno, Luis A., Morgan, Karen, Moschonis, George, Mossakowska, Malgorzata, Mostafa, Aya, Mota, Jorge, Esmaeel Motlagh, Mohammad, Motta, Jorge, Msyamboza, Kelias P., Mu, Thet Thet, Muiesan, Maria L., Müller-Nurasyid, Martina, Murphy, Neil, Mursu, Jaakko, Musil, Vera, Nabipour, Iraj, Nagel, Gabriele, Naidu, Balkish M., Nakamura, Harunobu, Námešná, Jana, Nang, Ei Ei K., Nangia, Vinay B., Narake, Sameer, Nauck, Matthias, Navarrete-Muñoz, Eva Maria, Ndiaye, Ndeye Coumba, Neal, William A., Nenko, Ilona, Neovius, Martin, Nervi, Flavio, Nguyen, Chung T., Nguyen, Nguyen D., Nguyen, Quang Ngoc, Nguyen, Quang V., Nieto-Martínez, Ramfis E., Niiranen, Teemu J., Ning, Guang, Ninomiya, Toshiharu, Nishtar, Sania, Noale, Marianna, Noboa, Oscar A., Noorbala, Ahmad Ali, Norat, Teresa, Noto, Davide, Al Nsour, Mohannad, O'Reilly, Dermot, Oda, Eiji, Oehlers, Glenn, Oh, Kyungwon, Ohara, Kumiko, Olinto, Maria Teresa A., Oliveira, Isabel O., Omar, Mohd Azahadi, Onat, Altan, Ong, Sok King, Ono, Lariane M., Ordunez, Pedro, Ornelas, Rui, Osmond, Clive, Ostojic, Sergej M., Ostovar, Afshin, Otero, Johanna A., Overvad, Kim, Owusu-Dabo, Ellis, Paccaud, Fred Michel, Padez, Cristina, Pahomova, Elena, Pajak, Andrzej, Palli, Domenico, Palmieri, Luigi, Pan, Wen-Harn, Panda-Jonas, Songhomitra, Panza, Francesco, Papandreou, Dimitrios, Park, Soon-Woo, Parnell, Winsome R., Parsaeian, Mahboubeh, Patel, Nikhil D., Pecin, Ivan, Pednekar, Mangesh S., Peer, Nasheeta, Peeters, Petra H., Peixoto, Sergio Viana, Peltonen, Markku, Pereira, Alexandre C., Peters, Annette, Petersmann, Astrid, Petkeviciene, Janina, Pham, Son Thai, Pigeot, Iris, Pikhart, Hynek, Pilav, Aida, Pilotto, Lorenza, Pitakaka, Freda, Piwonska, Aleksandra, Plans-Rubió, Pedro, Polašek, Ozren, Porta, Miquel, Portegies, Marileen L. 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Si-Ramlee, Khairil, Siantar, Rosalynn, Sibai, Abla M, Santos Silva, Diego Augusto, Simon, Mary, Simons, Judith, Simons, Leon A, Sjöström, Michael, Skovbjerg, Sine, Slowikowska-Hilczer, Jolanta, Slusarczyk, Przemyslaw, Smeeth, Liam, Smith, Margaret C, Snijder, Marieke B, So, Hung-Kwan, Sobngwi, Eugène, Söderberg, Stefan, Solfrizzi, Vincenzo, Sonestedt, Emily, Song, Yi, Sørensen, Thorkild I A, Soric, Maroje, Jérome, Charles Sossa, Soumare, Aicha, Staessen, Jan A, Stathopoulou, Maria G, Stavreski, Bill, Steene-Johannessen, Jostein, Stehle, Peter, Stein, Aryeh D, Stergiou, George S, Stessman, Jochanan, Stieber, Jutta, Stöckl, Dori, Stocks, Tanja, Stokwiszewski, Jakub, Stronks, Karien, Strufaldi, Maria Wany, Sun, Chien-An, Sung, Yn-Tz, Suriyawongpaisal, Paibul, Sy, Rody G, Shyong Tai, E, Tammesoo, Mari-Lii, Tamosiunas, Abdona, Tan, Eng Joo, Tang, Xun, Tanser, Frank, Tao, Yong, Tarawneh, Mohammed Rasoul, Tarqui-Mamani, Carolina B, Tautu, Oana-Florentina, Taylor, Anne, Theobald, Holger, Theodoridis, Xenophon, Thijs, Lutgarde, Thuesen, Betina H, Tjonneland, Anne, Tolonen, Hanna K, Tolstrup, Janne S, Topbas, Murat, Topór-Madry, Roman, Tormo, María José, Torrent, Matie, Traissac, Pierre, Trichopoulos, Dimitrio, Trichopoulou, Antonia, Trinh, Oanh T H, Trivedi, Atul, Tshepo, Lechaba, Tulloch-Reid, Marshall K, Tullu, Fikru, Tuomainen, Tomi-Pekka, Tuomilehto, Jaakko, Turley, Maria L, Tynelius, Per, Tzourio, Christophe, Ueda, Peter, Ugel, Eunice E, Ulmer, Hanno, Uusitalo, Hannu M T, Valdivia, Gonzalo, Valvi, Damaskini, van der Schouw, Yvonne T, Van Herck, Koen, Van Minh, Hoang, van Rossem, Lenie, Van Schoor, Natasja M, van Valkengoed, Irene G M, Vanderschueren, Dirk, Vanuzzo, Diego, Vatten, Lar, Vega, Toma, Velasquez-Melendez, Gustavo, Veronesi, Giovanni, Monique Verschuren, W M, Verstraeten, Roosmarijn, Victora, Cesar G, Viet, Lucie, Viikari-Juntura, Eira, Vineis, Paolo, Vioque, Jesu, Virtanen, Jyrki K, Visvikis-Siest, Sophie, Viswanathan, Bharathi, Vlasoff, Tiina, Vollenweider, Peter, Voutilainen, Sari, Wade, Alisha N, Wagner, Aline, Walton, Janette, Wan Bebakar, Wan Mohamad, Wan Mohamud, Wan Nazaimoon, Wanderley, Rildo S, Wang, Ming-Dong, Wang, Qian, Wang, Ya Xing, Wang, Ying-Wei, Wannamethee, S Goya, Wareham, Nichola, Wedderkopp, Niel, Weerasekera, Deepa, Whincup, Peter H, Widhalm, Kurt, Widyahening, Indah S, Wiecek, Andrzej, Wijga, Alet H, Wilks, Rainford J, Willeit, Johann, Willeit, Peter, Williams, Emmanuel A, Wilsgaard, Tom, Wojtyniak, Bogdan, Wong-McClure, Roy A, Wong, Justin Y Y, Wong, Tien Yin, Woo, Jean, Giwercman Wu, Aleksander, Wu, Frederick C, Wu, Shouling, Xu, Haiquan, Yan, Weili, Yang, Xiaoguang, Ye, Xingwang, Yiallouros, Panayiotis K, Yoshihara, Akihiro, Younger-Coleman, Novie O, Yusoff, Ahmad Faudzi, Zainuddin, Ahmad Ali, Zambon, Sabina, Zampelas, Antoni, Zdrojewski, Tomasz, Zeng, Yi, Zhao, Dong, Zhao, Wenhua, Zheng, Wei, Zheng, Yingfeng, Zhu, Dan, Zhussupov, Baurzhan, Zimmermann, Esther, Cisneros, Julio Zuñiga, The State Key Laboratory of Cell Biology [Shanghai, China] (CAS Center for Excellence in Molecular Cell Science), Shanghai Institute of Biochemistry and Cell Biology [Shanghai, China]-University of Chinese Academy of Sciences [Shanghai, China], Imperial College London, University of Kentucky, Middlesex University, Cleveland Clinic, Universidad Peruana Cayetano Heredia (UPCH), Brandeis University, Mulago Hospital [Kampala, Ouganda], Department of Epidemiology and Public Health, Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), World Health Organisation (WHO), Al-Quds University, Discipline of Medicine, University of South Australia [Adelaide], Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán - National Institute of Medical Science and Nutrition Salvador Zubiran [Mexico], Leibniz Institute for Prevention Research and Epidemiology - BIPS, Leibniz Association, Centre for Industrial Management, Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Epidémiologie des maladies chroniques : impact des interactions gène environnement sur la santé des populations, Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé, Institute of Preventive Medicine, Copenhagen University Hospitals, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Dept. Atherosclerose, University of Iceland [Reykjavik], Institute for Biotechnology and Bioengineering (IBB), Technical University of Lisbon, Medical University of Łódź (MUL), Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid (UAM), Faculté de Médecine de Tunis, Université de Tunis El Manar (UTM), Sunder Lal Jain Hospital, Ufa Eye Research Institute [Bashkortostan], National Institute of Public Health, Department of Epidemiology, Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke (DifE), Leibniz Association-Leibniz Association, CHU Toulouse [Toulouse], Institute of Social and Preventive Medicine, Lausanne university hospital, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg] (DKFZ), Department of Medical Sciences [Turin, Italy] (DMS), Università degli studi di Torino = University of Turin (UNITO), ASU - School for Engineering of Matter, Transport and Energy, Arizona State University [Tempe] (ASU), Universidade do Porto = University of Porto, University of Oxford [Oxford], Cancer & Radiation Epidemiology Unit, Gertner Institute, Chaim Sheba Medical Center, Consorcio de Investigación Biomédica en Red especializado en Epidemiología y Salud Pública (CIBERESP), Los Centros de Investigación Biomédica en Red (CIBER), 2nd Department of Internal Medicine, Molecular Medicine, Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven)-IRC KULAK, Department of Public Health, State University of Ghent, MRC Lifecourse Epidemiology Unit [Southampton, UK], University of Southampton, Réseau International des Instituts Pasteur (RIIP), Institute of Epidemiology [Neuherberg] (EPI), German Research Center for Environmental Health - Helmholtz Center München (GmbH), Sahlgrenska University Hospital [Gothenburg], Institute of Metabolic Science, MRC, Institut National de Nutrition et de Technologie Alimentaire (INNTA), University of Huddersfield, IMIM-Hospital del Mar, Generalitat de Catalunya, Medstar Research Institute, Queen's University [Belfast] (QUB), Medical Research Council, Applied Sciences, National Research Institute on Food and Nutrition, Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Infectious diseases division, Department of internal medicine, Washington University in Saint Louis (WUSTL), Innsbruck Medical University [Austria] (IMU), Department of Epidemiology [Rotterdam], Erasmus University Medical Center [Rotterdam] (Erasmus MC), Laboratoire d'Etude des Mammifères Marins (LEMM), Océanopolis [Brest], Faculté de Médecine Henri Warembourg - Université de Lille, Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark (SDU), Icelandic Heart Association, Heart Preventive Clinic and Research Institute, Centro Investig Quim Aplicada, Coahuila, Mexico, Centro Investigacion en Quimica Aplicada, Coahuila, Mexico, University of Geneva [Switzerland], Department of Civil Engineering [Hamirpur], National Institute of Technology [Hamirpur], Health Services Research Unit, Danish Cancer Society, Institute of Cancer Epidemiology, London School of Hygiene and Tropical Medicine (LSHTM), University College of London [London] (UCL), The Georges Institute for International Health, The University of Sydney, School of Information Technology, Deakin University Waurn Ponds, Faculté de Médecine, Université Djilali Liabès [Sidi-Bel-Abbès], Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), CIBER de Epidemiología y Salud Pública (CIBERESP), VU University Medical Center [Amsterdam], Universiteit Gent = Ghent University [Belgium] (UGENT), Faculty of Agricultural and Food Science, American University of Beirut [Beyrouth] (AUB), Åbo Akademi University [Turku], Department of Public Health Sciences, Karolinska Institutet [Stockholm], Great Lakes Institute for Environmental Research, University of Windsor [Ca], Universität Heidelberg [Heidelberg], Research Center for Prevention and Health, University of Ljubljana, Division of Cancer Epidemiology, University of Crete School of medicine, School of Public Health and Clinical Nutrition, University of Eastern Finland, Institute of Epidemiology and Social Medicine, Westfälische Wilhelms-Universität Münster = University of Münster (WWU), Research Institute of Child Nutrition Dortmund, Rheinische Friedrich-Wilhelms-Universität Bonn, Cancer Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge [UK] (CAM), Department of Oncology, University of Tampere Medical School, University of Tampere, Wageningen University and Research [Wageningen] (WUR), Centre for Environmental Health, National Institue of Public Health, School of Public Health, The University of Hong Kong (HKU), Tehran University of Medical Sciences, Istituto Nazionale di Ricerca per gli Alimenti e la Nutrizione (INRAN), INRAN, National University of Singapore (NUS), Faculty of Medicine and Life Sciences [Tampere], University of Tampere [Finland], Centre Européen de Réalité Virtuelle (CERV), École Nationale d'Ingénieurs de Brest (ENIB), Uppsala Universitet [Uppsala], Department of Public Health and Community Medicine, University of Gothenburg (GU), Institute of Earthquake Science, CEA, Beijing, CEA, Beijing, University of Porto Medical School, Laboratoire de Chimie Physique D'Orsay (LCPO), Université Paris-Sud - Paris 11 (UP11)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), Aging Program, National research council, Padua, Italy, Baker IDI Heart and Diabetes Institute, Institute of Internal Medicine, Russian Academy of Medical Sciences, Department of Nutrition and Dietetics, Harokopio University, Emory University [Atlanta, GA], Départment of Biotechnology, Faculty of Science, University of Oran Es-Senia [Oran] | Université d'Oran Es-Senia [Oran], Institut National de la Santé et de la Recherche Médicale (INSERM), University of Tartu, Department of Community, Université Ain Shams-Faculty of Medicine-Environmental and Occupational Medicine, Pécsi Tudemányegyetem, Department of Community, Environmental and Occupational Medicine, Université Ain Shams, Research Centre in Physical Activity, Health and Leisure, Nutrition and Metabolism Section, International Agency for Research on Cancer, Bushehr University of Medical Sciences, Institute of Epidemiology and Medical Biometry [Ulm, Allemagne], Universität Ulm - Ulm University [Ulm, Allemagne], Università degli studi di Palermo - University of Palermo, MRc Environmental Epidemiology Unit, Department of Cardiology and Department of Clinical Epidemiology, Aarhus University Hospital, Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Department of Epidemiology and Population Studies, Jagiellonian University, Uniwersytet Jagielloński w Krakowie = Jagiellonian University (UJ), Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute – ISPO, Social Robotics Laboratory, University of Freiburg, Freiburg im Breisgau, Department of Ophthalmology, Universitätsklinikum Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, University of Bari Aldo Moro (UNIBA), Department of Cardiology, Eastbourne General Hospital, Julius Center for Health Sciences and Primary Care, University Medical Center [Utrecht], Laboratoire d'Innovation pour les Technologies des Energies Nouvelles et les nanomatériaux (LITEN), Institut National de L'Energie Solaire (INES), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Centre National de la Recherche Scientifique (CNRS), King‘s College London, Public Health Sciences, University of Edinburgh, Movement Disorders and Tourette Centre, Genetica medicala, Victor Babeş University of Medicine and Pharmacy (UMFT), Andrology Unit, United Laboratories of Tartu University Clinics, Tampere University Hospital, Department of Hygiene and Epidemiology, Dept of Epidemiology and Public Health, Department of Epidemiology and Biostatistics, Imperial College London-School of public health, The University of Hong Kong (HKU)-The University of Hong Kong (HKU), Department of Emergency and Cardiovascular Medicine, Sahlgrenska Academy, Institut de Veille Sanitaire (INVS), Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain, parent, Department of Chronic Disease Prevention, National Institute for Health and Welfare [Helsinki], University of São Paulo (USP), Institut de Recherche pour le Développement (IRD [France-Sud]), Institute for plasma research, Institute for Plasma Research, Department of Biosciences and Nutrition, Department of Reproductive Endocrinology, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC - Academic medical center, Central Hospital and Faculty of medicine and biomedical sciences university, University of Yaoundé [Cameroun], Department of Clinical Sciences, Lund University [Lund]-Lund University Diabetes Centre, School of Computing [Leeds], University of Leeds, Copenhagen University Hospital, Neuroépidémiologie, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Maastricht University [Maastricht], Interactions Gène-Environnement en Physiopathologie Cardio-Vasculaire (IGE-PCV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Applied Food Science, Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, University of Amsterdam, Dept. of Social Medecine, Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University Hospital, Africa Centre for Health and Population Studies, University of KwaZulu-Natal [Durban, Afrique du Sud] (UKZN)-Medical Research Council of South Africa, Center for Family and Community Medicine, Department of Neurobiology, Care Sciences and Society, Department of Cardiovascular Sciences [Leuven], Cancer Epidemiology Institute, Department of Epidemiology and Health Promotion (MONICA Data Centre), National Public Health Institute, Nutrition et Alimentation des Populations aux Suds (NutriPass), Université Montpellier 1 (UM1)-Institut de Recherche pour le Développement (IRD)-Université Montpellier 2 - Sciences et Techniques (UM2)-Université de Montpellier (UM)-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), Havard School of Public Health, Dept of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School [Athens], University of Kuopio, Tampere University, University Medical Centre Utrecht, Department of Social Medicine, Amsterdam, Center for Metabolic Bone Diseases, Catholic University of Leuven, Norwegian University of Science and Technology [Trondheim] (NTNU), Norwegian University of Science and Technology (NTNU), Universidad Miguel Hernández [Elche] (UMH), Institute of Public Health and Clinical Nutrition [Kuopio, Finland], Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV), Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Division of Community Health Sciences, St George's University of London, Medizinische Universität Wien = Medical University of Vienna, Medical University of Silesia (SUM), National Institute for Public Health and the Environment [Bilthoven] (RIVM), University of Innsbruck, National Institute of Hygiene Warsaw, Johns Hopkins University School of Medicine [Baltimore], Food Science and Technology, Beijing Forestry University, College of Automation Engineering, Nanjing University of Aeronautics and Astronautics (CAE-NUAA), NUAA, Chinese Center for Disease Control and Prevention, Department of Applied Mathematics, School of Science, Northwestern Polytechnical University, Xi’an, Shaanxi 710072, Siemens Corporate Research, Siemens AG [Munich], Franche-Comté Électronique Mécanique, Thermique et Optique - Sciences et Technologies (UMR 6174) (FEMTO-ST), Université de Technologie de Belfort-Montbeliard (UTBM)-Ecole Nationale Supérieure de Mécanique et des Microtechniques (ENSMM)-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), This work was supported by the Wellcome Trust [101506/Z/13/Z]., NCD Risk Factor Collaboration (NCD-RisC). We thank WHO country and regional offices and the World Heart Federation for support in data identification and access., Universidad Autonoma de Madrid (UAM), University of Turin, Universidade do Porto, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Université Lille 2 - Faculté de Médecine, Westfälische Wilhelms-Universität Münster (WWU), Centre National de la Recherche Scientifique (CNRS)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Centre National de la Recherche Scientifique (CNRS)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), University of KwaZulu-Natal (UKZN)-Medical Research Council of South Africa, Institut de Recherche pour le Développement (IRD)-Université Montpellier 1 (UM1)-Université Montpellier 2 - Sciences et Techniques (UM2)-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Université de Montpellier (UM), Université de Technologie de Belfort-Montbeliard (UTBM)-Ecole Nationale Supérieure de Mécanique et des Microtechniques (ENSMM)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS), Lund University Diabetes Centre-Lund University [Lund], Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro), Medical University of Silesia, Katowice, Apollo - University of Cambridge Repository, University of Kentucky (UK), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Lausanne University Hospital, University of Oxford, Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Innsbruck Medical University = Medizinische Universität Innsbruck (IMU), Université de Genève = University of Geneva (UNIGE), Deakin University [Waurn Ponds], Universiteit Gent = Ghent University (UGENT), Universität Heidelberg [Heidelberg] = Heidelberg University, Università degli studi di Bari Aldo Moro = University of Bari Aldo Moro (UNIBA), Universidade de São Paulo = University of São Paulo (USP), Lund University [Lund], Laboratoire Chrono-environnement (UMR 6249) (LCE), Leopold Franzens Universität Innsbruck - University of Innsbruck, National Institute of Public Health - National Institute of Hygiene [Poland], Yiallouros, Panayiotis K. [0000-0002-8339-9285], Giampaoli, Simona [0000-0002-6679-1488], Moschonis, George [0000-0003-3009-6675], Papandreou, Dimitrios [0000-0002-4923-484X], Stathopoulou, Maria G. [0000-0003-4376-2083], Stergiou, George S. [0000-0002-6132-0038], Trichopoulou, Antonia [0000-0002-7204-6396], Valvi, Damaskini [0000-0003-4633-229X], Chen, Z, Woodward, M, Key, T, and Smith, M
Subjects: systolic blood pressure, Settore MED/09 - Medicina Interna, blood pressure measurement, HEALTH EXAMINATION SURVEYS, Blood Pressure, Hypertension, Population Health, Global Health, Non-communicable Disease, Epidemiology, [SDV]Life Sciences [q-bio], global health, South Asia, purl.org/pe-repo/ocde/ford#3.03.09 [https], kohonnut verenpaine, Medicine and Health Sciences, middle income country, measurement method, skin and connective tissue diseases, VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Kardiologi: 771, Public, Environmental & Occupational Health, adult, Population health, public health, blood pressure regulation, Public Health, Global Health, Social Medicine and Epidemiology, Non-communicable disease, kansainvälinen vertailu, health survey, aged, female, priority journal, Blood pressure, mean arterial pressure, GLOBAL TRENDS, SODIUM-INTAKE, Life Sciences & Biomedicine, survey design, hypertension, prevalence, Global health, UNITED-STATES, URBAN COMMUNITIES, Article, SECULAR TRENDS, Middle East, Central Asia, male, disease prevalence, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, kansanterveys, blood, SYSTEMATIC ANALYSIS, human, verenpainetauti, non-communicable disease, Science & Technology, Pacific Ocean, high income country, diastolic blood pressure, Pacific Rim, Blood Pressure - Epidemiology - Population, North Africa, major clinical study, HYPERTENSION PREVALENCE, verenpaine, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, ARTERIAL-HYPERTENSION, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, POTASSIUM INTAKE, sense organs, trend analysis, trend study, population research, population health, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, low income country
Abstract: Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probit-transformed) prevalence of raised blood pressure and age-group-and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the high-income Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups., This work was supported by the Wellcome Trust [101506/Z/13/Z].
Published: 2018
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8. Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

Author: Ezzati, M. and Zhou, B. and Bentham, J. and Di Cesare, M. and Bixby, H. and Danaei, G. and Hajifathalian, K. and Taddei, C. and Carrillo-Larco, R.M. and Djalalinia, S. and Khatibzadeh, S. and Lugero, C. and Peykari, N. and Zhang, W.Z. and Bennett, J. and Bilano, V. and Stevens, G.A. and Cowan, M.J. and Riley, L.M. and Chen, Z. and Hambleton, I.R. and Jackson, R.T. and Kengne, A.P. and Khang, Y.-H. and Laxmaiah, A. and Liu, J. and Malekzadeh, R. and Neuhauser, H.K. and Sorić, M. and Starc, G. and Sundström, J. and Woodward, M. and Abarca-Gómez, L. and Abdeen, Z.A. and Abu-Rmeileh, N.M. and Acosta-Cazares, B. and Adams, R.J. and Aekplakorn, W. and Afsana, K. and Aguilar-Salinas, C.A. and Agyemang, C. and Ahmad, N.A. and Ahmadvand, A. and Ahrens, W. and Ajlouni, K. and Akhtaeva, N. and Al-Raddadi, R. and Ali, M.M. and Ali, O. and Alkerwi, A. and Aly, E. and Amarapurkar, D.N. and Amouyel, P. and Amuzu, A. and Andersen, L.B. and Anderssen, S.A. and Ängquist, L.H. and Anjana, R.M. and Ansong, D. and Aounallah-Skhiri, H. and Araújo, J. and Ariansen, I. and Aris, T. and Arlappa, N. and Arveiler, D. and Aryal, K.K. and Aspelund, T. and Assah, F.K. and Assunção, M.C.F. and Avdicová, M. and Azevedo, A. and Azizi, F. and Babu, B.V. and Bahijri, S. and Balakrishna, N. and Bamoshmoosh, M. and Banach, M. and Bandosz, P. and Banegas, J.R. and Barbagallo, C.M. and Barceló, A. and Barkat, A. and Barros, A.J.D. and Barros, M.V. and Bata, I. and Batieha, A.M. and Batyrbek, A. and Baur, L.A. and Beaglehole, R. and Romdhane, H.B. and Benet, M. and Benson, L.S. and Bernabe-Ortiz, A. and Bernotiene, G. and Bettiol, H. and Bhagyalaxmi, A. and Bharadwaj, S. and Bhargava, S.K. and Bi, Y. and Bikbov, M. and Bista, B. and Bjerregaard, P. and Bjertness, E. and Bjertness, M.B. and Björkelund, C. and Blokstra, A. and Bo, S. and Bobak, M. and Boeing, H. and Boggia, J.G. and Boissonnet, C.P. and Bongard, V. and Borchini, R. and Bovet, P. and Braeckman, L. and Brajkovich, I. and Branca, F. and Breckenkamp, J. and Brenner, H. and Brewster, L.M. and Bruno, G. and Bueno-de-Mesquita, H.B. and Bugge, A. and Burns, C. and Bursztyn, M. and de León, A.C. and Cacciottolo, J. and Cai, H. and Cameron, C. and Can, G. and Cândido, A.P.C. and Capuano, V. and Cardoso, V.C. and Carlsson, A.C. and Carvalho, M.J. and Casanueva, F.F. and Casas, J.-P. and Caserta, C.A. and Chamukuttan, S. and Chan, A.W. and Chan, Q. and Chaturvedi, H.K. and Chaturvedi, N. and Chen, C.-J. and Chen, F. and Chen, H. and Chen, S. and Cheng, C.-Y. and Dekkaki, I.C. and Chetrit, A. and Chiolero, A. and Chiou, S.-T. and Chirita-Emandi, A. and Chirlaque, M.-D. and Cho, B. and Cho, Y. and Christofaro, D.G. and Chudek, J. and Cifkova, R. and Cinteza, E. and Claessens, F. and Clays, E. and Concin, H. and Cooper, C. and Cooper, R. and Coppinger, T.C. and Costanzo, S. and Cottel, D. and Cowell, C. and Craig, C.L. and Crujeiras, A.B. and Cruz, J.J. and D'Arrigo, G. and d'Orsi, E. and Dallongeville, J. and Damasceno, A. and Dankner, R. and Dantoft, T.M. and Dauchet, L. and Davletov, K. and De Backer, G. and De Bacquer, D. and de Gaetano, G. and De Henauw, S. and de Oliveira, P.D. and De Smedt, D. and Deepa, M. and Dehghan, A. and Delisle, H. and Deschamps, V. and Dhana, K. and Di Castelnuovo, A.F. and Dias-da-Costa, J.S. and Diaz, A. and Dickerson, T.T. and Do, H.T.P. and Dobson, A.J. and Donfrancesco, C. and Donoso, S.P. and Döring, A. and Dorobantu, M. and Doua, K. and Drygas, W. and Dulskiene, V. and Džakula, A. and Dzerve, V. and Dziankowska-Zaborszczyk, E. and Eggertsen, R. and Ekelund, U. and El Ati, J. and Elliott, P. and Elosua, R. and Erasmus, R.T. and Erem, C. and Eriksen, L. and Eriksson, J.G. and Escobedo-de la Peña, J. and Evans, A. and Faeh, D. and Fall, C.H. and Farzadfar, F. and Felix-Redondo, F.J. and Ferguson, T.S. and Fernandes, R.A. and Fernández-Bergés, D. and Ferrante, D. and Ferrari, M. and Ferreccio, C. and Ferrieres, J. and Finn, J.D. and Fischer, K. and Föger, B. and Foo, 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S.T. and McLachlan, S. and McLean, R.M. and McLean, S.B. and McNulty, B.A. and Mediene-Benchekor, S. and Medzioniene, J. and Meirhaeghe, A. and Meisinger, C. and Menezes, A.B. and Menon, G.R. and Meshram, I.I. and Metspalu, A. and Meyer, H.E. and Mi, J. and Mikkel, K. and Miller, J.C. and Minderico, C.S. and Miquel, J.F. and Miranda, J.J. and Mirrakhimov, E. and Mišigoj-Durakovic, M. and Modesti, P.A. and Mohamed, M.K. and Mohammad, K. and Mohammadifard, N. and Mohan, V. and Mohanna, S. and Yusoff, M.F.M.D. and Møllehave, L.T. and Møller, N.C. and Molnár, D. and Momenan, A. and Mondo, C.K. and Monyeki, K.D.K. and Moon, J.S. and Moreira, L.B. and Morejon, A. and Moreno, L.A. and Morgan, K. and Moschonis, G. and Mossakowska, M. and Mostafa, A. and Mota, J. and Motlagh, M.E. and Motta, J. and Msyamboza, K.P. and ThetMu, T. and Muiesan, M.L. and Müller-Nurasyid, M. and Murphy, N. and Mursu, J. and Musil, V. and Nabipour, I. and Nagel, G. and Naidu, B.M. and Nakamura, H. and Námešná, J. and 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M.L. and Tynelius, P. and Tzourio, C. and Ueda, P. and Ugel, E.E. and Ulmer, H. and Uusitalo, H.M.T. and Valdivia, G. and Valvi, D. and van der Schouw, Y.T. and Van Herck, K. and Van Minh, H. and van Rossem, L. and Van Schoor, N.M. and van Valkengoed, I.G.M. and Vanderschueren, D. and Vanuzzo, D. and Vatten, L. and Vega, T. and Velasquez-Melendez, G. and Veronesi, G. and Verschuren, W.M.M. and Verstraeten, R. and Victora, C.G. and Viet, L. and Viikari-Juntura, E. and Vineis, P. and Vioque, J. and Virtanen, J.K. and Visvikis-Siest, S. and Viswanathan, B. and Vlasoff, T. and Vollenweider, P. and Voutilainen, S. and Wade, A.N. and Wagner, A. and Walton, J. and Wan Bebakar, W.M. and Wan Mohamud, W.N. and Wanderley, R.S., Jr. and Wang, M.-D. and Wang, Q. and Wang, Y.X. and Wang, Y.-W. and Wannamethee, S.G. and Wareham, N. and Wedderkopp, N. and Weerasekera, D. and Whincup, P.H. and Widhalm, K. and Widyahening, I.S. and Wiecek, A. and Wijga, A.H. and Wilks, R.J. and Willeit, J. and Willeit, P. and Williams, E.A. and Wilsgaard, T. and Wojtyniak, B. and Wong-McClure, R.A. and Wong, J.Y.Y. and Wong, T.Y. and Woo, J. and Wu, A.G. and Wu, F.C. and Wu, S. and Xu, H. and Yan, W. and Yang, X. and Ye, X. and Yiallouros, P.K. and Yoshihara, A. and Younger-Coleman, N.O. and Yusoff, A.F. and Zainuddin, A.A. and Zambon, S. and Zampelas, A. and Zdrojewski, T. and Zeng, Y. and Zhao, D. and Zhao, W. and Zheng, W. and Zheng, Y. and Zhu, D. and Zhussupov, B. and Zimmermann, E. and Cisneros, J.Z. and NCD Risk Factor Collaboration (NCD-RisC), Imperial College London, London, W2 1PG, United Kingdom, Imperial College London, United Kingdom, University of Kent, United Kingdom, Middlesex University, United Kingdom, Harvard TH Chan School of Public Health, United States, Cleveland Clinic, United States, Universidad Peruana Cayetano Heredia, Peru, Tehran University of Medical Sciences, Iran, Ministry of Health and Medical Education, Iran, Brandeis University, United States, Mulago Hospital, Uganda, Uganda Heart Institute, Uganda, World Health Organization, Switzerland, University of Oxford, United Kingdom, The University of the West Indies, Barbados, University of Auckland, New Zealand, South African Medical Research Council, South Africa, Seoul National University, South Korea, National Institute of Nutrition, India, Capital Medical University Beijing An Zhen Hospital, China, Robert Koch Institute, Germany, German Center for Cardiovascular Research, Germany, University of Zagreb, Croatia, University of Ljubljana, Slovenia, Uppsala University, Sweden, University of New South Wales, Australia, Caja Costarricense de Seguro Social, Costa Rica, Al-Quds University, Palestine, Birzeit University, Palestine, Instituto Mexicano del Seguro Social, Mexico, The University of Adelaide, Australia, Mahidol University, Thailand, BRAC, Bangladesh, Instituto Nacional de Ciencias Médicas y Nutricion, Mexico, University of Amsterdam, Netherlands, Ministry of Health Malaysia, Malaysia, Non- Communicable Diseases Research Center, Iran, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Germany, National Center for Diabetes and Endocrinology, Jordan, Kazakh National Medical University, Kazakhstan, King Abdulaziz University, Saudi Arabia, Universiti Malaysia Sabah, Malaysia, Luxembourg Institute of Health, Luxembourg, World Health Organization Regional Office for the Eastern Mediterranean, Egypt, Bombay Hospital and Medical Research Centre, India, Lille University and Hospital, France, London School of Hygiene and Tropical Medicine, United Kingdom, Western Norway University of Applied Sciences, Norway, Norwegian School of Sport Sciences, Norway, Bispebjerg and Frederiksberg Hospitals, Denmark, Madras Diabetes Research Foundation, India, Komfo Anokye Teaching Hospital, Ghana, National Institute of Public Health, Tunisia, Universidade do Porto, Portugal, Norwegian Institute of Public Health, Norway, Strasbourg University and Hospital, France, Nepal Health Research Council, Nepal, University of Iceland, Iceland, University of Yaoundé 1, Cameroon, Federal University of Pelotas, Brazil, Regional Authority of Public Health, Banska Bystrica, Slovakia, University of Porto Medical School, Portugal, Shahid Beheshti University of Medical Sciences, Iran, Indian Council of Medical Research, India, University of Science and Technology, Yemen, Medical University of Lodz, Poland, Medical University of Gdansk, Poland, Universidad Autónoma de Madrid, Spain, University of Palermo, Italy, Pan American Health Organization, United States, Université Mohammed V de Rabat, Morocco, University of Pernambuco, Brazil, Dalhousie University, Canada, Jordan University of Science and Technology, Jordan, University of Sydney, Australia, University Tunis El Manar, Tunisia, CAFAM University Foundation, Colombia, University of Utah School of Medicine, United States, Lithuanian University of Health Sciences, Lithuania, University of São Paulo, Brazil, BJ Medical College, India, Chirayu Medical College, India, SL Jain Hospital, India, Shanghai Jiao-Tong University School of Medicine, China, Ufa Eye Research Institute, Russian Federation, University of Southern Denmark, Denmark, University of Greenland, Greenland, University of Oslo, Norway, University of Gothenburg, Sweden, National Institute for Public Health and the Environment, Netherlands, University of Turin, Italy, University College London, United Kingdom, German Institute of Human Nutrition, Germany, Universidad de la República, Uruguay, CEMIC, Argentina, Toulouse University School of Medicine, France, University Hospital of Varese, Italy, Ministry of Health, Seychelles, University of Lausanne, Switzerland, Ghent University, Belgium, Universidad Central de Venezuela, Venezuela, Bielefeld University, Germany, German Cancer Research Center, Germany, Cork Institute of Technology, Ireland, Hadassah-Hebrew University Medical Center, Israel, Universidad de La Laguna, Spain, University of Malta, Malta, Vanderbilt University, United States, Canadian Fitness and Lifestyle Research Institute, Canada, Istanbul University, Turkey, Universidade Federal de Juiz de Fora, Brazil, Cardiologia di Mercato S. Severino, Italy, Karolinska Institutet, Sweden, University of Porto, Portugal, Santiago de Compostela University, Spain, Associazione Calabrese di Epatologia, Italy, India Diabetes Research Foundation, India, Duke-NUS Medical School, Singapore, National Institute of Medical Statistics, India, Academia Sinica, Taiwan, Capital Institute of Pediatrics, China, Duke University, United States, Kailuan General Hospital, China, The Gertner Institute for Epidemiology and Health Policy Research, Israel, University of Bern, Switzerland, Ministry of Health and Welfare, Taiwan, Victor Babes University of Medicine and Pharmacy Timisoara, Romania, Murcia Regional Health Council, Spain, Seoul National University College of Medicine, South Korea, Korea Centers for Disease Control and Prevention, South Korea, Universidade Estadual Paulista, Brazil, Medical University of Silesia, Poland, Charles University in Prague, Czech Republic, Carol Davila University of Medicine and Pharmacy, Romania, Katholieke Universiteit Leuven, Belgium, Agency for Preventive and Social Medicine, Austria, University of Southampton, United Kingdom, IRCCS Istituto Neurologico Mediterraneo Neuromed, Italy, Institut Pasteur de Lille, France, CIBEROBN, Spain, National Council of Research, Italy, Universidade Federal de Santa Catarina, Brazil, Eduardo Mondlane University, Mozambique, Bispebjerg and Frederiksberg Hospital, Denmark, Lille University Hospital, France, Erasmus Medical Center Rotterdam, Netherlands, University of Montreal, Canada, French Public Health Agency, France, Universidade do Vale do Rio dos Sinos, Brazil, National Council of Scientific and Technical Research, Argentina, National Institute of Nutrition, Viet Nam, University of Queensland, Australia, Istituto Superiore di Sanità, Italy, Universidad de Cuenca, Ecuador, Helmholtz Zentrum München, Germany, Ministère de la Santé et de la Lutte Contre le Sida, Cote d'Ivoire, The Cardinal Wyszynski Institute of Cardiology, Poland, University of Latvia, Latvia, National Institute of Nutrition and Food Technology, Tunisia, Institut Hospital del Mar d'Investigacions Mèdiques, Spain, University of Stellenbosch, South Africa, Karadeniz Technical University, Turkey, National Institute for Health and Welfare, Finland, Queen's University of Belfast, United Kingdom, University of Zurich, Switzerland, Centro de Salud Villanueva Norte, Spain, The University of the West Indies, Jamaica, Hospital Don Benito-Villanueva de la Serena, Spain, Ministry of Health, Argentina, Council for Agricultural Research and Economics, Italy, Pontificia Universidad Católica de Chile, Chile, University of Manchester, United Kingdom, University of Tartu, Estonia, Universiti Sains Malaysia, Malaysia, Umeå University, Sweden, Dalarna University, Sweden, Federal University of São Paulo, Brazil, Hospital Universitario Son Espases, Spain, Hospital de Clinicas de Porto Alegre, Brazil, Universidade Federal do Rio Grande do Sul, Brazil, Kindai University, Japan, Kyoto University, Japan, Medical University of Warsaw, Poland, University of Catania, Italy, CIBER en Epidemiología y Salud Pública, Spain, University of KwaZulu-Natal, South Africa, Geneva University Hospitals, Switzerland, Australian Bureau of Statistics, Australia, Wageningen University, Netherlands, B P Koirala Institute of Health Sciences, Nepal, University of Insubria, Italy, Ministry of Health, Israel, The Andes Clinic of Cardio-Metabolic Studies, Venezuela, National Institute of Hygiene, Epidemiology and Microbiology, Cuba, Université de Lille 2, France, Institute for Clinical and Experimental Medicine, Czech Republic, Children'sMemorial Health Institute, Poland, Alexander Technological Educational Institute, Greece, Jagiellonian University Medical College, Poland, Azienda Ospedaliera Universitaria Policlinico Vittorio Emanuele, Italy, University of Novi Sad, Serbia, National Center of Cardiovascular Diseases, China, Singapore Eye Research Institute, Singapore, Icelandic Heart Association, Iceland, Universidad Icesi, Colombia, King's College London, United Kingdom, International Agency for Research on Cancer, France, Healis-Sekhsaria Institute for Public Health, India, Eternal Heart Care Centre and Research Institute, India, University of Ibadan, Nigeria, Children's Memorial Health Institute, Poland, Institute for Clinical Effectiveness and Health Policy, Argentina, Danish Cancer Society Research Centre, Denmark, Kyushu University, Japan, Tulane University, United States, Chinese Center for Disease Control and Prevention, China, Academic Medical Center of University of Amsterdam, Netherlands, National Institute of Public Health, Mexico, Oulu University Hospital, Finland, Chronic Diseases Research Center, Iran, University of Hong Kong, Hong Kong, The Chinese University of Hong Kong, Hong Kong, University of Western Australia, Australia, Celal Bayar University, Turkey, Heart Institute, Brazil, Fundación Oftalmológica de Santander, Colombia, University of Oran 1, Algeria, Independent Public Health Specialist, Myanmar, Ministry of Health, Myanmar, Peking University, China, VU University Medical Center and VU University, Netherlands, American University of Beirut, Lebanon, Cairo University, Egypt, National Institute of Health and Nutrition, Japan, Aga Khan University, Pakistan, UHC Zagreb, Croatia, Niigata University, Japan, Hadassah University Medical Center, Israel, Duke- NUS Medical School, Singapore, Norwegian University of Science and Technology, Norway, University of Zagreb School of Medicine, Croatia, Heart Foundation, Australia, National Health Insurance Service, South Korea, Guangzhou 12th Hospital, China, Simon Fraser University, Canada, Ruprecht-Karls- University of Heidelberg, Germany, Research Centre for Prevention and Health, Denmark, World Health Organization Country Office, India, Czestochowa University of Technology, Poland, University of Crete, Greece, Universiti Kebangsaan Malaysia, Malaysia, Johns Hopkins Bloomberg School of Public Health, United States, University of Eastern Finland, Finland, National Institute of Epidemiology, India, University of Münster, Germany, Israel Center for Disease Control, Israel, Research Institute for Primordial Prevention of Noncommunicable Disease, Iran, VU University Medical Center, Netherlands, Kyrgyz State Medical Academy, Kyrgyzstan, Research Institute of Child Nutrition, Germany, University of Cambridge, United Kingdom, Medical University of Innsbruck, Austria, Muhimbili University of Health and Allied Sciences, Tanzania, National Cancer Center, South Korea, Institute of Tropical Medicine, Belgium, Tartu University Clinics, Estonia, Ministry of Health and Quality of Life, Mauritius, Polish Academy of Sciences Anthropology Unit in Wroclaw, Poland, University of Zürich, Switzerland, University of Groningen, Netherlands, North-West University, South Africa, National Institute of Public Health, Czech Republic, University of Jyväskylä, Finland, Amrita Institute of Medical Sciences, India, All India Institute of Medical Sciences, India, African Population and Health Research Center, Kenya, Ministerio de Salud Pública, Cuba, Sahlgrenska Academy, Sweden, Endocrinology and Metabolism Research Center, Iran, Food and Agriculture Organization of the United Nations, Italy, National University of Singapore, Singapore, Tampere University Hospital, Finland, University of Cape Town, South Africa, West Virginia University, United States, Oswaldo Cruz Foundation Rene Rachou Research Institute, Brazil, National Taiwan University, Taiwan, University of Chinese Academy of Sciences, China, University Medicine Greifswald, Germany, Consejería de Sanidad Junta de Castilla y León, Spain, University of Uppsala, Sweden, Universidade Federal de Ouro Preto, Brazil, The Jikei University School of Medicine, Japan, National Research Council, Italy, Baker Heart and Diabetes Institute, Australia, Agricultural University of Athens, Greece, Hospital Israelita Albert Einstein, Brazil, Shiraz University of Medical Sciences, Iran, Institute of Internal and Preventive Medicine, Russian Federation, Harokopio University, Greece, University of Otago, New Zealand, University of Padova, Italy, Lausanne University Hospital, Switzerland, CIBERCV, Spain, Emory University, United States, UiT The Arctic University of Norway, Norway, Cape Peninsula University of Technology, South Africa, Gorgas Memorial Institute of Health Studies, Panama, Brown University, United States, University of Edinburgh, United Kingdom, Statistics Canada, Canada, University College Dublin, Ireland, Institut National de la Santé et de la Recherche Médicale, France, Lusófona University, Portugal, Universita' degli Studi di Firenze, Italy, Ain Shams University, Egypt, Hypertension Research Center, Iran, University of Pécs, Hungary, Seoul National University Children's Hospital, South Korea, University Medical Science, Cuba, Universidad de Zaragoza, Spain, RCSI Dublin, Ireland, La Trobe University, Australia, International Institute of Molecular and Cell Biology, Poland, Ahvaz Jundishapur University of Medical Sciences, Iran, Gorgas Memorial Institute of Public Health, Panama, World Health Organization Country Office, Malawi, Department of Public Health, Myanmar, University of Brescia, Italy, Bushehr University of Medical Sciences, Iran, Ulm University, Germany, Kobe University, Japan, Suraj Eye Institute, India, University Medicine of Greifswald, Germany, INSERM, France, National Institute of Hygiene and Epidemiology, Viet Nam, The University of Pharmacy and Medicine of Ho Chi Minh City, Viet Nam, Hanoi Medical University, Viet Nam, National Hospital of Endocrinology, Viet Nam, Miami Veterans Affairs Healthcare System, United States, University of Turku Tyks, Finland, Heartfile, Pakistan, Eastern Mediterranean Public Health Network, Jordan, Tachikawa General Hospital, Japan, Academic Hospital of Paramaribo, Suriname, Ministry of Health, Brunei Darussalam, University of Madeira, Portugal, MRC Lifecourse Epidemiology Unit, United Kingdom, Aarhus University, Denmark, Kwame Nkrumah University of Science and Technology, Ghana, Institute for Social and Preventive Medicine, Switzerland, University of Coimbra, Portugal, Cancer Prevention and Research Institute, Italy, Ruprecht-Karls-University of Heidelberg, Germany, IRCCS Casa Sollievo della Sofferenza, Italy, Zayed University, United Arab Emirates, Catholic University of Daegu, South Korea, Jivandeep Hospital, India, University Hospital Centre Zagreb, Croatia, University Medical Center Utrecht, Netherlands, Vietnam National Heart Institute, Viet Nam, University of Sarajevo, Bosnia and Herzegovina, Cardiovascular Prevention Centre Udine, Italy, Ministry of Health and Medical Services, Solomon Islands, Public Health Agency of Catalonia, Spain, University of Split, Croatia, Digestive Oncology Research Center, Iran, Digestive Disease Research Institute, Iran, Alborz University of Medical Sciences, Iran, Ministry of Health, Viet Nam, University of Turku, Finland, Universiti Putra Malaysia, Malaysia, University of Malaya, Malaysia, University of Valencia, Spain, University of the Philippines, Philippines, Minas Gerais State Secretariat for Health, Brazil, Health Center San Agustín, Spain, PharmAccess Foundation, Netherlands, Universidade Nove de Julho, Brazil, Public Health Agency of Canada, Canada, Canarian Health Service, Spain, Universidad Industrial de Santander, Colombia, Instituto Nacional de Salud Pública, Mexico, Sitaram Bhartia Institute of Science and Research, India, Marmara University, Turkey, CIBER de Epidemiología y Salud Pública, Spain, University of Helsinki, Finland, National Institute of Health, Peru, Catalan Department of Health, Spain, Universidade de Lisboa, Portugal, University of Sao Paulo Clinics Hospital, Brazil, South Karelia Social and Health Care District, Finland, Isfahan Cardiovascular Research Center, Iran, Research and Education Institute of Child Health, Cyprus, Hospital Italiano de Buenos Aires, Argentina, Lagos State University College of Medicine, Nigeria, The University of Tokyo, Japan, Samsung Medical Center, South Korea, Federal University of Santa Catarina, Brazil, St Vincent's Hospital, Australia, Academic Medical Center Amsterdam, Netherlands, University of Bari, Italy, Lund University, Sweden, University of Copenhagen, Denmark, Institut Régional de Santé Publique, Benin, University of Bordeaux, France, University of Leuven, Belgium, Bonn University, Germany, Sotiria Hospital, Greece, National Institute of Public Health- National Institute of Hygiene, Poland, Fu Jen Catholic University, Taiwan, Ministry of Health, Jordan, Health Service of Murcia, Spain, IB-SALUT Area de Salut de Menorca, Spain, Institut de Recherche pour le Développement, France, Hellenic Health Foundation, Greece, GovernmentMedical College, India, Sefako Makgatho Health Science University, South Africa, Addis Ababa University, Ethiopia, Dasman Diabetes Institute, Kuwait, Ministry of Health, New Zealand, Universidad Centro-Occidental Lisandro Alvarado, Venezuela, University of Tampere Tays Eye Center, Finland, Utrecht University, Netherlands, Hanoi University of Public Health, Viet Nam, Amsterdam Public Health Research Institute, Netherlands, Universidade Federal de Minas Gerais, Brazil, Finnish Institute of Occupational Health, Finland, Universidad Miguel Hernandez, Spain, North Karelian Center for Public Health, Finland, University of the Witwatersrand, South Africa, University of Strasbourg, France, Institute for Medical Research, Malaysia, Xinjiang Medical University, China, Capital Medical University, China, St George's, University of London, United Kingdom, Medical University of Vienna, Austria, Universitas Indonesia, Indonesia, National Institute of Public Health-National Institute of Hygiene, Poland, Institute of Food and Nutrition Development of Ministry of Agriculture, China, Children's Hospital of Fudan University, China, University of Cyprus, Cyprus, Universiti Teknologi MARA, Malaysia, Inner Mongolia Medical University, China, Universidad Politécnica de Madrid, Spain, State University of Montes Claros, Brazil, and University of Limpopo, South Africa
Subjects: sense organs
Abstract: Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probittransformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the highincome Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups. © The Author(s) 2018.
Published: 2018

9. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults

Author: Ezzati, M, Bentham, J, Di Cesare, M, Bilano, V, Bixby, H, Zhou, B, Stevens, GA, Riley, LM, Taddei, C, Hajifathalian, K, Lu, Y, Savin, S, Cowan, MJ, Paciore, CJ, Chiritaemandi, A, Hayes, AJ, Katz, J, Kelishadi, R, Kengne, AP, Khang, Y-H, Laxmaiah, A, Li, Y, Ma, J, Miranda, JJ, Mostafa, A, Neovius, M, Padez, C, Rampal, L, Zhu, A, Bennet, JE, Danaei, G, Bhutta, ZA, Abarca-Gomez, L, Abdeen, ZA, Hamid, ZA, Abu-Rmeileh, NM, Acosta-Cazares, B, Acuin, C, Adams, RJ, Aekplakorn, W, Afsana, K, Aguilar-Salinas, CA, Agyemng, C, Ahmadvand, A, Ahrens, W, Ajlouni, K, Akhtaeva, N, Al-Hazzaa, HM, Al-Othman, AR, Al-Raddadi, R, AlBuhairan, F, AlDhukai, S, Ali, MM, Ali, O, Alkerwi, A, Alvarez-Pedrerol, M, Aly, E, Amarapurkar, DN, Amouyel, P, Amuzu, A, Andersen, LB, Anderssen, SA, Andrade, DS, Angquist, LH, Anjana, RM, Aounallah-Skhiri, H, Araujo, J, Arianse, I, Aris, T, Arlappa, N, Arveiler, D, Aryal, KK, Aspelund, T, Assah, FK, Assuncao, MCF, Aung, MS, Avdicova, M, Azevedo, A, Azizi, F, Babu, BV, Bahijri, S, Baker, JL, Balakrishna, N, Bamoshmoosh, M, Banach, M, Bandosz, P, Banegas, JR, Barbagallo, CM, Barcelo, A, Barkat, A, Barros, AJD, Barros, MVG, Bata, I, Batieha, AM, Batista, RL, Batyrbek, A, Baur, LA, Beaglehole, R, Ben Romdhane, H, Benedics, J, Benet, M, Bernabe, A, Bernotiene, G, Bettiol, H, Bhagyalaxmi, A, Bharadwaj, S, Bhargava, SK, Bhatti, Z, Bi, H, Bi, Y, Biehl, A, Bikbov, M, Bista, B, Bjelica, DJ, Bjerregaard, P, Bjertnes, E, Bjness, MB, Bjorkelund, C, Blokstra, A, Bo, S, Bobak, M, Boddy, LM, Boehm, BO, Boeing, H, Boggia, JG, Boissonnet, CP, Bonaccio, M, Bongard, V, Bovet, P, Braeckevelt, L, Braeckman, L, Bragt, MCE, Brajkovich, I, Branca, F, Breckenkamp, J, Breda, J, Brenner, H, Brewster, LM, Brian, GR, Brinduse, L, Bruno, G, Bueno-de-Mesquita, HB, Bugge, A, Buoncristiano, M, Burazeri, G, Burns, C, Cabrera de Leon, A, Cacciottolo, J, Cai, H, Cama, T, Cameron, C, Camola, J, Can, G, Candido, APCC, Capanzana, M, Capuano, V, Cardoso, VC, Carlsson, AC, Carvalho, MJ, Casanueva, FF, Casas, JP, Caserta, CA, Chamukuttan, S, Chan, AW, Chan, Q, Chaturvedi, HK, Chaturvedi, N, Chen, C-J, Chen, F, Chen, H, Chen, S, Chen, Z, Cheng, C-Y, Chetrit, A, Chikova-Iscener, E, Chiolero, A, Chiou, S-T, Chirita-Emandi, A, Chirlaque, M-D, Cho, B, Cho, Y, Christensen, K, Christofaro, DG, Chudek, J, Cifkova, R, Cinteza, E, Claessens, F, Clays, E, Concin, H, Confortin, SC, Cooper, C, Cooper, R, Coppinger, TC, Costanzo, S, Cottel, D, Cowell, C, Craig, CL, Crujeiras, AB, Cucu, A, D'Arrigo, G, d'Orsi, E, Dallongeville, J, Damasceno, A, Damsgaard, CT, Danae, G, Dankner, R, Dantoft, TM, Dastgiri, S, Dauchet, L, Davletov, K, De Backer, G, De Bacquer, D, De Curtis, A, de Gaetano, G, De Henauw, S, de Oliveira, PD, De Ridder, K, De Smedt, D, Deepa, M, Deev, AD, Dehghan, A, Delisle, H, Delpeuch, F, Deschamps, V, Dhana, K, Di Castelnuovo, AF, Dias-da-Costa, JS, Diaz, A, Dika, Z, Djalalinia, S, Do, HTP, Dobson, AJ, Donati, MB, Donfrancesco, C, Donoso, SP, Doering, A, Dorobantu, M, Dorosty, AR, Doua, K, Drygas, W, Duan, JL, Duante, C, Duleva, V, Dulskiene, V, Dzerve, V, Dziankowska-Zaborszczyk, E, Egbagbe, EE, Eggertsen, R, Eiben, G, Ekelund, U, El Ati, J, Elliott, P, Engle-Stone, R, Erasmus, RT, Erem, C, Eriksen, L, Eriksson, JG, Escobedo, J, Evans, A, Faeh, D, Fall, CH, Sant'Angelo, VF, Farzadfar, F, Felix-Redondo, FJ, Ferguson, TS, Fernandes, RA, Fernandez-Berges, D, Ferrante, D, Ferrari, M, Ferreccio, C, Ferrieres, J, Finn, JD, Fischer, K, Monterubio Flores, E, Foeger, B, Foo, LH, Forslund, A-S, Forsner, M, Fouad, HM, Francis, DK, Franco, MDC, Franco, OH, Frontera, G, Fuchs, FD, Fuch, SC, Fujita, Y, Furusawa, T, Gaciong, Z, Gafencu, M, Galeone, D, Galvano, F, Garcia-de-la-Hera, M, Gareta, D, Garnett, SP, Gaspoz, J-M, Gasull, M, Gates, L, Geiger, H, Geleijnse, JM, Ghasemian, A, Giampaoli, S, Gianfagna, F, Gill, TK, Giovannelli, J, Giwerman, A, Godos, J, Gogen, S, Goldsmith, RA, Goltzman, D, Goncalves, H, Gonzalez-Leon, M, Gonzalez-Rivas, JP, Gonzalez-Gross, M, 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Subjects: SDG 3 - Good Health and Well-being, Medicine (all)
Abstract: Made available in DSpace on 2018-11-26T20:04:45Z (GMT). No. of bitstreams: 0 Previous issue date: 2017-12-16 Wellcome Trust AstraZeneca Background Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults. Methods We pooled 2416 population-based studies with measurements of height and weight on 128.9 million participants aged 5 years and older, including 31.5 million aged 5-19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged 5-19 years: more than 2 SD below the median of the WHO growth reference for children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below the median (mild underweight), 1 SD below the median to 1 SD above the median (healthy weight), more than 1 SD to 2 SD above the median (overweight but not obese), and more than 2 SD above the median (obesity). Findings Regional change in age-standardised mean BMI in girls from 1975 to 2016 ranged from virtually no change (-0.01 kg/m (2) per decade; 95% credible interval -0.42 to 0.39, posterior probability [PP] of the observed decrease being a true decrease= 0.5098) in eastern Europe to an increase of 1.00 kg/m(2) per decade (0.69-1.35, PP> 0.9999) in central Latin America and an increase of 0.95 kg/m (2) per decade (0.64-1.25, PP> 0.9999) in Polynesia and Micronesia. The range for boys was from a non-significant increase of 0.09 kg/m(2) per decade (-0.33 to 0.49, PP= 0.6926) in eastern Europe to an increase of 0.77 kg/m (2) per decade (0.50-1.06, PP> 0.9999) in Polynesia and Micronesia. Trends in mean BMI have recently flattened in northwestern Europe and the high-income English-speaking and Asia-Pacific regions for both sexes, southwestern Europe for boys, and central and Andean Latin America for girls. By contrast, the rise in BMI has accelerated in east and south Asia for both sexes, and southeast Asia for boys. Global age-standardised prevalence of obesity increased from 0.7% (0.4-1.2) in 1975 to 5.6% (4.8-6.5) in 2016 in girls, and from 0.9% (0.5-1.3) in 1975 to 7.8% (6.7-9.1) in 2016 in boys; the prevalence of moderate and severe underweight decreased from 9.2% (6.0-12.9) in 1975 to 8.4% (6.8-10.1) in 2016 in girls and from 14.8% (10.4-19.5) in 1975 to 12.4% (10.3-14.5) in 2016 in boys. Prevalence of moderate and severe underweight was highest in India, at 22.7% (16.7-29.6) among girls and 30.7% (23.5-38.0) among boys. Prevalence of obesity was more than 30% in girls in Nauru, the Cook Islands, and Palau; and boys in the Cook Islands, Nauru, Palau, Niue, and American Samoa in 2016. Prevalence of obesity was about 20% or more in several countries in Polynesia and Micronesia, the Middle East and north Africa, the Caribbean, and the USA. In 2016, 75 (44-117) million girls and 117 (70-178) million boys worldwide were moderately or severely underweight. In the same year, 50 (24-89) million girls and 74 (39-125) million boys worldwide were obese. Interpretation The rising trends in children's and adolescents' BMI have plateaued in many high-income countries, albeit at high levels, but have accelerated in parts of Asia, with trends no longer correlated with those of adults. Imperial Coll London, Sch Publ Hlth, London W2 1PG, England Univ Kent, Canterbury, Kent, England Imperial College London, London, England Middlesex Univ, London, England WHO, Geneva, Switzerland Cleveland Clin, Cleveland, OH 44106 USA Yale Univ, New Haven, CT 06520 USA Univ Calif Berkeley, Berkeley, CA USA Victor Babes Univ Med & Pharm Timisoara, Timisoara, Romania Univ Sydney, Sydney, NSW, Australia Johns Hopkins Univ, Baltimore, MD 21218 USA Isfahan Univ Med Sci, Esfahan, Iran South African Med Res Council, Cape Town, South Africa Seoul Natl Univ, Seoul, South Korea Natl Inst Nutr, Secunderabad, India Harvard TH Chan Sch Publ Hlth, Boston, MA USA Peking Univ, Beijing, Peoples R China Univ Peruana Cayetano Heredia, Lima, Peru Ain Shams Univ, Cairo, Egypt Karolinska Inst, Stockholm, Sweden Univ Coimbra, Coimbra, Portugal Univ Putra Malasia, Seri Kembangan, Malaysia Hosp Sick Children, Toronto, ON, Canada Aga Khan Univ, Karachi, Pakistan Caja Costarricense Seguro Social, San Jose, Costa Rica Al Quds Univ, Jerusalem, Palestine Ctr Diabet & Endocrine Care, Bengaluru, India Birzeit Univ, Birzeit, Palestine Inst Mexicano Seguro Social, Mexico City, DF, Mexico Int Rice Res Inst, Los Banos, Philippines Univ Adelaide, Adelaide, SA, Australia Mahidol Univ, Salaya, Nakhon Pathom, Thailand BARC, Dhaka, Bangladesh Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Mexico City, DF, Mexico Univ Amsterdam, Amsterdam, Netherlands Noncommun Dis Res Ctr, Tehran, Iran Leibniz Inst Prevent Res & Epidemiol BIPS, Leipzig, Germany Natl Ctr Diabet Endocrinol, Amman, Jordan Kazakh Natl Med Univ, Alma Ata, Kazakhstan King Saud Univ, Riyadh, Saudi Arabia Kuwait Inst Sci Res, Kuwait, Kuwait Minist Hlth, Riyadh, Saudi Arabia King Abdullah Int Med Res Ctr, Riyadh, Saudi Arabia Univ Malaysia Sabah, Kota Kinabalu, Malaysia Luxembourg Inst Hlth, Luxembourg, Luxembourg ISGlobal Ctr Res Environm Epidemol, Barcelona, Spain WHO, Reg Off Eastern Mediterranean, Cairo, Egypt Bombay Hosp & Med Res Ctr, Bombay, Maharashtra, India Lille Univ & Hosp, Lille, France London Sch Hyg & Trop Med, London, England Western Norway Univ App Sci, Bergen, Norway Norwegian Sch Sport Sci, Oslo, Norway Univ Cuenca, Cuenca, Ecuador Bispebjerg Hosp, Copenhagen, Denmark Frederiksberg Univ Hosp, Copenhagen, Denmark Madras Diabet Res Fdn, Madras, Tamil Nadu, India Natl Inst Publ Hlth, Tunis, Tunisia Univ Porto, Oporto, Portugal Norwegian Inst Publ Hlth, Oslo, Norway Minist Hlth Malaysia, Putrajaya, Malaysia Natl Inst Nutr, Bangalore, Karnataka, India Univ Strasbourg, Strasbourg, France Strasbourg Univ Hosp, Strasbourg, France Nepal Hlth Res Council, Kathmandu, Nepal Univ Iceland, Reykjavik, Iceland Univ Yaounde, Yaounde, Cameroon Univ Fed Pelotas, Pelotas, Brazil Univ Med, Yangon, Myanmar Univ Porto, Med Sch, Oporto, Portugal Shahid Beheshti Univ Med Sci, Tehran, Iran Indian Council Med Res, New Delhi, India King Abdulaziz Univ, Riyadh, Saudi Arabia Univ Sci & Technol, Taizi, Yemen Med Univ Lodz, Lodz, Poland Med Univ Gdansk, Gdansk, Poland Univ Autonoma Madrid, Madrid, Spain Univ Palermo, Palermo, Italy Pan Amer Hlth Org, Washington, DC USA Mohammed V Univ Rabat, Rabat, Morocco Univ Pernambuco, Recife, PE, Brazil Dalhousie Univ, Calgary, AB, Canada Jordan Univ Technol, Amman, Jordan Univ Fed Maranhao, Sao Luis, Brazil Univ Auckland, Auckland, New Zealand Univ Tunis El Manar, El Manar, Tunisia Fed Minist Hlth & Womens Affairs, Vienna, Austria CAFAM Univ Fdn, Bogota, Colombia Imperial Coll London, London, England Lithuanian Univ Hlth Sci, Kaunas, Lithuania Univ Sao Paulo, Sao Paulo, Brazil BJ Med Coll, Pune, Maharashtra, India Chirayu Med Coll, Bhopal, India Sunder Lal Jain Hosp, Delhi, India Shandong Univ Tradit Chinese Med, Shanghai, Peoples R China Shanghai Jiao Tong Univ, Sch Med, Shanghai, Peoples R China Norwegian Inst Publ, Oslo, Norway Ufa Eye Res Inst, Moscow, Russia Univ Montenegro, Montenegro, Mexico Univ Southern Denmark, Lyngby, Denmark Univ Oslo, Oslo, Norway Univ Gothenburg, Gothenburg, Sweden Natl Inst Publ Hlth & Environm, Amsterdam, Netherlands Univ Turin, Turin, Italy UCL, London, England Liverpool John Moores Univ, Liverpool, Merseyside, England Nanyang Technol Univ, Singapore, Singapore German Inst Human Nutr, Hamburg, Germany Univ Republica, Montevideo, Uruguay CEMIC, La Plata, Buenos Aires, Argentina IRCCS Ist Neurol Mediterraneo Neuromed, Naples, Italy Toulouse Univ, Sch Med, Toulouse, France Univ Lausanne, Minist Hlth, Lausanne, Switzerland Flemish Agcy Care & Hlth, Brussels, Belgium Univ Ghent, Ghent, Belgium FrieslandCampina, Amersfoort, Netherlands Univ Cent Venezuela, Caracas, Venezuela Bielefeld Univ, Bielefeld, Germany WHO, Reg Off Europe, Copenhagen, Denmark German Canc Res Ctr, Heidelberg, Germany Fred Hollows Fdn New Zealand, Auckland, New Zealand Carol Davila Univ Med & Pharm, Bucharest, Romania Natl Inst Publ Hlth & Environm, Amersroot, Netherlands Univ Southern Denmark, Copenhagen, Denmark Inst Publ Hlth, Tirana, Albania Cork Inst Technol, Cork, Ireland Univ La Laguna, San Cristobal la Laguna, Spain Univ Malta, Msida, Malta Vanderbilt Univ, 221 Kirkland Hall, Nashville, TN 37235 USA Minist Hlth, Pangai, Tonga Canadian Fitness & Lifestyle Res Inst, Ottawa, ON, Canada Hosp Santa Maria, Lisbon, Portugal Istanbul Univ, Istanbul, Turkey Univ Fed Juiz de Fora, Juiz De Fora, Portugal Food & Nutr Res Inst, Manila, Philippines Santiago de Compostela Univ, Santiago De Compostela, Spain Assoc Calabrese Epatol, Perugia, Italy India Diabet Res Fdn, Delhi, India Duke NUS Med Sch, Singapore, Singapore Natl Inst Med Stat, New Delhi, India Acad Sinica, Taipei, Taiwan Capital Inst Pediat, Beijing, Peoples R China Duke Univ, Durham, NC 27706 USA Kailuan General Hospital, Tangshan, Peoples R China Univ Oxford, Oxford, England Duke NUS MEd Sch, Singapore, Singapore Gertner Inst Epidemiol & Hlth Policy Res, Tel Aviv, Israel Natl Ctr Publ Hlth & Anal, Sofia, Bulgaria Univ Bern, Bern, Switzerland Minist Hlth & Welfare, Taipei, Taiwan Murcia Reg Hlth Council, Murcia, Spain Seoul Natl Univ, Coll Med, Seoul, South Korea Korea Ctr Dis Control & Prevent, Seoul, South Korea Univ Estadual Paulista, Sao Paulo, Brazil Med Univ Silesia, Katowice, Poland Charles Univ Prague, Prague, Czech Republic Katholieke Univ Leuven, Leuven, Belgium Agcy Prevent & Social Med, Vienna, Austria Univ Fed Santa Catarina, Sao Carlos, SP, Brazil Univ Southampton, Southampton, Hants, England Inst Pasteur, Lille, France CIBEROBN, Barcelona, Spain Natl Inst Publ Hlth, Bucharest, Romania Natl Council Res, Rome, Italy Univ Fed Santa Catarin, Sao Carlos, SP, Brazil Eduardo Mondlane Univ, Maputo, Mozambique Univ Copenhagen, Copenhagen, Denmark Res Ctr Prevent & Hlth, Glostrup, Denmark Tabriz Hlth Serv Managemnet Ctr, Tabriz, Iran Lille Univ Hosp, Lille, France Sci Inst Publ Hlth, Brussels, Belgium Madaras Diabet Res Fdn, Chennai, India Natl Res Ctr Prevent Med, Moscow, Russia Erasmus MC, Rotterdam, Netherlands Univ Montreal, Montreal, PQ, Canada Inst Rech Dev, Montpellier, France French Publ Hlth Agcy, St Maurice, France Univ Vale Rio Sino, Sao Leopoldo, Brazil Natl Council Sci & Tech Res, Buenos Aires, DF, Argentina Univ Zagreb, Zagreb, Croatia Univ Tehran Med Sci, Tehran, Iran Natl Inst Nutr, Hanoi, Vietnam Univ Queensland, Brisbane, Qld, Australia Ist Super Sanita, Rome, Italy Helmholtz Zentrum Munchen, Munich, Germany Minist Sante & Lutte Contre Sida, Abidjan, Cote Ivoire Cardinal Wyszynski Inst Cardiol, Warsaw, Poland Beijing Ctr Dis Prevent & Control, Beijing, Peoples R China Univ Latvia, Riga, Latvia Univ Benin, Benin, Nigeria Univ Skovde, Skovde, Sweden Natl Inst Nutr & Food Technol, Tunis, Tunisia Univ Calif Davis, Davis, CA 95616 USA Univ Stellenbosch, Stellenbosch, South Africa Karadeniz Tech Univ, Trabzon, Turkey Univ Southern Copenhagen, Copenhagen, Denmark Natl Inst Hlth & Welfare, Helsinki, Finland Queens Univ Belfast, Belfast, Antrim, North Ireland Univ Zurich, Zurich, Switzerland Primary Health Care, Floriana, Malta Ctr Salud Villanueva Norte, Villanueva De La Serena, Spain Univ West Indies, Mona, Jamaica Hosp Don Benito Villanueva de la Serena, Villanueva De La Serena, Spain Minist Hlth, Buenos Aires, DF, Argentina Council Agr Res & Econ, Rome, Italy Pontificia Univ Catolica Chile, Santiago, Chile Univ Toulouse, Sch Med, Toulouse, France Univ Manchester, Manchester, Lancs, England Univ Tartu, Tartu, Estonia Inst Nacl Salud Publ, Cuernavaca, Morelos, Mexico Univ Sains Malaysia, George Town, Malaysia Umea Univ, Umea, Sweden Dalarna University, Falun, Sweden Univ West Indies, Kingston, Jamaica Univ Fed Sao Paulo, Sao Paulo, Brazil Hosp Univ Son Espases, Palma De Mallorca, Spain Hosp Clin Porto Alegre, Porto Alegre, RS, Brazil Univ Fed Rio Grande do Sul, Rio Grande, Brazil Kindai Univ, Higashiosaka, Osaka, Japan Kyoto Univ, Kyoto, Japan Med Univ Warsaw, Warsaw, Poland Minist Hlth, Rome, Italy Univ Catania, Catania, Italy CIBER Epidemiol & Salud Publ, Barcelona, Spain Univ KwaZulu Natal, Durban, South Africa Geneva Univ Hosp, Geneva, Switzerland Australian Bur Stat, Canberra, ACT, Australia Agcy Prevent & Social Med, Innsbruck, Austria Wageningen Univ, Wageningen, Netherlands Noncommunicable Dis Res Ctr, Shiraz, Iran Univ Insubria, Varese, Italy Lund Univ, Lund, Sweden Minist Hlth, Ankara, Turkey Minist Hlth, Jerusalem, Israel McGill Univ, Montreal, PQ, Canada Andes Clin Cardiometab Studies, Timotes, Venezuela Univ Politecn Madrid, Madrid, Spain Univ Lille 2, Lille, France Minist Hlth, Lisbon, Portugal Inst Clin & Expt Med, Prague, Czech Republic Childrens Mem Hlth Inst, Warsaw, Poland Alexander Technol Educ Inst, Sindos, Greece Dalhousie Univ, Halifax, NS, Canada Jagiellonian Univ, Med Coll, Krakow, Poland Univ Southern Denmark, Odense, Denmark Azienda Osped Univ Policlin Vittorio Emanuele, Catania, Italy Univ Novi Sad, Novi Sad, Serbia Natl Ctr Cardiovasc Dis, Beijing, Peoples R China Univ Ferrara, Ferrara, Italy Singapore Eye Res Inst, Singapore, Singapore Iceland Heart Assoc, Kopavogur, Iceland Univ Icesi, Cali, Colombia Univ Estadual Montes Claros, Montes Claros, Brazil Kings Coll London, London, England Int Agcy Res Canc, Lyon, France Capital Med Univ, Beijing, Peoples R China Healis Sekhsaria Inst Publ Hlth, Navi Mumbai, India Eternal Heart Care Ctr Res Inst, Jaipur, Rajasthan, India Univ Ibadan, Ibadan, Nigeria Childrens Memorial Hlth Inst, Warsaw, Poland Inst Clin Effectiveness & Hlth Policy, Buenos Aires, DF, Argentina Res & Educ Inst Child Hlth, Nicosia, Cyprus Minist Hlth, Seri Begawan, Brunei Danish Canc Soc, Res Ctr, Copenhagen, Denmark Univ West Indies, Bridgetown, Barbados Alexander Technol Educ Inst Thessaloniki, Sindos, Greece Kyushu Univ, Fukuoka, Japan Tulane Univ, New Orleans, LA 70118 USA Univ Pecs, Pecs, Hungary Univ Coll Dublin, Dublin, Ireland Univ Amsterdam, Acad Med Ctr, Amsterdam, Netherlands Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico Oulu Univ Hosp, SF-90100 Oulu, Finland Univ Autonoma Bucaramanga, Bucaramanga, Colombia Swiss Fed Inst Technol, Zurich, Switzerland Chron Diseases Res Ctr, Tehran, Iran Univ Hong Kong, Hong Kong, Hong Kong, Peoples R China Chinese Univ Hong Kong, Hong Kong, Hong Kong, Peoples R China Univ Western Australia, Perth, WA, Australia Kingston Gen Hosp, Kingston, ON, Canada Heart Inst, Sao Paulo, Brazil Fdn Oftalmol Santander, Floridablanca, Colombia Univ Oran 1, Oran, Algeria Minist Hlth, Naypyitaw, Myanmar Vrije Univ Amsterdam, Med Ctr, Amsterdam, Netherlands Vrije Univ Amsterdam, Amsterdam, Netherlands Amer Univ Beirut, Beirut, Lebanon IRCCS Ist Neurol Mediterraneo Neuromed, Pozzilli, Italy Cardiol Mercato S Severino, Mercato San Severino, Italy Cairo Univ, Giza, Egypt Natl Inst Hlth & Nutr, Tokyo, Japan UHC Zagreb, Zagreb, Croatia Niigata Univ, Niigata, Japan Hadassah Univ, Med Ctr, Jerusalem, Israel Jordan Univ Sci & Technol, Irbid, Jordan Norwegian Univ Sci & Technol, Trondheim, Norway Sports Univ Tirana, Tirana, Albania Univ Zagreb, Sch Med, Zagreb, Croatia Heart Fdn, Fortitude Valley, Australia Natl Hlth Insurance Serv, Seoul, South Korea Guangzhou 12th Hosp, Guangzhou, Guangdong, Peoples R China Natl Inst Hyg Epidemiol & Microbiol, Havana, Cuba Simon Fraser Univ, Burnaby, BC, Canada Heidelberg Univ, Heidelberg, Germany World Hlth Org Country Off, Agra, Uttar Pradesh, India Inst Publ Hlth Serbia, Belgrade, Serbia Czestochowa Tech Univ, Czestochowa, Poland Univ Ljubljana, Ljubljana, Slovenia Univ Crete, Rethimnon, Greece Univ Kebangsaan Malaysia, Bangi, Malaysia Hellen Med Assoc Obes, Athens, Greece Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD USA Univ Eastern Finland, Joensuu, Finland Natl Inst Epidemiol, Madras, Tamil Nadu, India Ufa Eye Res Inst, Ufa, Russia Univ Munster, Munster, Germany Israel Ctr for Dis Control, Ramat Gan, Israel Oulu Univ Hosp, Oulu, Finland Isfahan Univ Med Sci, Isfahan, Israel Kyrgyz State Med Acad, Bishkek, Kyrgyzstan Res Inst Child Nutr, Dortmund, Germany Natl Ctr Diabetes & Endocrinol, Amman, Jordan Univ Cambridge, Cambridge, England Med Univ Innsbruck, Innsbruck, Austria Muhimbili Univ Hlth & Allied Sci, Dar Es Salaam, Tanzania Natl Canc Ctr, Goyang Si, South Korea Natl Hlh Insurance Serv, Seoul, South Korea Stat Austria, Vienna, Austria BP Koirala Inst Hlth Sci, Dharan, Nepal Inst Trop Med, Antwerp, Belgium Tartu Univ Clin, Tartu, Estonia Natl Inst Pharm & Nutr, Budapest, Hungary Minis Hlth & Qual Life, Port Louis, Mauritius Polish Acad Sci, Anthropol Unit Wroclaw, Wroclaw, Poland Univ Hosp Ulm, Ulm, Germany Univ Groningen, Groningen, Netherlands North West Univ, Potchefstroom, South Africa Natl Inst Publ Hlth, Prague, Czech Republic Univ Jyvaskyla, Jyvaskyla, Finland Amrita Inst Med Sci, Thiruvananthapuram, Kerala, India Inst Endocrinol, Prague, Czech Republic All India Inst Med Sci, New Delhi, India African Populat & Hlth Res Ctr, Nairobi, Kenya Hanoi Univ Publ Hlth, Hanoi, Vietnam Higher Inst Nursing Profess & Tech Hlth Morocco, Rabat, Morocco Natl Inst Publ Hlth Algeria, Algiers, Algeria Minist Salud Publ, Havana, Cuba Sahlgrens Acad, Gothenburg, Sweden Endocrinol & Met Res Ctr, Arak, Iran Indicium Res, Manila, Philippines Food & Agr Org, Rome, Italy Natl Univ Singapore, Singapore, Singapore Tampere Univ Hosp, Tampere, Finland Univ Cape Town, Cape Town, South Africa West Virginia Univ, Morgantown, WV USA Fundacao Oswaldo Cruz, Rene Rachou Res Inst, Belo Horizonte, MG, Brazil Natl Taiwan Univ, Taipei, Taiwan Univ Chinese Acad Sci, Beijing, Peoples R China Uppsala Univ, Uppsala, Sweden Capital Med Univ, Beijing An Zhen Hosp, Beijing, Peoples R China Natl Inst Hlth Dev, Tallinn, Estonia Univ Med Greifswald, Greifswald, Germany Consejeria Sanidad Junta Castilla & Leon, Valladolid, Spain Univ Fed Ouro Pret, Ouro Preto, Brazil Jikei Univ, Sch Med, Tokyo, Japan CNR, Rome, Italy Baker Heart & Diabet Inst, Melbourne, Vic, Australia Agr Univ Athens, Athens, Greece Univ Putra Malaysia, Seri Kembangan, Malaysia Inst Rech Dev, Marseille, France Hosp Israelita Albert Einstein, Sao Paulo, Brazil Shiraz Univ Med Sci, Shiraz, Iran Inst Internal & Prevent Med, Novosibirsk, Russia Harokopio Univ, Kallithea, Greece Univ Otago, Dunedin, New Zealand Univ Padua, Padua, Italy Technol Educ Inst Crete, Iraklion, Greece Loughborough Univ Technol, Loughborough, Leics, England Univ Fed Santa Catarina, Florianopolis, SC, Brazil Lausanne Univ Hosp, Lausanne, Switzerland Inst Hosp Mard Invest Med, Barcelona, Spain Mary Immaculate Coll, Limerick, Ireland Emory Univ, Atlanta, GA 30322 USA Hungarian Soc Sports Med, Budapest, Hungary Sherikashmir Inst Med Sci, Srinagar, Jammu & Kashmir, India UiT Arctic Univ Norway, Tromso, Norway Cape Peninsula Univ Technol, Cape Town, South Africa Univ Rzeszow, Rzeszow, Poland Univ Yaounde I, Yaounde, Cameroon Brown Univ, Providence, RI 02912 USA Univ Edinburgh, Edinburgh, Midlothian, Scotland Stat Canada, Ottawa, ON, Canada Int Med Univ, Kuala Lumpur, Malaysia INSERM, Villejuif, France Helmholtz Zentrum Munchen, Oberschleissheim, Germany Robert Koch Inst, Berlin, Germany Lusofona Univ, Lisbon, Portugal Democritus Univ Greece, Komotini, Greece Grigore T Popa Univ Med & Pharm, Iasi, Romania Univ Firenze, Florence, Italy Hypertens Res Ctr, Esfahan, Iran Mulago Hosp, Kampala, Uganda Univ Limpopo, Polokwane, South Africa Seoul Natl Univ, Childrens Hosp, Seoul, South Korea Univ Fed Rio Grande do Sul, Porto Alegre, RS, Brazil Univ Med Sci, Havana, Cuba Univ Zaragoza, Zaragoza, Spain R CSI Dublin, Dublin, Ireland Int Inst Mol & Cell Biol, Warsaw, Poland Ain Shams University, Cairo, Egypt Ahvaz Jundishapur Univ Med Sci, Ahwaz, Iran Gorgas Memorial Inst Publ Hlth, Panama City, Panama Dept Publ Hlth, Nay Pyi Taw, Myanmar Univ Brescia, Brescia, Italy Helmholtz Zentrum Munchen, Neuherberg, Germany Univ Eastern Finland, Kuopio, Finland Mary Immaculate Coll, Tours, France Bushehr Univ Med Sci, Bushehr, Iran Ulm Univ, Ulm, Germany Inst Publ Hlth, Kuala Lumpur, Malaysia Kobe Univ, Kobe, Hyogo, Japan Banska Bystrica Reg Author Publ Hlth, Banska Bystrica, Slovakia Suraj Eye Inst, Nagpur, Maharashtra, India Helen Keller Int, Yaounde, Cameroon Karolinska Inst, Solna, Sweden Natl Inst Hyg & Epidemiol, Hanoi, Vietnam Univ Pharm & Med Ho Chi Minh City, Ho Chi Minh City, Vietnam Hanoi Med Univ, Hanoi, Vietnam Miami Vet Affairs Healthcare Syst, Miami, FL USA Heartfile, Islamabad, Pakistan Natl Canc Ctr, Tokyo, Japan Eastern Mediterranean Publ Hlth Network, Amman, Jordan State Univ Med & Pharm, Kishinev, Moldova Tachikawa Gen Hosp, Tachikawa, Tokyo, Japan Acad Hosp Paramaribo, Paramaribo, Surinam Univ Vale Rio dos Sinos, Sao Leopoldo, Brazil Natl Food & Nutr Inst, Warsaw, Poland Minist Hlth, Bandar Seri Begawan, Brunei Univ Fed Santa Catarin, Florianopolis, SC, Brazil Univ Madeira, Funchal, Portugal Univ Puerto Rico, San Juan, PR USA MRC Lifecourse Epidemiol Unit, Southampton, Hants, England Aarhus Univ, Aarhus, Denmark Kwame Nkrumah Univ Sci & Technol, Kumasi, Ghana Inst Social & Prevent, Lausanne, Switzerland Canc Prevent & Res Inst, Florence, Italy Univ Wisconsin Madison, Madison, WI USA IRCCS Casa Sollievo Sofferenz, San Giovanni Rotondo, Italy Zayed Univ, Dubai, U Arab Emirates Catholic Univ Daegu, Gyongsan, South Korea Tg Mures Univ Med & Pharm, Targu Mures, Romania Jivandeep Hosp, Surat, India South African Med Res Council, Tygerberg, South Africa Univ Med Ctr Utrecht, Utrecht, Netherlands Fundacao Oswaldo Cruz, Rene Rachou Res Inst, Rio De Janeiro, Brazil Spanish Agcy Consumer Affairs Social Serv & Nutr, Madrid, Spain Univ Puerto Rico, Med Sci Campus, San Juan, PR USA Minist Hlth & Med Educ, Tehran, Iran Vietnam Natl Heart Inst, Hanoi, Vietnam Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany Univ Sarajevo, Sarajevo, Bosnia & Herceg Cardiovasc Prevent Ctr Udine, Udine, Italy Univ Hosp Pisa, Pisa, Italy Minist Hlth & Med Serv, Honiara, Solomon Islands Publ Hlth Agcy Catalonia, Barcelona, Spain Univ Kebangsaan Malaysia, Kuala Lumpur, Malaysia Univ Montenegro, Podgorica, Montenegro Inst Hosp Mar Invest Med, Barcelona, Spain Agcy Prevent and Social Med, Innsbruck, Austria Digest Oncol Res Ctr, Tehran, Iran Digest Dis Res Inst, Tehran, Iran CHU Vaudois, Lausanne, Switzerland Ctr Dis & Prevent Control, Riga, Latvia Al Quds Univ, Jerusalem, Israel Alborz Univ Med Sci, Karaj, Iran Minist Hlth, Hanoi, Vietnam BRAC, Dhaka, Bangladesh Inst Epidemiol Dis Control & Res, Dhaka, Bangladesh Univ Turku, Turku, Finland India Diabet Res Fdn, Madras, Tamil Nadu, India Univ New South Wales, Sydney, NSW, Australia Inst Univ Invest Atencio Primaria Jordi Gol, Barcelona, Spain Univ Malaya, Kuala Lumpur, Malaysia Univ Valencia, Valencia, Spain Univ Philippines, Quezon City, Philippines Nutr Res Fdn, Barcelona, Spain Minas Gerais State Secretariat Hlth, Belo Horizonte, MG, Brazil Hlth Ctr San Agustin, San AgustIn, Spain PharmAccess Fdn, Amsterdam, Netherlands Natl Inst Hlth Doutor Ricardo Jorge, Lisbon, Portugal Publ Hlth Agcy Canada, Ottawa, ON, Canada Canarian Hlth Serv, Barcelona, Spain Univ Ind Santander, Bucaramanga, Colombia Inst Nacl Salud Publ, Mexico City, DF, Mexico CIBEROBN, Madrid, Spain Gothenburg Univ, Gothenburg, Sweden Fiji Natl Univ, Suva, Fiji CNR, Inst Food Sci, Rome, Italy Sitaram Bhartia Inst Sci & Res, New Delhi, India Univ Tunis El Mana, Tunis, Tunisia Natl Inst Publ Hlth, Mexico City, DF, Mexico Univ Helsinki, Helsinki, Finland Natl Inst Hlth Peru, Lima, Peru Minist Hlth, South Jakarta, Indonesia Catalan Dept Hlth, Barcelona, Spain Publ Hlth Subdelegate Off, Barcelona, Spain Univ Lisbon, Lisbon, Portugal Prevent Med & Publ Hlth, Lisbon, Portugal Univ Sao Paulo, Clin Hosp, Sao Paulo, Brazil South Karelia Social & Hlth Care Dist, Lappeenranta, Finland Isfahan Cardiovasc Res Ctr, Esfahan, Iran Hosp Italiano Buenos Aires, Buenos Aires, DF, Argentina Rigshosp, Copenhagen, Denmark Minist Hlth, Naypyidaw, Myanmar Lagos State Univ, Coll Med, Lagos, Nigeria Univ Las Palmas Gran Canaria, Las Palmas Gran Canaria, Spain Baker Heart and Diabet Inst, Melbourne, Vic, Australia Univ Tokyo, Tokyo, Japan Samsung Med Ctr, Seoul, South Korea Finnish Inst Occupat Hlth, Helsinki, Finland St Vincents Hosp, Melbourne, Vic, Australia Acad Med Ctr Amsterdam, Amsterdam, Netherlands Hlth Polytech Jakarta II Inst, Jakarta, Indonesia Univ Bari, Bari, Italy Inst Reg Sante Publ, Cotonou, Benin Univ Bordeaux, Bordeaux, France Inst Publ Hlth Republ Macedonia, Skopje, Macedonia Univ Leuven, Leuven, Belgium Lamprecht & Stamm Sozialforsch & Beratung AG, Zurich, Switzerland INSERM, Paris, France Univ Bonn, Bonn, Germany Sotiria Hosp, Athens, Greece Natl Inst Publ Hlth, Natl Inst Hyg, Warsaw, Poland Swansea Univ, Swansea, W Glam, Wales Fu Jen Catholic Univ, New Taipei, Taiwan Minist Hlth, Amman, Jordan Natl Inst Hlth, Lima, Peru UNICEF, Yaounde, Cameroon Danish Canc Soc Res Ctr, Copenhagen, Denmark Hlth Serv Murcia, Murcia, Spain Res & Educ Inst, Nicosia, Cyprus IB SALUT Area Salut Menorca, Palma de Mallorca, Spain Univ Bologna, Bologna, Italy Hellen Hlth Fdn, Athens, Greece Univ Pharm & Med Ho Chi Min City, Ho Chi Minh, Vietnam Governm Med Coll, Secunderabad, India Sefako Makgatho Hlth Sci Univ, Kangnung, South Korea Addis Ababa Univ, Addis Ababa, Ethiopia Dasman Diabet Inst, Kuwait, Kuwait Minist Hlth, Thorndon, New Zealand Hellen Med Associat Obes, Athens, Greece Univ Ctr Occidental Lisandro Alvarado, Barquisimeto, Venezuela Meharry Med Coll, Nashville, TN USA Dokuz Eylul Univ, Izmir, Turkey Univ Tampere, Tays Eye Ctr, Tampere, Finland Polytech Inst Porto, Oporto, Portugal Univ Utrecht, Utrecht, Netherlands Amsterdam Publ Hlth Res Inst, Amsterdam, Netherlands Univ Fed Minas Gerais, Belo Horizonte, MG, Brazil Natl Inst Publ Hlth & Environm, Bilthoven, Netherlands Fed Univ Pelota, Pelotas, Brazil Italian Natl Res Council, Rome, Italy Univ Miguel Hernandez, Elche, Spain Minist Hlth, Victoria, Seychelles North Karelian Ctr Publ Hlth, Joensuu, Finland ISGlobal Ctr Res Environm Epidemiol, Barcelona, Spain Univ Witwatersrand, Johannesburg, South Africa Med Univ Vienna, Vienna, Austria Univ Coll Cork, Cork, Ireland Inst Med Res, Kuala Lumpur, Malaysia Xinjiang Med Univ, Urumqi, Peoples R China St Georges Univ London, London, England Univ Indonesia, Depok, Indonesia Natl Inst Hyg, Warsaw, Poland Caja Costarricense Seguro Social, Atenas, Costa Rica Univ Kebangsaan Malaysia, Bangi Selangor, Malaysia Univ New South Wales, Kensington, NSW, Australia Univ Mancheste, Manchester, Lancs, England Shandong Univ Tradit Chinese Med, Jinan, Shandong, Peoples R China Kailuan Gen Hosp, Tangshan, Peoples R China Minist Agr, Inst Food & Dev, Beijing, Peoples R China Fudan Univ, Childrens Hosp, Shanghai, Peoples R China Chinese Ctr Dis Control & Prevent, Beijing, Peoples R China Univ Cyprus, Nicosia, Cyprus Univ Teknol MARA, Shah Alam, Malaysia Capital Med Univ Beijing, An Zhen Hosp, Beijing, Peoples R China West Kazakhstan State Med Univ, Aktobe, Kazakhstan Inner Mongolia Med Univ, Hohhot, Peoples R China Gorgas Mem Inst Publ Hlth, Panama City, Panama Univ Estadual Paulista, Sao Paulo, Brazil
Published: 2017

10. Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19·1 million participants

Author: Zhou, B. and Bentham, J. and Di Cesare, M. and Bixby, H. and Danaei, G. and Cowan, M.J. and Paciorek, C.J. and Singh, G. and Hajifathalian, K. and Bennett, J.E. and Taddei, C. and Bilano, V. and Carrillo-Larco, R.M. and Djalalinia, S. and Khatibzadeh, S. and Lugero, C. and Peykari, N. and Zhang, W.Z. and Lu, Y. and Stevens, G.A. and Riley, L.M. and Bovet, P. and Elliott, P. and Gu, D. and Ikeda, N. and Jackson, R.T. and Joffres, M. and Kengne, A.P. and Laatikainen, T. and Lam, T.H. and Laxmaiah, A. and Liu, J. and Miranda, J.J. and Mondo, C.K. and Neuhauser, H.K. and Sundström, J. and Smeeth, L. and Sorić, M. and Woodward, M. and Ezzati, M. and Abarca-Gómez, L. and Abdeen, Z.A. and Rahim, H.A. and Abu-Rmeileh, N.M. and Acosta-Cazares, B. and Adams, R. and Aekplakorn, W. and Afsana, K. and Aguilar-Salinas, C.A. and Agyemang, C. and Ahmadvand, A. and Ahrens, W. and Al Raddadi, R. and Al Woyatan, R. and Ali, M.M. and Alkerwi, A. and Aly, E. and Amouyel, P. and Amuzu, A. and Andersen, L.B. and Anderssen, S.A. and Ängquist, L. and Anjana, R.M. and Ansong, D. and Aounallah-Skhiri, H. and Araújo, J. and Ariansen, I. and Aris, T. and Arlappa, N. and Aryal, K. and Arveiler, D. and Assah, F.K. and Assunção, M.C.F. and Avdicová, M. and Azevedo, A. and Azizi, F. and Babu, B.V. and Bahijri, S. and Balakrishna, N. and Bandosz, P. and Banegas, J.R. and Barbagallo, C.M. and Barceló, A. and Barkat, A. and Barros, A.J.D. and Barros, M.V. and Bata, I. and Batieha, A.M. and Baur, L.A. and Beaglehole, R. and Romdhane, H.B. and Benet, M. and Benson, L.S. and Bernabe-Ortiz, A. and Bernotiene, G. and Bettiol, H. and Bhagyalaxmi, A. and Bharadwaj, S. and Bhargava, S.K. and Bi, Y. and Bikbov, M. and Bjerregaard, P. and Bjertness, E. and Björkelund, C. and Blokstra, A. and Bo, S. and Bobak, M. and Boeing, H. and Boggia, J.G. and Boissonnet, C.P. and Bongard, V. and Braeckman, L. and Brajkovich, I. and Branca, F. and Breckenkamp, J. and Brenner, H. and Brewster, L.M. and Bruno, G. and Bueno-de-Mesquita, H.B. and Bugge, A. and Burns, C. and Bursztyn, M. and de León, A.C. and Cacciottolo, J. and Cameron, C. and Can, G. and Cândido, A.P.C. and Capuano, V. and Cardoso, V.C. and Carlsson, A.C. and Carvalho, M.J. and Casanueva, F.F. and Casas, J.-P. and Caserta, C.A. and Chamukuttan, S. and Chan, A.W. and Chan, Q. and Chaturvedi, H.K. and Chaturvedi, N. and Chen, C.-J. and Chen, F. and Chen, H. and Chen, S. and Chen, Z. and Cheng, C.-Y. and Dekkaki, I.C. and Chetrit, A. and Chiolero, A. and Chiou, S.-T. and Chirita-Emandi, A. and Cho, B. and Cho, Y. and Chudek, J. and Cifkova, R. and Claessens, F. and Clays, E. and Concin, H. and Cooper, C. and Cooper, R. and Coppinger, T.C. and Costanzo, S. and Cottel, D. and Cowell, C. and Craig, C.L. and Crujeiras, A.B. and Cruz, J.J. and D'Arrigo, G. and d'Orsi, E. and Dallongeville, J. and Damasceno, A. and Dankner, R. and Dantoft, T.M. and Dauchet, L. and De Backer, G. and De Bacquer, D. and de Gaetano, G. and De Henauw, S. and De Smedt, D. and Deepa, M. and Dehghan, A. and Delisle, H. and Deschamps, V. and Dhana, K. and Di Castelnuovo, A.F. and Dias-da-Costa, J.S. and Diaz, A. and Dickerson, T.T. and Do, H.T.P. and Donfrancesco, C. and Dobson, A.J. and Donoso, S.P. and Döring, A. and Doua, K. and Drygas, W. and Dulskiene, V. and Džakula, A. and Dzerve, V. and Dziankowska-Zaborszczyk, E. and Ekelund, U. and El Ati, J. and Ellert, U. and Elosua, R. and Erasmus, R.T. and Erem, C. and Eriksen, L. and Escobedo-de la Peña, J. and Evans, A. and Faeh, D. and Fall, C.H. and Farzadfar, F. and Felix-Redondo, F.J. and Ferguson, T.S. and Fernández-Bergés, D. and Ferrante, D. and Ferrari, M. and Ferreccio, C. and Ferrieres, J. and Finn, J.D. and Fischer, K. and Föger, B. and Foo, L.H. and Forslund, A.-S. and Forsner, M. and Fortmann, S.P. and Fouad, H.M. and Francis, D.K. and do Carmo Franco, M. and Franco, O.H. and Frontera, G. and Fuchs, F.D. and Fuchs, S.C. and Fujita, Y. and Furusawa, T. and Gaciong, Z. and 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Netherlands, Research Institute of Child Nutrition, Germany, Seoul National University, South Korea, University of Cambridge, United Kingdom, Medical University of Innsbruck, Austria, Muhimbili University of Health and Allied Sciences, Tanzania, National Cancer Center, South Korea, Institute of Tropical Medicine, Belgium, Tartu University Clinics, Estonia, Polish Academy of Sciences Anthropology Unit in Wroclaw, Poland, University of Groningen, Netherlands, North-West University, South Africa, National Institute of Public Health, Czech Republic, University of Jyväskylä, Finland, Amrita Institute of Medical Sciences, India, All India Institute of Medical Sciences, India, African Population and Health Research Center, Kenya, Ministerio de Salud Pública, Cuba, Sahlgrenska Academy, Sweden, Endocrinology and Metabolism Research Center, Iran, Food and Agriculture Organization, Italy, National University of Singapore, Singapore, Tampere University Hospital, Finland, Universiti Putra Malaysia, Malaysia, University of Cape Town, South Africa, West Virginia University, United States, Oswaldo Cruz Foundation Rene Rachou Research Institute, Brazil, National Taiwan University, Taiwan, University of Chinese Academy of Sciences, China, University Medicine Greifswald, Germany, Consejería de Sanidad Junta de Castilla y León, Spain, Universidade do Porto, Portugal, University of Uppsala, Sweden, Universidade Federal de Ouro Preto, Brazil, The Jikei University School of Medicine, Japan, National Research Council, Italy, Baker IDI Heart and Diabetes Institute, Australia, Hospital Israelita Albert Einstein, Brazil, Institute of Internal and Preventive Medicine, Russian Federation, Harokopio University, Greece, University of Otago, New Zealand, University of Padova, Italy, Emory University, United States, UiT The Arctic University of Norway, Norway, Cape Peninsula University of Technology, South Africa, Gorgas Memorial Institute of Health Studies, Panama, Brown University, United States, University of Edinburgh, United Kingdom, University College Dublin, Ireland, Penang Medical College, Malaysia, Institut National de la Santé et de la Recherche Médicale, France, Ain Shams University, Egypt, Hypertension Research Center, Iran, University of Pécs, Hungary, University of Limpopo, South Africa, Universidad de Zaragoza, Spain, RCSI Dublin, Ireland, International Institute of Molecular and Cell Biology, Poland, Ahvaz Jundishapur University of Medical Sciences, Iran, Gorgas Memorial Institute of Public Health, Panama, University of Brescia, Italy, Ulm University, Germany, Institute of Public Health, Malaysia, Kobe University, Japan, Suraj Eye Institute, India, INSERM, France, The University of Pharmacy and Medicine of Ho Chi Minh City, Viet Nam, Hanoi Medical University, Viet Nam, Universidad Centro-Occidental Lisandro Alvarado, Venezuela, Heartfile, Pakistan, Eastern Mediterranean Public Health Network, Jordan, Aarhus University, Denmark, Kwame Nkrumah University of Science and Technology, Ghana, Institute for Social and Preventive Medicine, Switzerland, University of Coimbra, Portugal, Cancer Prevention and Research Institute, Italy, University of Bari, Italy, Zayed University, United Arab Emirates, University Medical Center Utrecht, Netherlands, Public Health Agency of Canada, Canada, Heart Institute, Brazil, National Institute of Hygiene, Epidemiology and Microbiology, Cuba, Vietnam National Heart Institute, Viet Nam, Federal Ministry of Health, Bosnia and Herzegovina, Cardiovascular Prevention Centre Udine, Italy, University of New South Wales, Australia, Public Health Agency of Catalonia, Spain, University of Split, Croatia, Alborz University of Medical Sciences, Iran, Turku University Hospital, Finland, Julius Centre University of Malaya, Malaysia, University of Valencia, Spain, University of the Philippines, Philippines, Minas Gerais State Secretariat for Health, Brazil, Health Center San Agustín, Spain, PharmAccess Foundation, Netherlands, Canarian Health Service, Spain, Universidad Industrial de Santander, Colombia, Instituto Nacional de Salud Pública, Mexico, University of Madeira, Portugal, Sitaram Bhartia Institute of Science and Research, India, Marmara University, Turkey, University of Helsinki, Finland, National Institute of Health, Peru, Catalan Department of Health, Spain, Universidade de Lisboa, Portugal, University of Sao Paulo Clinics Hospital, Brazil, South Karelia Social and Health Care District, Finland, Robert Koch Institut, Germany, Isfahan Cardiovascular Research Center, Iran, Research and Education Institute of Child Health, Cyprus, Hospital Italiano de Buenos Aires, Argentina, Lagos State University College of Medicine, Nigeria, Digestive Diseases Research Institute, Iran, The University of Tokyo, Japan, St Vincent's Hospital, Australia, Lund University, Sweden, University of Copenhagen, Denmark, Institut Régional de Santé Publique, Benin, University of Bordeaux, France, University of Leuven, Belgium, Heart Foundation, Australia, Bonn University, Germany, Sotiria Hospital, Greece, National Institute of Public Health-National Institute of Hygiene, Poland, Fu Jen Catholic University, Taiwan, Ministry of Health, Jordan, IB-SALUT Area de Salut de Menorca, Spain, Institut de Recherche pour le Développement, France, Harvard T H Chan School of Public Health, United States, Hellenic Health Foundation, Greece, Government Medical College, India, Sefako Makgatho Health Science University, South Africa, Dasman Diabetes Institute, Kuwait, Ministry of Health, New Zealand, University of Tampere Tays Eye Center, Finland, Centro di Prevenzione Cardiovascolare Udine, Italy, Universidade Federal de Minas Gerais, Brazil, Finnish Institute of Occupational Health, Finland, Universidad Miguel Hernandez, Spain, Centre for Research in Environmental Epidemiology, Spain, University of the Witwatersrand, South Africa, University of Strasbourg, France, University College Cork, Ireland, Institute for Medical Research, Malaysia, Xinjiang Medical University, China, Beijing Tongren Hospital, China, St George's, University of London, United Kingdom, Medical University of Vienna, Austria, Institute of Food and Nutrition Development of Ministry of Agriculture, China, Children's Hospital of Fudan University, China, Chinese Center for Disease Control and Prevention, China, University of Cyprus, Cyprus, Ministry of Health, Malaysia, and Inner Mongolia Medical University, China
Abstract: Background Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defined as systolic blood pressure of 140 mm Hg or higher or diastolic blood pressure of 90 mm Hg or higher. Methods For this analysis, we pooled national, subnational, or community population-based studies that had measured blood pressure in adults aged 18 years and older. We used a Bayesian hierarchical model to estimate trends from 1975 to 2015 in mean systolic and mean diastolic blood pressure, and the prevalence of raised blood pressure for 200 countries. We calculated the contributions of changes in prevalence versus population growth and ageing to the increase in the number of adults with raised blood pressure. Findings We pooled 1479 studies that had measured the blood pressures of 19·1 million adults. Global age-standardised mean systolic blood pressure in 2015 was 127·0 mm Hg (95% credible interval 125·7–128·3) in men and 122·3 mm Hg (121·0–123·6) in women; age-standardised mean diastolic blood pressure was 78·7 mm Hg (77·9–79·5) for men and 76·7 mm Hg (75·9–77·6) for women. Global age-standardised prevalence of raised blood pressure was 24·1% (21·4–27·1) in men and 20·1% (17·8–22·5) in women in 2015. Mean systolic and mean diastolic blood pressure decreased substantially from 1975 to 2015 in high-income western and Asia Pacific countries, moving these countries from having some of the highest worldwide blood pressure in 1975 to the lowest in 2015. Mean blood pressure also decreased in women in central and eastern Europe, Latin America and the Caribbean, and, more recently, central Asia, Middle East, and north Africa, but the estimated trends in these super-regions had larger uncertainty than in high-income super-regions. By contrast, mean blood pressure might have increased in east and southeast Asia, south Asia, Oceania, and sub-Saharan Africa. In 2015, central and eastern Europe, sub-Saharan Africa, and south Asia had the highest blood pressure levels. Prevalence of raised blood pressure decreased in high-income and some middle-income countries; it remained unchanged elsewhere. The number of adults with raised blood pressure increased from 594 million in 1975 to 1·13 billion in 2015, with the increase largely in low-income and middle-income countries. The global increase in the number of adults with raised blood pressure is a net effect of increase due to population growth and ageing, and decrease due to declining age-specific prevalence. Interpretation During the past four decades, the highest worldwide blood pressure levels have shifted from high-income countries to low-income countries in south Asia and sub-Saharan Africa due to opposite trends, while blood pressure has been persistently high in central and eastern Europe. Funding Wellcome Trust. © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license
Published: 2017

11. Cost-effectiveness of providing patients with information on managing mild low-back symptoms in an occupational health setting

Author: Simo Taimela, Jaro Karppinen, Jarmo Rantonen, Eira Viikari-Juntura, S Luoto, Markku Hupli, Aki Vehtari, Antti Malmivaara, Department of Public Health, Clinicum, FICEBO, Finnish Institute of Occupational Health, Department of Computer Science, South Karelia Social and Health Care District, National Institute for Health and Welfare, Evalua International, Aalto-yliopisto, and Aalto University
Subjects: Male, Cost effectiveness, Cost-Benefit Analysis, Psychological intervention, law.invention, 0302 clinical medicine, Randomized controlled trial, law, Medicine, 030212 general & internal medicine, PRIMARY-CARE MANAGEMENT, health care economics and organizations, EDUCATIONAL BOOKLET, Response rate (survey), lcsh:Public aspects of medicine, PAIN, Health Care Costs, RANDOMIZED CONTROLLED-TRIAL, Middle Aged, Low back pain, 3142 Public health care science, environmental and occupational health, 3. Good health, Cohort, population characteristics, Female, medicine.symptom, Sick Leave, Cohort study, PHYSICAL-THERAPY, CLINICAL-TRIALS, RCT, Research Article, Adult, medicine.medical_specialty, The Back Book, Visual analogue scale, Quasi-experimental study, Intervention, WHITEHALL-II, Sickness absence, 03 medical and health sciences, Patient Education as Topic, health services administration, Humans, Health economy, Occupational Health, Disability, business.industry, Prevention, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, GLOBAL BURDEN, Physical therapy, Pamphlets, FOLLOW-UP, business, 030217 neurology & neurosurgery
Abstract: Background Evidence shows that low back specific patient information is effective in sub-acute low back pain (LBP), but effectiveness and cost-effectiveness (CE) of information in early phase symptoms is not clear. We assessed effectiveness and CE of patient information in mild LBP in the occupational health (OH) setting in a quasi-experimental study. Methods A cohort of employees (N = 312, aged
Published: 2016

12. Co-occurrence of mental distress and insomnia associates with more severe musculoskeletal pain - Northern Finland Birth Cohort 1966 study.

Author: Hoffrén J, Määttä J, Karppinen J, Oura P, and Heikkala E
Abstract: Objective: This cross-sectional study demonstrates the differences in the dimensions of musculoskeletal (MSK) pain between participants with mental distress and/or insomnia among general population with MSK pain within the past 12 months., Methods: Participants of Northern Finland Birth Cohort 1966 (NFBC1966) were studied (n = 4316). They were divided into groups based on their mental distress and insomnia status (co-occurring mental distress and insomnia [CMI], isolated mental distress [M] and insomnia [I], and absence of both [AMI]). The AMI group was used as a reference for the main analyses. The dimensions of MSK pain included frequency, bothersomeness (Numerical Rating Scale [NRS] 0-10), intensity of pain (NRS), and number of pain sites (1-8). Multinomial and general linear regression analyses were used to study the associations, and adjustments were made for sex, education, number of somatic diseases, and physical activity., Results: The CMI group was associated with more severe pain in every dimension when contrasted to all other groups (daily pain adjusted OR 5.08, 95 % CI 3.43-7.51; bothersomeness adjusted β 1.7, 95 % CI 1.5-2.0; intensity adjusted β 1.4, 95 % CI 1.2-1.7; number of pain sites adjusted β 1.2, 95 % CI 1.0-1.4). Compared to AMI, I and M groups also had relationships with all pain dimensions, but with lower magnitude compared to the CMI group., Conclusions: The results suggest that insomnia and mental distress co-exist with more severe MSK pain, and when co-occurring, MSK pain severity tends to increase. Therefore, contemplating insomnia and mental distress are important to consider when comprehensively evaluating MSK pain symptoms., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to declare. NFBC1966 46y follow-up study received financial support from the University of Oulu Grant no. 24000692, Oulu University Hospital Grant no. 24301140, ERDF European Regional Development Fund Grant no. 539/2010 A31592. The funders played no role in the study design, data collection or interpretation, nor in the decision to submit the study for publication. The authors did not receive any external funding., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Published: 2024
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13. Effects of Bariatric Surgery on Knee Articular Cartilage and Osteoarthritis Symptoms-A 12-Month Follow-Up Using T2 Relaxation Time and WOMAC Osteoarthritis Index.

Author: Lehtovirta S, Kemppainen A, Haapea M, Nevalainen M, Lammentausta E, Kyllönen E, Koivukangas V, Lehenkari P, Karppinen J, Casula V, and Nieminen MT
Subjects: Humans, Female, Male, Middle Aged, Prospective Studies, Follow-Up Studies, Longitudinal Studies, Adult, Treatment Outcome, Obesity, Morbid surgery, Obesity, Morbid diagnostic imaging, Obesity, Morbid complications, Obesity complications, Obesity surgery, Cartilage, Articular diagnostic imaging, Cartilage, Articular surgery, Osteoarthritis, Knee surgery, Osteoarthritis, Knee diagnostic imaging, Bariatric Surgery, Magnetic Resonance Imaging, Knee Joint diagnostic imaging, Knee Joint surgery, Knee Joint physiopathology, Weight Loss
Abstract: Background: Obesity is a significant risk factor for osteoarthritis (OA). The most effective treatment for morbid obesity is bariatric surgery., Purpose: To study the effects of potential surgically induced weight loss on knee articular cartilage and OA symptoms of obese patients over a 12-month follow-up., Study Type: Prospective longitudinal cohort study., Subjects: 45 obese patients (38 female, BMI = 42.3 ± 6.5 kg/m 2 ) who underwent gastric bypass (intervention group), and 46 age-matched conservative-care controls (37 female, BMI = 39.8 ± 4.6 kg/m 2 )., Field Strength/sequence: Multiecho spin echo sequence at 3 T., Assessment: Knee cartilage T2 measurements and WOMAC Indices were measured presurgery and after 12 months. The intervention group was split into successful (≥20% total weight loss (TWL)) and unsuccessful (<20% TWL) weight loss groups. T2 and WOMAC indices were also measured in controls at baseline and after 12 months. Changes among the three groups were analyzed., Statistical Tests: Analysis of variance (significance level 0.05)., Results: Twenty-six (58%) intervention patients achieved ≥20% TWL. The <20% TWL group demonstrated significantly more T2 reduction in the deep lateral femur over 12 months compared with the ≥20% TWL group (-3.83 ± 8.18 msec vs. 2.47 ± 6.54 msec, respectively), whereas no significant differences were observed on the medial femoral compartment (P = 0.385, P = 0.551, and P = 0.511 for bulk, superficial and deep regions, respectively). Changes in WOMAC indices over 12 months were significantly greater in the ≥20% TWL group compared with controls. In the <20% TWL group, pain significantly improved over 12 months compared with controls, while stiffness and function changes were not statistically significant (P = 0.063 and P = 0.051, respectively)., Data Conclusion: Cartilage matrix, measured by T2, showed improvement on lateral femoral cartilage with <20% TWL compared with ≥20% TWL. Bariatric surgery provided significant improvements in knee symptoms with ≥20% TWL compared with conservative WL. This effect is also seen to some extent with <20% TWL compared with conservative WL., Level of Evidence: 2 TECHNICAL EFFICACY: Stage 4., (© 2024 The Authors. Journal of Magnetic Resonance Imaging published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.)
Published: 2024
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14. Proteomic analysis of serum in a population-based cohort did not reveal a biomarker for Modic changes.

Author: Schulze F, Määttä J, Grad S, Heggli I, Brunner F, Farshad M, Distler O, Karppinen J, Lotz J, and Dudli S
Abstract: Introduction: Modic changes (MC) are bone marrow lesions of vertebral bones, which can be detected with magnetic resonance imaging (MRI) adjacent to degenerated intervertebral discs. Defined by their appearance on T1 and T2 weighted images, there are three interconvertible types: MC1, MC2, and MC3. The inter-observer variability of the MRI diagnosis is high, therefore a diagnostic serum biomarker complementing the MRI to facilitate diagnosis and follow-up would be of great value., Methods: We used a highly sensitive and reproducible proteomics approach: DIA/SWATH-MS to find serum biomarkers in a subset of the Northern Finland Birth Cohort 1966. Separately, we measured a panel of factors involved in inflammation and angiogenesis to confirm some potential biomarkers published before with an ELISA-based method called V-Plex., Results: We found neither an association between the serum concentrations of the proteins detected with DIA/SWATH-MS with the presence of MC, nor a correlation with the size of the MC lesions. We did not find any association between the factors measured with the V-Plex and the presence of MC or their size., Conclusion: Altogether, our study suggests that a robust and generally usable biomarker to facilitate the diagnosis of MC cannot readily be found in serum., Competing Interests: All authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 The Author(s). JOR Spine published by Wiley Periodicals LLC on behalf of Orthopaedic Research Society.)
Published: 2024
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15. Pressure Pain Sensitivity and Chronotype: A Population-based Study of Middle-aged Finns.

Author: Heikkala E, Oura P, Määttä J, Karppinen J, and Merikanto I
Subjects: Humans, Male, Female, Middle Aged, Finland epidemiology, Sleep Initiation and Maintenance Disorders epidemiology, Sleep Initiation and Maintenance Disorders physiopathology, Musculoskeletal Pain epidemiology, Musculoskeletal Pain physiopathology, Chronic Pain physiopathology, Chronic Pain epidemiology, Pressure, Cohort Studies, Mental Disorders epidemiology, Mental Disorders physiopathology, Chronotype, Pain Threshold physiology, Circadian Rhythm physiology
Abstract: Evening chronotype individuals experience pain more often than morning chronotypes, but relationships with pain sensitivity have rarely been studied. We examined whether chronotype is associated with pressure pain sensitivity, with special reference to mental health disorders, insomnia, and chronic musculoskeletal (MSK) pain as potential moderating factors. The study sample consisted of members of the Northern Finland Birth Cohort 1966 aged 46. Pressure pain threshold and tolerance were measured via the standardized protocol, categorized as lowest quartile versus others. Chronotype (morning [M; the reference], intermediate [I], and evening [E]) was defined using the Short Morningness-Eveningness questionnaire. Sex-stratified binary logistic regression models were separately adjusted for education, body mass index, long-term diseases (fully adjusted model), and for mental health disorders, insomnia, and chronic MSK pain (a residual confounding analysis). Interaction terms (Chronotype × Mental health/insomnia/chronic MSK pain) were tested. The study had 2,132 males and 2,830 females. The E-type males had 1.5-fold odds of having a low pain threshold (fully adjusted odds ratio [OR] 1.45, 95% confidence interval 1.05-2.00) and pressure pain tolerance (fully adjusted OR 1.47, 1.07-2.02), in comparison to M-types. Having a mental health disorder intensified the association with low pain threshold fourfold (4.06, 1.56-10.6). Being an E-type female was also associated with a low pain threshold, but the association was statistically nonsignificant (fully adjusted OR 1.18, .90-1.53). No statistically significant interactions were found among females. These results emphasize the role of chronotype in pain sensitivity and add an understanding of pain experience in light of innate circadian types. PERSPECTIVE: Male evening chronotypes are more sensitive to pain than morning chronotypes. Diagnosed mental health disorders in particular indicate a low pain threshold for evening chronotype males., (Copyright © 2024 United States Association for the Study of Pain, Inc. Published by Elsevier Inc. All rights reserved.)
Published: 2024
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16. Semiautomatic Assessment of Facet Tropism From Lumbar Spine MRI Using Deep Learning: A Northern Finland Birth Cohort Study.

Author: Kowlagi N, Kemppainen A, Panfilov E, McSweeney T, Saarakkala S, Nevalainen M, Niinimäki J, Karppinen J, and Tiulpin A
Subjects: Humans, Male, Female, Finland epidemiology, Cohort Studies, Retrospective Studies, Reproducibility of Results, Cross-Sectional Studies, Magnetic Resonance Imaging methods, Lumbar Vertebrae diagnostic imaging, Lumbar Vertebrae pathology, Tropism, Deep Learning, Zygapophyseal Joint diagnostic imaging, Zygapophyseal Joint pathology
Abstract: Study Design: This is a retrospective, cross-sectional, population-based study that automatically measured the facet joint (FJ) angles from T2-weighted axial magnetic resonance imagings (MRIs) of the lumbar spine using deep learning (DL)., Objective: This work aimed to introduce a semiautomatic framework that measures the FJ angles using DL and study facet tropism (FT) in a large Finnish population-based cohort., Summary of Data: T2-weighted axial MRIs of the lumbar spine (L3/4 through L5/S1) for (n=1288) in the NFBC1966 Finnish population-based cohort were used for this study., Materials and Methods: A DL model was developed and trained on 430 participants' MRI images. The authors computed FJ angles from the model's prediction for each level, that is, L3/4 through L5/S1, for the male and female subgroups. Inter-rater and intrarater reliability was analyzed for 60 participants using annotations made by two radiologists and a musculoskeletal researcher. With the developed method, we examined FT in the entire NFBC1966 cohort, adopting the literature definitions of FT thresholds at 7° and 10°. The rater agreement was evaluated both for the annotations and the FJ angles computed based on the annotations. FJ asymmetry ( - was used to evaluate the agreement and correlation between the raters. Bland-Altman analysis was used to assess the agreement and systemic bias in the FJ asymmetry. The authors used the Dice score as the metric to compare the annotations between the raters. The authors evaluated the model predictions on the independent test set and compared them against the ground truth annotations., Results: This model scored Dice (92.7±0.1) and intersection over union (87.1±0.2) aggregated across all the regions of interest, that is, vertebral body (VB), FJs, and posterior arch (PA). The mean FJ angles measured for the male and female subgroups were in agreement with the literature findings. Intrarater reliability was high, with a Dice score of VB (97.3), FJ (82.5), and PA (90.3). The inter-rater reliability was better between the radiologists with a Dice score of VB (96.4), FJ (75.5), and PA (85.8) than between the radiologists and the musculoskeletal researcher. The prevalence of FT was higher in the male subgroup, with L4/5 found to be the most affected region., Conclusion: The authors developed a DL-based framework that enabled us to study FT in a large cohort. Using the proposed method, the authors present the prevalence of FT in a Finnish population-based cohort., Competing Interests: The authors report no conflicts of interest., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
Published: 2024
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17. The Clinical Significance of the Modic Changes Grading Score.

Author: Udby PM, Modic M, Elmose S, Carreon LY, Andersen MØ, Karppinen J, and Samartzis D
Abstract: Study Design: Cross-sectional retrospective observational study., Objective: To evaluate the reliability and clinical utility of the Modic changes (MC) grading score., Method: Patients from the Danish national spine registry, DaneSpine, scheduled for lumbar discectomy were identified. MRI of patients with MC were graded based on vertical height involvement: Grade A (<25%), Grade B (25%-50%), and Grade C (>50%). All MRIs were reviewed by 2 physicians to evaluate the reliability of the MC grade., Results: Of 213 patients included, 142 patients had MC, 71 with MC-1 and 71 with MC-2; 34% were Grade A, 45% were Grade B, and 21% were Grade C. MC grade demonstrated substantial intra-rater (κ = .68) and inter-rater (κ = .61) reliability. A significantly higher proportion (n = 40, 57%) of patients with MC-1 had a severe MC grade compared to patients with MC-2 (n = 30, 43%, P < .001). Severe MC grade was associated with the presence of severe lumbar disc degeneration (DD) (Pfirrmann grade = V, P = .024), worse preoperative ODI (52.49 vs 44.17, P = .021) and EQ-5D scores (.26 vs .46, P = .053). MC alone including type was not associated with a significant difference in patient-reported outcomes ( P > .05)., Conclusion: The MC grade score was demonstrated to have substantial intra- and inter-observer reliability. Severe MC grade was associated with both severe DD and MC type, being more prevalent in patients with MC-1. The MC grade was also significantly associated with worse disability and reduced health-related quality of life. Results from the study suggest that MC grade is more clinically important than MC type., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Published: 2024
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18. Association between vertebral cross-sectional area and lumbar disc displacement - a population-based study.

Author: Ollila L, Oura P, Karppinen J, Niinimäki J, and Junno JA
Subjects: Middle Aged, Humans, Research, Body Mass Index, Educational Status, Spine, Intervertebral Disc Degeneration diagnostic imaging, Intervertebral Disc Degeneration epidemiology
Abstract: Purpose: Vertebral dimensions may constitute a potential risk factor for degenerative changes in the spine. Previous studies have found a positive association between vertebral height and both type 2 Modic changes and intervertebral disc height loss. Also, vertebral endplate size has been associated with disc degeneration. However, only a few studies have investigated the association between vertebral dimensions and lumbar disc displacement (LDD). This study aimed to investigate the association between vertebral cross-sectional area (CSA) and LDD among the general middle-aged Finnish population. We hypothesized that larger vertebral CSA is associated with LDD., Materials and Methods: The study was conducted by using data from the Northern Finland Birth Cohort 1966 (NFBC1966). At the age of 46, a subpopulation of NFBC1966 underwent clinical examinations including magnetic resonance imaging (MRI) (n = 1249). MRI scans were used to measure L4 CSA and evaluate the presence of LDD (bulge, protrusion, and extrusion/sequestration) in the adjacent discs. The association between L4 CSA and LDD was analysed using logistic regression, with adjustment for sex, education, body mass index, leisure-time physical activity, smoking, diet, and L4 height., Results: Larger L4 CSA was associated with LDD; an increase of 1 cm 2 in vertebral CSA elevated the odds of LDD relative to no LDD by 10% (adjusted odds ratio 1.10, 95% CI 1.01-1.19). The association was similar among either sex., Conclusions: Larger L4 vertebral CSA was associated with LDD in our study sample. Even though smaller vertebral size exposes our vertebrae to osteoporotic fractures, it simultaneously seems to protect us from LDD., (© 2023. The Author(s).)
Published: 2024
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19. Health-related quality of life after hip fracture: effects of a 12-month home-based exercise intervention-secondary analyses of an RCT.

Author: Soukkio PK, Suikkanen SA, Sintonen H, Kukkonen-Harjula KT, Kautiainen H, Kääriä SM, Hupli MT, Aartolahti EM, Pitkälä KH, and Sipilä S
Subjects: Aged, 80 and over, Female, Humans, Male, Exercise, Physical Therapy Modalities, Quality of Life psychology, Aged, Middle Aged, Exercise Therapy methods, Hip Fractures rehabilitation
Abstract: Purpose: In this randomized controlled trial, we analyzed the effects of a 12-month home-based exercise intervention on the health-related quality of life (HRQoL) of patients with a hip fracture., Methods: Participants (n = 121) aged ≥ 60 years, with a Mini-Mental State Examination (MMSE) score of ≥ 12 and an operated hip fracture, were placed into Exercise (n = 61) or Usual care (n = 60) groups. Physiotherapist-supervised, home-based training was given twice a week over 12 months. HRQoL was assessed using the 15D instrument at baseline and at 3, 6, and 12 months. The total 15D scores and dimension scores were analyzed and compared to national age- and sex-matched reference data., Results: The participants' mean age was 81 years (SD 7), 75% were women, and 61% had a femoral neck fracture. The mean within-group change in total 15D score over 12 months was 0.023 (95% CI: -0.003 to 0.048) in the Usual care group, and 0.028 (CI: 0.003 to 0.054) in the Exercise group (between-group p = 0.76). We found a statistically significant change in total 15D score in the Exercise group, as well as in the dimension scores of mobility and usual activities in both groups. All 15D scores remained below the general population reference level., Conclusion: Exercise training for 12 months did not enhance the HRQoL of home-dwelling patients with hip fractures any more than usual care. In addition, HRQoL remained below the population level in both groups., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)
Published: 2024
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20. Chronic disease clusters are associated with prolonged, bothersome, and multisite musculoskeletal pain: a population-based study on Northern Finns.

Author: Heikkala E, Oura P, Paananen M, Ho E, Ferreira P, Tanguay-Sabourin C, and Karppinen J
Subjects: Middle Aged, Humans, Aged, Finland epidemiology, Disease Hotspot, Surveys and Questionnaires, Chronic Disease, Musculoskeletal Pain epidemiology, Musculoskeletal Pain complications
Abstract: Background: Chronic diseases often accumulate with musculoskeletal (MSK) pain. However, less evidence is available on idiosyncratic patterns of chronic diseases and their relationships with the severity of MSK pain in general MSK pain populations., Material and Methods: Questionnaire-based data on physician-diagnosed chronic diseases, MSK pain and its dimensions (frequency, intensity, bothersomeness, and the number of pain sites), and confounders were collected from the Northern Finland Birth Cohort 1966 at the age of 46. Latent Class Analysis (LCA) was used to identify chronic disease clusters among individuals who reported any MSK pain within the previous year ( n = 6105). The associations between chronic disease clusters, pain dimensions, and severe MSK pain, which was defined as prolonged (over 30 d within the preceding year), bothersome (Numerical Rating Scale >5), and multisite (two or more pain sites) pain, were analyzed using logistic regression and general linear regression models, adjusted for sex and educational level (n for the full sample = 4768)., Results: LCA resulted in three clusters: Metabolic (10.8% of the full sample), Psychiatric (2.9%), and Relatively Healthy (86.3%). Compared to the Relatively Healthy cluster, the Metabolic and Psychiatric clusters had higher odds for daily pain and higher mean pain intensity, bothersomeness, and the number of pain sites. Similarly, the odds for severe MSK pain were up to 75% (95% confidence interval: 44%-113%) and 155% (81%-259%) higher in the Metabolic and Psychiatric clusters, respectively, after adjustments for sex and educational level., Conclusions: Distinct patterns of chronic disease accumulation can be identified in the general MSK pain population. It seems that mental and metabolic health are at interplay with severe MSK pain. These findings suggest a potential need to screen for psychiatric and metabolic entities of health when treating working-aged people with MSK pain.Key messagesThis large study on middle-aged people with musculoskeletal pain aimed to examine the idiosyncratic patterns of chronic diseases and their relationships with the severity of musculoskeletal pain. Latent class cluster analysis identified three chronic disease clusters: Psychiatric , Metabolic , and Relatively Healthy . People with accumulated mental ( Psychiatric cluster) or metabolic diseases ( Metabolic cluster) experienced more severe pain than people who were relatively healthy ( Relatively Healthy cluster). These findings suggest a potential need to screen for psychiatric and metabolic entities of health when treating working-aged people with MSK pain.
Published: 2023
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21. Cartilaginous endplates: A comprehensive review on a neglected structure in intervertebral disc research.

Author: Crump KB, Alminnawi A, Bermudez-Lekerika P, Compte R, Gualdi F, McSweeney T, Muñoz-Moya E, Nüesch A, Geris L, Dudli S, Karppinen J, Noailly J, Le Maitre C, and Gantenbein B
Abstract: The cartilaginous endplates (CEP) are key components of the intervertebral disc (IVD) necessary for sustaining the nutrition of the disc while distributing mechanical loads and preventing the disc from bulging into the adjacent vertebral body. The size, shape, and composition of the CEP are essential in maintaining its function, and degeneration of the CEP is considered a contributor to early IVD degeneration. In addition, the CEP is implicated in Modic changes, which are often associated with low back pain. This review aims to tackle the current knowledge of the CEP regarding its structure, composition, permeability, and mechanical role in a healthy disc, how they change with degeneration, and how they connect to IVD degeneration and low back pain. Additionally, the authors suggest a standardized naming convention regarding the CEP and bony endplate and suggest avoiding the term vertebral endplate. Currently, there is limited data on the CEP itself as reported data is often a combination of CEP and bony endplate, or the CEP is considered as articular cartilage. However, it is clear the CEP is a unique tissue type that differs from articular cartilage, bony endplate, and other IVD tissues. Thus, future research should investigate the CEP separately to fully understand its role in healthy and degenerated IVDs. Further, most IVD regeneration therapies in development failed to address, or even considered the CEP, despite its key role in nutrition and mechanical stability within the IVD. Thus, the CEP should be considered and potentially targeted for future sustainable treatments., Competing Interests: Benjamin Gantenbein and Christine Le Maitre are editorial board members of JOR Spine and co‐author of this article. They were excluded from editorial decision‐making related to the acceptance of this article for publication in the journal. All other authors have no conflicts of interest to declare in relation to this article., (© 2023 The Authors. JOR Spine published by Wiley Periodicals LLC on behalf of Orthopaedic Research Society.)
Published: 2023
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22. Trends of Low Back Pain Research in Older and Working-Age Adults from 1993 to 2023: A Bibliometric Analysis.

Author: Zheng DKY, Kawchuk GN, Bussières AE, Al Zoubi FM, Hartvigsen J, Fu SN, de Luca K, Weiner DK, Karppinen J, Samartzis D, Ferreira ML, Wu J, Dennett L, and Wong AYL
Abstract: Although the number of publications focusing on low back pain in older adults (LBP-O) and working-age adults (LBP-W) has been growing for decades, comparative research trends in these two populations, which may help to guide future investigation, have not been rigorously explored. This analysis aimed to describe publication patterns and trends of research targeting LBP-O and LBP-W over the last three decades. Peer-reviewed LBP-O and LBP-W articles published between 1993 and 2023 were retrieved from the Web of Science, which provided the details of annual publication volume, and prominent journals/countries/institutions. The relationship between the annual publication volumes and years was analyzed by Spearman correlation analysis. The hot topics and emerging trends were analyzed by VOSviewer and CiteSpace, respectively. A total of 4217 LBP-O-related and 50,559 LBP-W-related documents were included. The annual publication volumes of LBP-O and LBP-W articles increased over the years ( r =0.995 to 0.998, p <0.001). The United States had the highest number of prominent institutions publishing relevant articles. The most prolific journal for LBP-O (5.4%) and LBP-W-related (6.1%) papers is the journal "Spine". Cognitive behavioral therapy, intervertebral disc (IVD) degeneration, physiotherapy, physical activity, and walking were the recent hot topics and physical activity was an emerging trend in LBP-O, while surgery and IVD degeneration (also a hot topic) were emerging trends in LBP-W. This study highlights the paucity of LBP-O-related research in the past. The United States and the journal Spine stand out in LBP research. The research trend of physical activity in LBP-O is consistent with the recognized importance of physical activity for older adults in general, and for managing LBP-O in particular. Conversely, the emerging trends of surgery and intervertebral disc degeneration in LBP-W research highlight a focus on the biomedical model of LBP despite LBP being a biopsychosocial condition., Competing Interests: Professor Jaro Karppinen reports consultation fee from Orion Pharma Ltd outside the submitted work. The authors report no other conflicts of interest in this work., (© 2023 Zheng et al.)
Published: 2023
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23. Measuring the determinants of implementation behavior in multiprofessional rehabilitation.

Author: Paukkunen M, Ala-Mursula L, Öberg B, Karppinen J, Sjögren T, Riska H, Nikander R, and Abbott A
Subjects: Humans, Surveys and Questionnaires, Language, Allied Health Personnel, Delphi Technique, Health Personnel, Brain Diseases
Abstract: Background: The Determinants of Implementation Behavior Questionnaire (DIBQ) measures facilitators or barriers of healthcare professionals' implementation behaviors based on the current implementation research on practice and policy. The DIBQ covers 18 domains of the Theoretical Domains Framework and consists of 93 items. A previously tailored version (DIBQ-t) covering 10 domains and 28 items focuses on implementing best-practice low back pain care., Aim: To tailor a shortened version of DIBQ to multiprofessional rehabilitation context with cross-cultural adaptation to Finnish language., Design: A two-round Delphi study., Setting: National-level online survey., Population: Purposively recruited experts in multiprofessional rehabilitation (N.=25)., Methods: Cross-cultural translation of DIBQ to Finnish was followed by a two-round Delphi survey involving diverse experts in rehabilitation (physicians, physiotherapists, occupational therapists, psychologists, nursing scientists, social scientists). In total, 25 experts in Round 1, and 21 in Round 2 evaluated the importance of DIBQ items in changing professionals' implementation behavior by rating on a 5-point Likert Scale (1 = Strongly Disagree, 5 = Strongly Agree) of including each item in the final scale. Consensus to include an item was defined as a mean score of ≥4 by ≥75% of Delphi participants. Open comments were analyzed using inductive content analysis. Items with agreement of ≤74% were either directly excluded or reconsidered and modified depending on qualitative judgements, amended with experts' suggestions. After completing an analogous second-round, a comparison with DIBQ-t was performed. Lastly, the relevance of each item was indexed using content validity index on item-level (I-CVI) and scale-level (S-CVI/Ave)., Results: After Round 1, 17 items were included and 48 excluded by consensus whereas 28 items were reconsidered, and 20 items added for Round 2. The open comments were categorized as: 1) "modifying"; 2) "supportive"; and 3) "critical". After Round 2, consensus was reached regarding all items, to include 21 items. After comparison with DIBQ-t, the final multiprofessional DIBQ (DIBQ-mp) covers 11 TDF domains and 21 items with I-CVIs of ≥0.78 and S-CVI/Ave of 0.93., Conclusions: A Delphi study condensed a DIBQ-mp with excellent content validity for multiprofessional rehabilitation context., Clinical Rehabilitation Impact: A potential tool for evaluating determinants in implementing evidence-based multiprofessional rehabilitation interventions.
Published: 2023
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24. The Örebro Musculoskeletal Pain Screening Questionnaire-Short Form and 2-year follow-up of registered work disability.

Author: Heikkala E, Oura P, Ruokolainen O, Ala-Mursula L, Linton SJ, and Karppinen J
Subjects: Humans, Middle Aged, Follow-Up Studies, Risk Factors, Logistic Models, Surveys and Questionnaires, Pensions, Disability Evaluation, Musculoskeletal Pain diagnosis, Musculoskeletal Pain epidemiology
Abstract: Background: The Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) was developed to identify psychological and functioning-related risk factors among individuals with musculoskeletal pain at risk of work disability. This study aimed to examine whether the short version of the ÖMPSQ (ÖMPSQ-SF) can be used for this purpose, using registry-based outcomes., Methods: The ÖMPSQ-SF was completed by the members of the Northern Finland Birth Cohort 1966 at the age of 46 years (baseline). These data were enriched with national registers, including information on sick leaves and disability pensions (indicators of work disability). The associations between the ÖMPSQ-SF categories (low-, medium- and high risk) and work disability over a 2-year follow-up were analysed using negative binomial regression and binary logistic regression models. We made adjustments for sex, baseline education level, weight status and smoking., Results: Overall, 4063 participants provided full data. Of these, 90% belonged to the low-risk, 7% to the medium-risk and 3% to the high-risk group. Compared to the low-risk group, the high-risk group had a 7.5 [Wald 95% confidence interval (CI) 6.2-9.0] times higher number of sick leave days and 16.1 (95% CI 7.1-36.8) times higher odds of disability pension after adjustments in the 2-year follow-up., Conclusions: : Our study suggests that the ÖMPSQ-SF could be used for predicting registry-based work disability at midlife. Those allocated to the high-risk group seemed to have a particularly great need of early interventions to support their work ability., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Public Health Association.)
Published: 2023
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25. Early disc degeneration in radiotherapy-treated childhood brain tumor survivors.

Author: Grahn P, Remes T, Kivisaari R, Suo-Palosaari MH, Arikoski PM, Koskenkorva PKT, Lähteenmäki PM, Lönnqvist TRI, Ojaniemi MK, Sirkiä KH, Sutela AK, Toiviainen-Salo SM, Rantala HMJ, Harila AH, Niinimäki J, Karppinen J, and Ahonen M
Subjects: Child, Humans, Lumbar Vertebrae diagnostic imaging, Lumbar Vertebrae pathology, Cross-Sectional Studies, Quality of Life, Magnetic Resonance Imaging methods, Intervertebral Disc Degeneration pathology, Intervertebral Disc Displacement complications, Brain Neoplasms diagnostic imaging, Brain Neoplasms radiotherapy, Brain Neoplasms complications, Intervertebral Disc pathology
Abstract: Background: Childhood brain tumor (BT) survivors have an increased risk of treatment-related late effects, which can reduce health-related quality of life and increase morbidity. This study aimed to investigate lumbar disc degeneration in magnetic resonance imaging (MRI) in adult survivors of radiotherapy-treated childhood BT compared to age and sex-matched population controls., Methods: In this cross-sectional comparative study, 127 survivors were identified from hospital registries. After a mean follow-up of 20.7 years (range 5-33.1), 67 survivors (mean age 28.4, range 16.2-43.5) were investigated with MRI and compared to 75 sex-matched population-based controls. Evaluated MRI phenotypes included Pfirrmann grading, , intervertebral disc protrusions, extrusions, and high-intensity-zone-lesions (HIZ). Groups were also compared for known risk factors of lumbar intervertebral disc (IVD) degeneration., Results: Childhood BT survivors had higher Pfirrmann grades than controls at all lumbar levels (all p < 0.001). Lumbar disc protrusions at L4-5 (p = 0.02) and extrusions at L3-4 (p = 0.04), L4-5 (p = 0.004), and L5-S1 (p = 0.01) were significantly more common in the BT group compared to the control. The survivor cohort also had significantly more HIZ-lesons than the controls (n=13 and n=1, p=0.003). Age at diagnosis was associated with lower degree of IVD degeneration (p < 0.01). Blood pressure correlated with IVD degeneration (P < 0.05)., Conclusions: Signs of early disc degeneration related to tumor treatment can be seen in the IVDs of survivors. Disc degeneration was more severe in children treated in adolescence., (© 2023. The Author(s).)
Published: 2023
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26. The role of co-occurring insomnia and mental distress in the association between lumbar disc degeneration and low back pain related disability.

Author: Mertimo T, Heikkala E, Niinimäki J, Blanco Sequeiros R, Määttä J, Kankaanpää M, Oura P, and Karppinen J
Subjects: Humans, Lumbosacral Region, Lumbar Vertebrae diagnostic imaging, Magnetic Resonance Imaging methods, Low Back Pain diagnosis, Low Back Pain epidemiology, Low Back Pain complications, Intervertebral Disc Degeneration complications, Intervertebral Disc Degeneration diagnostic imaging, Intervertebral Disc Degeneration epidemiology, Sleep Initiation and Maintenance Disorders complications, Sleep Initiation and Maintenance Disorders epidemiology, Intervertebral Disc Displacement complications
Abstract: Background: Lumbar disc degeneration (LDD) is associated with low back pain (LBP). Although both insomnia and mental distress appear to influence the pain experience, their role in the association between LDD and LBP is uncertain. Our objective was to investigate the role of co-occurring insomnia and mental distress in the association between LDD and LBP-related disability., Methods: A total of 1080 individuals who had experienced LBP during the previous year underwent 1.5-T lumbar magnetic resonance imaging, responded to questionnaires, and participated in a clinical examination at the age of 47. Full data was available for 843 individuals. The presence of LBP and LBP-related disability (numerical rating scale, range 0-10) were assessed using a questionnaire. LDD was assessed by a Pfirrmann-based sum score (range 0-15, higher values indicating higher LDD). The role of insomnia (according to the five-item Athens Insomnia Scale) and mental distress (according to the Hopkins Symptom Check List-25) in the association between the LDD sum score and LBP-related disability was analyzed using linear regression with adjustments for sex, smoking, body mass index, education, leisure-time physical activity, occupational physical exposure, Modic changes, and disc herniations., Results: A positive association between LDD and LBP-related disability was observed among those with absence of both mental distress and insomnia (adjusted B = 0.132, 95% CI = 0.028-0.236, p = 0.013), and among those with either isolated mental distress (B = 0.345 CI = 0.039-0.650, p = 0.028) or isolated insomnia (B = 0.207, CI = 0.040-0.373, p = 0.015). However, among individuals with co-occurring insomnia and mental distress, the association was not significant (B = -0.093, CI = -0.346-0.161, p = 0.470)., Conclusions: LDD does not associate with LBP-related disability when insomnia and mental distress co-occur. This finding may be useful when planning treatment and rehabilitation that aim to reduce disability among individuals with LDD and LBP. Future prospective research is warranted., (© 2023. The Author(s).)
Published: 2023
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27. Finnish emergency medical services managers' and medical directors' perceptions of collaborating with patients concerning patient safety issues: a qualitative study.

Author: Venesoja A, Tella S, Castrén M, and Lindström V
Subjects: Humans, Finland, Patient Safety, Qualitative Research, Physician Executives, Emergency Medical Services methods
Abstract: Objectives: This study aimed to describe emergency medical services (EMS) managers' and medical directors' perceptions of collaborating with patients concerning patient safety issues in the EMS., Design: The study used a descriptive qualitative approach. Five focus groups and two individuals were interviewed using a semi-structured guide with open-ended questions. The data were analysed using reflexive thematic analysis. Consolidated criteria for Reporting Qualitative research was used to guide the reporting of this study., Setting: EMS organisations from Finland's five healthcare districts., Participants: EMS medical directors (n=5) and EMS managers (n=14). Purposive sampling was used., Results: Two main themes, 'Patient safety considered an organisational responsibility' and 'EMS patients' opportunities and obstacles to speaking up', were generated from the data. Under the main theme, 'Patient safety considered an organisational responsibility', were three subthemes: patient safety considered part of the quality in EMS, system-level models for handling and observing patient safety in EMS, and management's ability to find a balance when using patients' feedback for patient safety development. Under the other main theme were four subthemes: 'social and feedback skills of EMS personnel and management', 'managements' assumptions of patients' reasons for not speaking up', 'EMS organisations' different but unsystematic ways of collecting feedback' and 'management's openness to develop patient participation'., Conclusions: The nature of the EMS organisations and EMS assignments could affect a patient's participation in developing patient safety in EMS. However, EMS managers and medical directors are receptive to collaborating with patients concerning patient safety issues if they have sufficient resources and a coherent way to collect patient safety concerns. The management is open to collaborating with patients, but there is a need to develop a systematic method with enough resources to facilitate the management's collaborating with patients., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Published: 2023
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28. Eveningness is Associated With Persistent Multisite Musculoskeletal Pain: A 15-Year Follow-up Study of Northern Finns.

Author: Heikkala E, Merikanto I, Tanguay-Sabourin C, Karppinen J, and Oura P
Subjects: Humans, Follow-Up Studies, Cohort Studies, Finland epidemiology, Longitudinal Studies, Cross-Sectional Studies, Circadian Rhythm, Sleep, Surveys and Questionnaires, Musculoskeletal Pain epidemiology
Abstract: Chronotype, a phenotype representing a person's 24-hour circadian rhythm, has been increasingly acknowledged as playing a role in musculoskeletal (MSK) pain. Most prior research on chronotype and MSK pain have been based on cross-sectional data, and no study has explored multisite MSK pain (2 or more pain locations) as the outcome. We drew the study sample from the 31- and 46-year data collections (baseline and follow-up, respectively) of the Northern Finland Birth Cohort 1966 and collected self-reported data on chronotype at follow-up (morning [M]-type, intermediate [I]-type, and evening [E]-type) and longitudinal multisite MSK pain trajectories (n = 3,294). Multinomial logistic regression was used to estimate odds ratios (ORs) with 95% confidence intervals (CIs) in multisite MSK pain trajectories between the chronotypes. We conducted additional sensitivity analyses that 1) accounted for several confounders, and 2) examined the potential moderating role of sex, mental distress, and sleep disturbance status in the chronotype-multisite MSK pain associations. The E-types had two-and-a-half-times higher odds of multisite MSK pain at baseline and follow-up (OR 2.47, 95% CI 1.84-3.32) than the M-types. Having severe mental distress or poor sleep at baseline and follow-up, or sex did not change the strength of this association. Our examination of this longitudinal birth cohort study suggested that evening types, in comparison to morning types, are more likely to experience multisite MSK pain between ages 31 and 46 years. Chronotype should be recognized as a predictor of multisite pain and thus taken into account in the evaluation of a patient's risk for multisite pain. PERSPECTIVE: This longitudinal study shows that evening types, compared to morning types, have higher odds of experiencing multisite MSK pain between ages 31 and 46 years. Chronotype should be considered while evaluating MSK patient's risk for persistent multisite pain symptoms., (Copyright © 2022 United States Association for the Study of Pain, Inc. Published by Elsevier Inc. All rights reserved.)
Published: 2023
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29. External Validation of SpineNet, an Open-Source Deep Learning Model for Grading Lumbar Disk Degeneration MRI Features, Using the Northern Finland Birth Cohort 1966.

Author: McSweeney TP, Tiulpin A, Saarakkala S, Niinimäki J, Windsor R, Jamaludin A, Kadir T, Karppinen J, and Määttä J
Subjects: Humans, Birth Cohort, Finland epidemiology, Reproducibility of Results, Lumbar Vertebrae diagnostic imaging, Lumbar Vertebrae pathology, Magnetic Resonance Imaging methods, Intervertebral Disc Degeneration diagnostic imaging, Intervertebral Disc Degeneration pathology, Low Back Pain diagnostic imaging, Low Back Pain pathology, Deep Learning
Abstract: Study Design: This is a retrospective observational study to externally validate a deep learning image classification model., Objective: Deep learning models such as SpineNet offer the possibility of automating the process of disk degeneration (DD) classification from magnetic resonance imaging (MRI). External validation is an essential step to their development. The aim of this study was to externally validate SpineNet predictions for DD using Pfirrmann classification and Modic changes (MCs) on data from the Northern Finland Birth Cohort 1966 (NFBC1966)., Summary of Data: We validated SpineNet using data from 1331 NFBC1966 participants for whom both lumbar spine MRI data and consensus DD gradings were available., Materials and Methods: SpineNet returned Pfirrmann grade and MC presence from T2-weighted sagittal lumbar MRI sequences from NFBC1966, a data set geographically and temporally separated from its training data set. A range of agreement and reliability metrics were used to compare predictions with expert radiologists. Subsets of data that match SpineNet training data more closely were also tested., Results: Balanced accuracy for DD was 78% (77%-79%) and for MC 86% (85%-86%). Interrater reliability for Pfirrmann grading was Lin concordance correlation coefficient=0.86 (0.85-0.87) and Cohen κ=0.68 (0.67-0.69). In a low back pain subset, these reliability metrics remained largely unchanged. In total, 20.83% of disks were rated differently by SpineNet compared with the human raters, but only 0.85% of disks had a grade difference >1. Interrater reliability for MC detection was κ=0.74 (0.72-0.75). In the low back pain subset, this metric was almost unchanged at κ=0.76 (0.73-0.79)., Conclusions: In this study, SpineNet has been benchmarked against expert human raters in the research setting. It has matched human reliability and demonstrates robust performance despite the multiple challenges facing model generalizability., Competing Interests: The authors report no conflicts of interest., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
Published: 2023
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30. Family structure and multisite musculoskeletal pain in adolescence: a Northern Finland Birth Cohort 1986 study.

Author: Heikkala E, Oura P, Karppinen J, Herbert A, Varis H, Hagnäs M, Mikkola I, and Paananen M
Subjects: Humans, Adolescent, Family Structure, Finland, Birth Cohort, Cross-Sectional Studies, Musculoskeletal Pain
Abstract: Background: Family structure is suggested to be associated with adolescent pain, but evidence on its association with multisite MS pain is sparse. The purpose of this cross-sectional study was to investigate the potential associations between family structure ('single-parent family', 'reconstructed family', and 'two-parent family') and multisite musculoskeletal (MS) pain in adolescence., Methods: The dataset was based on the 16-year-old Northern Finland Birth Cohort 1986 adolescents with available data on family structure, multisite MS pain, and a potential confounder (n = 5,878). The associations between family structure and multisite MS pain were analyzed with binomial logistic regression and modelled as unadjusted, as the evaluated potential confounder, mother's educational level, did not meet the criteria for a confounder., Results: Overall, 13% of the adolescents had a 'single-parent family' and 8% a 'reconstructed family'. Adolescents living in a single-parent family had 36% higher odds of multisite MS pain compared to adolescents from two-parent families (the reference) (Odds Ratio [OR]: 1.36, 95% Confidence Interval [CI]: 1.17 to 1.59). Belonging to a 'reconstructed family' was associated with 39% higher odds of multisite MS pain (OR 1.39, 1.14 to 1.69)., Conclusion: Family structure may have a role in adolescent multisite MS pain. Future research is needed on causality between family structure and multisite MS pain, to establish if there is a need for targeted support., (© 2023. The Author(s).)
Published: 2023
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31. Accumulation of long-term diseases is associated with musculoskeletal pain dimensions among middle-aged individuals with musculoskeletal pain.

Author: Heikkala E, Oura P, Ho E, Ferreira P, Paananen M, and Karppinen J
Subjects: Male, Middle Aged, Female, Humans, Retrospective Studies, Cross-Sectional Studies, Self Report, Logistic Models, Musculoskeletal Pain epidemiology, Musculoskeletal Pain complications, Musculoskeletal Diseases complications
Abstract: Background: Long-term diseases often co-occur with musculoskeletal (MSK) pain. In middle-aged individuals with MSK pain, it remains unclear whether an accumulation (two or more) of long-term diseases is associated with MSK pain dimensions, including pain frequency, bothersomeness of pain, pain intensity and number of pain sites., Methods: This cross-sectional study included data from the Northern Finland Birth Cohort 1966 collected in 2012-2014 when the participants were 46 years of age. We included participants who reported having MSK pain during the previous year (collected retrospectively) and provided self-reported information related to MSK pain dimensions, long-term diseases and potential confounders (n = 4469). The association between long-term diseases and pain dimensions was modelled by general linear and logistic regression models, with beta (β) coefficients, odds ratios (ORs) and their 95% confidence intervals (CIs) being presented. Unadjusted models were followed by models adjusted for sex, educational level and smoking., Results: The presence of accumulated long-term diseases was associated with over two-fold higher odds of daily pain (adjusted OR 2.6, 95% CI 2.0-3.4) and significantly higher levels of bothersomeness of pain and pain intensity (adjusted β 1.1, 95% CI 0.9-1.4; adjusted β 1.0, 95% CI 0.8-1.1, respectively), relative to the absence of long-term diseases. Females with accumulated long-term diseases had a stronger relationship to number of pain sites than males. Associations between one long-term disease and pain dimensions were significant but smaller in magnitude., Conclusion: There is a need for a better understanding of the relationships between accumulated long-term diseases and MSK pain., Significance: This study on middle-aged individuals with musculoskeletal pain showed that the presence of long-term diseases was clearly associated with pain frequency, bothersomeness of pain, pain intensity and number of pain sites. Compared with no long-term diseases, the association between accumulated (two or more) long-term diseases and pain dimensions was stronger than the association between one long-term disease and pain dimensions., (© 2022 European Pain Federation - EFIC ®.)
Published: 2023
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32. Spouses' need for information and satisfaction with the patient's care and rehabilitation after stroke. Importance of depression and prescheduled follow-up.

Author: Berg A, Tapiola T, and Hujala M
Subjects: Humans, Spouses, Follow-Up Studies, Depression, Patient Satisfaction, Personal Satisfaction, Caregivers, Stroke, Stroke Rehabilitation methods
Abstract: Objectives: We aimed to study the information needs of the spouses of stroke survivors, and whether the functional ability, depressive mood, or demographic factors of the survivors or spouses associate with the information needs or satisfaction with care. We also investigated whether prescheduled follow-up improves information provision., Methods: Ninety-six spouses of consecutive stroke survivors completed a questionnaire on their information needs and satisfaction with care 21 months post-stroke. The results of samples before (n = 59) and after (n = 37) the implementation of the prescheduled follow-up were compared., Results: Before the follow-up, 75% of the spouses had received information on stroke and the well-being of the survivor, with 31% having received information on the survivors' and 18% on the spouses' own mood. The information provision improved after the follow-up: 86%, 44%, and 50%, respectively. The need for more information and satisfaction with care were associated with the spouse's depression, but not with functional impairment., Conclusions: Even if information on stroke is satisfactorily provided, the mood and well-being of spouses is often neglected. Information provision and support can be improved with systematic prescheduled follow-up., Practice Implications: Our results suggest the routine assessment of the depressive symptoms and needs of spouses of stroke survivors., Competing Interests: Declaration of Competing Interest The authors report no conflict of interest., (Copyright © 2022 Elsevier B.V. All rights reserved.)
Published: 2023
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33. Burden of mortality linked to community-nominated priorities in rural South Africa.

Author: Mattila P, Davies J, Mabetha D, Tollman S, and D'Ambruoso L
Subjects: Autopsy, Cause of Death, Humans, Risk Factors, South Africa epidemiology, Public Health, Rural Population
Abstract: Background: Community knowledge is a critical input for relevant health programmes and strategies. How community perceptions of risk reflect the burden of mortality is poorly understood., Objective: To determine the burden of mortality reflecting community-nominated health risk factors in rural South Africa, where a complex health transition is underway., Methods: Three discussion groups (total 48 participants) representing a cross-section of the community nominated health priorities through a Participatory Action Research process. A secondary analysis of Verbal Autopsy (VA) data was performed for deaths in the same community from 1993 to 2015 (n = 14,430). Using population attributable fractions (PAFs) extracted from Global Burden of Disease data for South Africa, deaths were categorised as 'attributable at least in part' to community-nominated risk factors if the PAF of the risk factor to the cause of death was >0. We also calculated 'reducible mortality fractions' (RMFs), defined as the proportions of each and all community-nominated risk factor(s) relative to all possible risk factors for deaths in the population ., Results: Three risk factors were nominated as the most important health concerns locally: alcohol abuse , drug abuse , and lack of safe water . Of all causes of deaths 1993-2015, over 77% (n = 11,143) were attributable at least in part to at least one community-nominated risk factor. Causes of attributable deaths, at least in part, to alcohol abuse were most common (52.6%, n = 7,591), followed by drug abuse (29.3%, n = 4,223), and lack of safe water (11.4%, n = 1,652). In terms of the RMF, alcohol use contributed the largest percentage of all possible risk factors leading to death (13.6%), then lack of safe water (7.0%), and drug abuse (1.3%) ., Conclusion: A substantial proportion of deaths are linked to community-nominated risk factors. Community knowledge is a critical input to understand local health risks.
Published: 2022
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34. The differential effects of sleep deprivation on pain perception in individuals with or without chronic pain: A systematic review and meta-analysis.

Author: Chang JR, Fu SN, Li X, Li SX, Wang X, Zhou Z, Pinto SM, Samartzis D, Karppinen J, and Wong AY
Subjects: Humans, Sleep Deprivation, Health Status, Pain Perception, Chronic Pain
Abstract: Many experimental sleep deprivation (SD) studies were conducted to clarify the causal relationship between sleep and pain. This systematic review and meta-analysis aimed to update the evidence regarding the effects of different experimental SD paradigms on various pain outcomes. Five databases were searched from their inception to June 2022. Separate random-effects models were used to estimate the pooled effect sizes (ES) of different experimental SD paradigms on various pain outcomes. Thirty-one studies involving 699 healthy individuals and 47 individuals with chronic pain were included. For healthy individuals, limited evidence substantiated that total SD significantly reduced pain threshold and tolerance (ES 0.74-0.95), while moderate evidence supported that partial SD significantly increased spontaneous pain intensity (ES 0.30). Very limited to moderate evidence showed that sleep fragmentation significantly increased peripheral and central sensitization in healthy individuals (ES 0.42-0.79). Further, there was very limited evidence that total or partial SD significantly aggravated spontaneous pain intensity in people with chronic pain. Our results accentuated that different SD paradigms differentially increased subjective pain intensity and worsened peripheral/central pain sensitization in healthy individuals, whereas the corresponding findings in people with chronic pain remain uncertain. Further rigorous studies are warranted to quantify their relationships in clinical populations., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Published: 2022
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35. Ocular surface health of the Finnish elderly population.

Author: Aapola U, Nättinen J, Suurkuukka I, Tuomilehto J, Keinänen-Kiukaanniemi S, Saramies J, and Uusitalo H
Subjects: Male, Female, Aged, Humans, Tears, Finland epidemiology, Cross-Sectional Studies, Meibomian Glands, Dry Eye Syndromes diagnosis, Dry Eye Syndromes epidemiology, Dry Eye Syndromes drug therapy
Abstract: Purpose: The aim of this study was to describe the clinical ocular surface characteristics in a population-based sample of Finnish elderly people., Methods: This cross-sectional study included 601 subjects (335 females, 266 males) born between the years 1933-1956 and living in Savitaipale, Finland. Ocular surface health was evaluated using a comprehensive set of diagnostic tests. Previous dry eye (DE) diagnosis and history of drug treatment of DE were also recorded. Differences between sexes were estimated with Wilcoxon rank sum test and Fisher's exact test., Results: Overall, 10% and 33% of people displayed signs of DE and ocular surface disease (OSD), respectively, and 30% had been previously diagnosed with DE and 36% used some form of drugs for DE. Men displayed more severe signs of meibomian gland dysfunction, blepharitis and conjunctival redness (p < 0.001), while women had higher scores in corneal staining (p = 0.005) and OSD Index (p < 0.001)., Conclusion: Signs of OSD and DE are common among the Finnish elderly population. However, the diagnosis is affected by the diagnostic criteria used and significant differences exist between sexes. Although women were more frequently diagnosed with DE and OSD and experienced more ocular surface irritation, men had more often lid and meibomian gland-related issues. The current diagnostic criteria of DE pose a risk of misclassifying men, who commonly display less severe symptoms in comparison with women yet exhibit more severe clinical signs associated especially with the lid margin., (© 2022 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.)
Published: 2022
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36. Eveningness intensifies the association between musculoskeletal pain and health-related quality of life: a Northern Finland Birth Cohort Study 1966.

Author: Heikkala E, Paananen M, Merikanto I, Karppinen J, and Oura P
Subjects: Birth Cohort, Circadian Rhythm, Cohort Studies, Finland epidemiology, Humans, Middle Aged, Sleep, Surveys and Questionnaires, Musculoskeletal Pain epidemiology, Quality of Life
Abstract: Abstract: People with an evening (E)-type preference (ie, chronotype) experience musculoskeletal (MSK) pain and reduced health-related quality of life (HRQoL) more often than morning (M) types. Musculoskeletal pain is a well-established contributor to reduced HRQoL. This study aimed to evaluate whether eveningness amplifies the association between MSK pain and HRQoL in contrast to morningness. Questionnaire data on MSK pain dimensions (intensity, disability at work, number of pain sites [NPSs], and frequency), chronotype, covariates (sex, sufficiency of sleep duration, mental distress, and presence of coexisting diseases), and HRQoL (measured by 15D) were collected among 46-year-old individuals belonging to the Northern Finland Birth Cohort 1966 (N = 4257). Individuals without any MSK pain were excluded. General linear models were conducted to estimate the associations between chronotypes, MSK pain dimensions, and HRQoL. The interaction terms (chronotype × pain dimension) were tested in the models. There were 13% E-types and 43% M-types in the study sample. Each pain dimension and chronotype were related to HRQoL. In the sex-adjusted chronotype-specific models, the reduction in HRQoL in relation to pain appeared to be stronger among E-types than among M-types in respect to all pain dimensions. After adjustments, this was particularly seen in terms of NPS and pain frequency. Our findings suggest that eveningness intensifies the association between MSK pain and HRQoL, and, thus, they are indicative of E-types being more sensitive than M-types to the consequences of MSK pain. As such, MSK pain treatment and rehabilitation actions to improve HRQoL should be especially targeted at E-types., (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the International Association for the Study of Pain.)
Published: 2022
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37. Changes in the Severity of Frailty Among Older Adults After 12 Months of Supervised Home-Based Physical Exercise: A Randomized Clinical Trial.

Author: Suikkanen S, Soukkio P, Kautiainen H, Kääriä S, Hupli MT, Sipilä S, Pitkälä K, Aartolahti E, and Kukkonen-Harjula K
Subjects: Aged, Exercise, Exercise Therapy, Female, Frail Elderly, Humans, Male, Prevalence, Frailty
Abstract: Objective: To investigate the effects of 12 months of physiotherapist-supervised, home-based physical exercise on the severity of frailty and on the prevalence of the 5 frailty phenotype criteria, using secondary analyses., Design: Randomized clinical trial, with 1:1 allocation into 12-month home-based physical exercise, or usual care. The multicomponent exercise sessions (60 minutes) were supervised by the physiotherapist and included strength, balance, functional, and flexibility exercises twice a week at participants' homes., Setting and Participants: Home-dwelling older adults aged ≥65 years who were frail (meeting 3-5 criteria) or prefrail (1-2 criteria) according to frailty phenotype criteria., Methods: The severity of frailty (nonfrail, prefrail, or frail) was assessed using frailty phenotype criteria, and the prevalence of each frailty criterion (weight loss, low physical activity, exhaustion, weakness, and slowness) were assessed at baseline and at 12 months., Results: Two hundred ninety-nine persons were included in the analyses, of whom 184 were prefrail and 115 were frail at baseline. Their mean age was 82.5 (SD 6.3) years, and 75% were women. There was a significant difference between the exercise and usual care groups' transitions to different frailty states from baseline to 12 months among those who at baseline were prefrail (P = .032) and frail (P = .009). At 12 months, the mean number of frailty criteria had decreased in the exercise group (-0.27, 95% CI -0.47, -0.08) and remained unchanged in the usual care group (0.01, 95% CI -0.16, 0.18; P = .042). The prevalence of the exhaustion (P = .009) and the low physical activity (P < .001) criteria were lower at 12 months in the exercise group than in the usual care group., Conclusions and Implications: The severity of frailty can be reduced through 12-month supervised home-based exercise training. Exercise should be included in the care of older adults with signs of frailty., (Copyright © 2022 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)
Published: 2022
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38. Effects of a 12-month home-based exercise program on functioning after hip fracture - Secondary analyses of an RCT.

Author: Soukkio PK, Suikkanen SA, Kukkonen-Harjula KT, Kautiainen H, Hupli MT, Aartolahti EM, Kääriä SM, Pitkälä KH, and Sipilä S
Subjects: Activities of Daily Living, Aged, 80 and over, Exercise Therapy, Female, Humans, Male, Physical Therapy Modalities, Hand Strength, Hip Fractures surgery
Abstract: Background: Long-term functional limitations are common after hip fractures. Exercise may alleviate these negative consequences but there is no consensus on an optimal training program. The objective was to study the effects of a 12-month home-based supervised, progressive exercise program on functioning, physical performance, and physical activity., Methods: Secondary analysis of a randomized controlled trial targeting patients with surgical repair of a hip fracture, aged ≥60 years, Mini-Mental State Examination (MMSE) score of ≥12. The participants were randomized into Exercise (n = 61) or Usual care (n = 60). Assessments at baseline, 3, 6, and 12 months included Lawton's Instrumental Activities of Daily Living (IADL), Short Physical Performance Battery (SPPB), handgrip strength, and self-reported frequency of sessions of leisure-time physical activity. Analyzed using mixed-effects models., Results: Participants' (n = 121) mean age was 81 years (SD 7), and 75% were women. The mean IADL score at baseline was 17.1 (SD 4.5) in the exercise group, and 17.4 (5.1) in the usual care group. The mean SPPB scores were 3.9 (1.6) and 4.2 (1.8), and handgrip strength was 17.7 (8.9) kg and 20.8 (8.0) kg, respectively. The age- and sex-adjusted mean changes in IADL over 12 months were 3.7 (95% CI 2.8-4.7) in the exercise and 2.0 (1.0-3.0) in the usual care group (between-group difference, p = 0.016); changes in SPPB 4.3 (3.6-4.9) and 2.1 (1.5-2.7) (p < 0.001); and changes in handgrip strength 1.2 kg (0.3-2.0) and 1.0 kg (-1.9 to -0.2) (p < 0.001), respectively. We found no between-group differences in changes in the frequency of leisure-time activity sessions., Conclusion: A 12-month home-based supervised, progressive exercise program improved functioning and physical performance more than usual care among patients with hip fractures. However, the training did not increase leisure-time physical activity., (© 2022 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society.)
Published: 2022
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39. 1 H NMR Urinary Metabolomic Analysis in Older Adults after Hip Fracture Surgery May Provide Valuable Information for Patient Profiling-A Preliminary Investigation.

Author: Douzi W, Bon D, Suikkanen S, Soukkio P, Boildieu N, Nenonen A, Hupli M, Kukkonen-Harjula K, and Dugué B
Abstract: In these times of precision and personalized medicine, profiling patients to identify their needs is crucial to providing the best and most cost-effective treatment. In this study, we used urine metabolomics to explore the characterization of older adults with hip fractures and to explore the forecasting of patient outcomes. Overnight urine specimens were collected from 33 patients (mean age 80 ± 8 years) after hip fracture surgery during their stay at a rehabilitation hospital. The specimens were analyzed with 1 H NMR spectroscopy. We performed a metabolomics study regarding assessments of frailty status, Functional Independence Measure (FIM), and Short Physical Performance Battery (SPPB). The main metabolic variations concerned 10 identified metabolites: paracetamol derivatives (4 peaks: 2.15 ppm; 2.16 ppm; 7.13 ppm and 7.15 ppm); hippuric acid; acetate; acetone; dimethylamine; glycine; alanine; lactate; valine; TMAO. At baseline, the urinary levels of these metabolites were significantly higher (i) in frail compared with non-frail patients, (ii) in persons with poorer FIM scores, and (iii) in persons with poorer compared SPPB scores. Our findings suggested that patients with increased levels of urine metabolites associated with metabolic, inflammatory, and renal disorders presented clear signs of frailty, impaired functional independence, and poor physical performance. Metabolomics could be a valuable tool to further characterize older adults, especially after major medical events., Competing Interests: The authors declare no conflict of interest.
Published: 2022
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40. Association of musculoskeletal pain with the achievement of treatment targets for type 2 diabetes among primary care patients.

Author: Heikkala E, Hagnäs M, Jokelainen J, Karppinen J, Ferreira P, Ferreira ML, and Mikkola I
Subjects: Blood Pressure physiology, Cross-Sectional Studies, Glycated Hemoglobin analysis, Humans, Primary Health Care, Diabetes Mellitus, Type 2 diagnosis, Diabetes Mellitus, Type 2 drug therapy, Diabetes Mellitus, Type 2 epidemiology, Musculoskeletal Pain complications, Musculoskeletal Pain diagnosis, Musculoskeletal Pain epidemiology
Abstract: Aims: To assess the association of diagnosed musculoskeletal (MS) pain (low back, neck, shoulder, and knee pain; and the number of pain sites) with the achievement of targets for glycosylated haemoglobin A1c (HbA1c), low-density-lipoprotein cholesterol (LDL), and systolic blood pressure (SBP) among primary care patients with type 2 diabetes (T2D)., Methods: The cross-sectional study population consisted of 3478 patients with a registry-based T2D diagnosis and available registry-based data on MS pain diagnoses, covariates, and outcomes between 2016 and 2019. Logistic regression analysis was used to evaluate the study aims., Results: Overall, 22% had at least one of the four types of MS pain, and 73%, 57%, and 51% achieved the treatment targets of HbA1c, LDL, and SBP, respectively. T2D patients with or without MS pain did not differ in their achievement of T2D treatment goals. Of pain locations, low back pain was associated with higher rates of achievement of the LDL target (OR 1.29, 95% CI 1.01-1.65), but the association was attenuated in the adjusted model., Conclusions: MS pain was relatively prevalent among primary care patients with T2D, but did not influence the achievement of T2D treatment goals., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Published: 2022
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41. Burden of disease and management of osteoarthritis and chronic low back pain: healthcare utilization and sick leave in Sweden, Norway, Finland and Denmark (BISCUITS): study design and patient characteristics of a real world data study.

Author: Hallberg S, Rolfson O, Karppinen J, Schiøttz-Christensen B, Stubhaug A, Rivano Fischer M, Gerdle B, Toresson Grip E, Gustavsson A, Robinson RL, Varenhorst C, and Schepman P
Subjects: Humans, Finland epidemiology, Sweden epidemiology, Sick Leave, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Norway, Patient Acceptance of Health Care, Cost of Illness, Denmark epidemiology, Low Back Pain therapy, Low Back Pain drug therapy, Osteoarthritis therapy, Osteoarthritis drug therapy
Abstract: Objectives: Osteoarthritis (OA) and chronic low back pain (CLBP) are common musculoskeletal disorders with substantial patient and societal burden. Nordic administrative registers offer a unique opportunity to study the impact of these conditions in the real-world setting. The Burden of Disease and Management of Osteoarthritis and Chronic Low Back Pain: Health Care Utilization and Sick Leave in Sweden, Norway, Finland and Denmark (BISCUITS) study was designed to study disease prevalence and the societal and economic burden in broad OA and CLBP populations., Methods: Patients in Sweden, Norway, Finland and Denmark with diagnoses of OA or CLBP (low back pain record plus ≥2 pain relief prescriptions to indicate chronicity) were identified in specialty care, in primary care (Sweden and Finland) and in a quality-of-care register (Sweden). Matched controls were identified for the specialty care cohort. Longitudinal data were extracted on prevalence, treatment patterns, patient-reported outcomes, social and economic burden., Results: Almost 1.4 million patients with OA and 0.4 million with CLBP were identified in specialty care, corresponding to a prevalence in the Nordic countries of 6.3 and 1.9%, respectively. The prevalence increased to 11-14% for OA and almost 6% for CLBP when adding patients identified in primary care. OA patients had a higher Elixhauser comorbidity index (0.66 vs. 0.46) and were using opioids (44.7 vs. 10.2%) or long-term nonsteroidal anti-inflammatory drug (NSAIDs) (20.9 vs. 4.5%) more than four times as often as compared to controls. The differences were even larger for CLBP patients compared to their controls (comorbidity index 0.89 vs. 0.39, opioid use 77.7 vs. 9.4%, and long-term NSAID use 37.2 vs. 4.8%)., Conclusions: The BISCUITS study offers an unprecedented, longitudinal healthcare data source to quantify the real-world burden of more than 1.8 million patients with OA or CLBP across four countries. In subsequent papers we aim to explore among others additional outcomes and subgroups of patients, primarily those patients who may benefit most from better healthcare management., (© 2022 Walter de Gruyter GmbH, Berlin/Boston.)
Published: 2022
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42. Elevated One-Hour Post-Load Glucose Is Independently Associated with Albuminuria: A Cross-Sectional Population Study.

Author: Saunajoki A, Auvinen J, Bloigu A, Saramies J, Tuomilehto J, Uusitalo H, Hussi E, Cederberg-Tamminen H, Suija K, Keinänen-Kiukaanniemi S, and Timonen M
Abstract: The purpose of this study was to examine and compare the associations between albuminuria and fasting (FPG), 1 h post-load (1 h PG) and 2 h post-load plasma glucose (2 h PG) in an oral glucose tolerance test (OGTT). A total of 496 people free of known diabetes (mean age 72 years) participated in the examinations including the OGTT with plasma glucose measurements at 0, 1, and 2 h and levels of HbA1c. Albuminuria was determined by the urinary albumin-to-creatinine ratio and was defined as ≥3.0 mg/mmol. Compared with those without albuminuria, participants with albuminuria had significantly higher 1 h PG and 2 h PG levels, but not FPG or HbA1c levels. An elevated 1 h PG increased the estimated odds ratio of albuminuria more than three times in people with prediabetic 1 h PG (8.6-11.5 mmol/L: OR 3.60; 95% CI 1.70-7.64) and diabetic 1 h PG (≥11.6 mmol/L: OR 3.05; 95% CI 1.29-7.23). After adjusting for blood pressure and age, the association of elevated 1 h PG with albuminuria remained significant. Prediabetic or diabetic FPG, 2 h PG, or HbA1c did not have a statistically significant association with albuminuria. These findings suggest that 1 h PG seems to be the best glycemic parameter and is useful in recognizing persons with an elevated risk of early kidney disease due to hyperglycemia.
Published: 2022
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43. Patients' conceptions of undergoing physiotherapy for persistent low back pain delivered in Finnish primary healthcare by physiotherapists who had participated in brief training in cognitive functional therapy.

Author: Holopainen R, Vuoskoski P, Piirainen A, Karppinen J, and O'Sullivan P
Subjects: Cognition, Finland, Humans, Physical Therapy Modalities, Primary Health Care, Low Back Pain psychology, Low Back Pain therapy, Physical Therapists psychology
Abstract: Purpose: To explore the conceptions of patients with persistent low back pain (LBP) of undergoing physiotherapy delivered in Finnish primary healthcare by physiotherapists who had participated in brief training in Cognitive Functional Therapy (CFT)., Methods: As part of a feasibility implementation study exploring CFT in management of LBP in the Finnish primary healthcare system, we interviewed nine patients from four geographical areas in Finland after receiving care. We used a phenomenographic approach to explore the variation in their conceptions., Results: The analysis revealed four descriptive categories: "hung out to dry," "stuck," "making sense and taking control," and "holistic approach to care and living," that varied based on six themes., Conclusions: Although the participants accepted this approach to care well, there was significant variation in patients' conceptions. Restricted access to care within the healthcare system and a lack of social support led some of them to feel they had been left alone to suffer with their pain. On the other hand, based on the results of this study, positive experiences of physiotherapy and good collaboration with the physiotherapist, wider social support outside of physiotherapy, a better understanding of the multidimensional nature of pain and the acquisition of self-management skills were reported as positive aspects of undergoing physiotherapy that may be related to positive treatment outcomes.Implications for rehabilitationThe participants of this study saw undergoing physiotherapy delivered within biopsychosocial framework as different from their previous physiotherapy experiences and for some the process ended with feeling empty-handed and for others it could be a turning point in their lives.This study encourages the health care providers to create flexible care pathways and ongoing support for more vulnerable individuals so that they don't feel abandoned by the system.Professionals could also pay attention to building strong therapeutic alliance, help patients understand pain in biopsychosocial framework, take into consideration social support networks of the patients, and support patients toward effective self-management strategies.
Published: 2022
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44. Association Between Family History of Surgically Treated Low Back Pain and Adolescent Low Back Pain.

Author: Heikkala E, Karppinen J, Mikkola I, Hagnäs M, and Oura P
Subjects: Adolescent, Adult, Cross-Sectional Studies, Humans, Odds Ratio, Risk Factors, Surveys and Questionnaires, Young Adult, Low Back Pain diagnosis, Low Back Pain epidemiology, Low Back Pain genetics
Abstract: Study Design: Cross-sectional., Objective: To study the associations between a family history of surgically treated low back pain (LBP) and adolescent LBP., Summary of Background Data: A family history of LBP is related to adolescent LBP, but whether a family history of back surgery is relevant to adolescent LBP is not known., Methods: A subpopulation of the Northern Finland Birth Cohort 1986 was contacted when they were aged between 18 and 19years. The postal questionnaire asked the participants to report their LBP and a relative's (mother, father, sibling) LBP and back surgery, and to provide data on potential covariates. The association between a family history of LBP ("no family history of LBP," "family history of LBP but no surgery," and "family history of LBP and surgery") and adolescent LBP (no LBP, occasional LBP, and frequent LBP) were evaluated using logistic regression analysis with odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for sex, smoking, and psychological distress., Results: Of the 1374 adolescents in the study, 33% reported occasional LBP and 9% frequent LBP. Both the "family history of LBP but no surgery" and "family history of LBP and surgery" categories were associated with frequent LBP (adjusted OR [aOR] 2.09, 95% CI 1.38-3.16; aOR 2.23, 95% CI 1.02-4.90, respectively). Occasional LBP was associated with the "family history of LBP and surgery" category. A subgroup analysis of adolescents with a family history of LBP found no statistically significant associations between family history of back surgery and adolescent LBP., Conclusion: Our findings suggest that adolescents who report a family history of LBP have higher odds of frequent LBP irrespectively of a family history of back surgery.Level of evidence: 4., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
Published: 2022
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45. Pressure injury prevalence and incidence in acute inpatient care and related risk factors: A cross-sectional national study.

Author: Tervo-Heikkinen TA, Heikkilä A, Koivunen M, Kortteisto TR, Peltokoski J, Salmela S, Sankelo M, Ylitörmänen TS, and Junttila K
Subjects: Adult, Cross-Sectional Studies, Humans, Incidence, Prevalence, Risk Factors, Inpatients, Pressure Ulcer epidemiology, Pressure Ulcer etiology
Abstract: The aim of this national cross-sectional study was to explore the prevalence of pressure injuries and incidence of hospital-acquired pressure injuries, and the relating factors in somatic-specialised inpatient care in Finland. The study was conducted in 16 (out of 21) Finnish health care organisations offering specialised health care services. Data were collected in 2018 and 2019 from adult patients (N = 5902) in inpatient, emergency follow-up, and rehabilitation units. Pressure injury prevalence (all stages/categories) was 12.7%, and the incidence of hospital-acquired pressure injuries was 10%. Of the participants, 2.6% had at least one pressure injury at admission. The risk of hospital-acquired pressure injuries was increased for medical patients with a higher age, the inability to move independently, mode of arrival, being underweight, and the absence of a skin assessment or pressure injury risk assessment at admission. For surgical patients, the risk was associated with the inability to move independently, mode of arrival, and lack of skin assessment at admission, while being overweight protected the patients. Overall, medical patients were in greater risk of hospital-acquired pressure injuries than the surgical patients. An assessment of the pressure injury risk and skin status should be carried out more systematically in Finnish acute care hospitals., (© 2021 The Authors. International Wound Journal published by Medicalhelplines.com Inc (3M) and John Wiley & Sons Ltd.)
Published: 2022
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46. Chronotypes and disabling musculoskeletal pain: A Finnish birth cohort study.

Author: Heikkala E, Oura P, Korpela T, Karppinen J, and Paananen M
Subjects: Birth Cohort, Circadian Rhythm, Cohort Studies, Finland epidemiology, Humans, Sleep, Surveys and Questionnaires, Musculoskeletal Pain epidemiology, Sleep Initiation and Maintenance Disorders epidemiology
Abstract: Background: It has been suggested that chronotype, the individual preference for 24-h circadian rhythms, influences health. Sleep problems and mental distress are amongst the greatest risk factors for musculoskeletal (MS) pain. The aims of this study were first, to explore the associations between chronotypes and MS pain, with special reference to disabling MS pain and second, to test whether mental distress and insomnia have a modifying role in the associations between chronotypes and MS pain., Methods: The dataset of 4961 individuals was composed of Northern Finns surveyed on MS pain, chronotypes and confounding factors (sex, insomnia, sleep duration, smoking, mental distress, occupational status, education level and number of coexisting diseases) at 46 years. The relationships between chronotypes (evening [E], intermediate [I] and morning [M]) and MS pain were evaluated using multinomial logistic regression. To address the second aim, we included an interaction term (chronotype*mental distress, chronotype*insomnia) in the logistic model., Results: Compared to the M-types, both the E- and I-types had increased odds of suffering 'disabling pain' in the unadjusted model (odds ratio [OR] 1.79, 95% confidence interval [CI] 1.37-2.33; OR 1.54, 95% CI 1.29-1.84, respectively). However, the association remained statistically significant only after adjusting for all covariates amongst the I-types (OR 1.39, 95% CI 1.15-1.67). Neither mental distress nor insomnia was found to modify the chronotype-MS pain association., Conclusions: The results highlight the importance of chronotypes for individuals' MS health but suggest the presence of confounding factors in the interplay between these factors., Significance: This study shows that evening and intermediate chronotypes are associated with disabling MS pain, but that mental distress, insomnia and coexisting diseases also play a role in these associations., (© 2022 The Authors. European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation - EFIC ®.)
Published: 2022
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47. Are Morphometric and Biomechanical Characteristics of Lumbar Multifidus Related to Pain Intensity or Disability in People With Chronic Low Back Pain After Considering Psychological Factors or Insomnia?

Author: Pinto SM, Cheung JPY, Samartzis D, Karppinen J, Zheng YP, Pang MYC, and Wong AYL
Abstract: Introduction: Lumbar multifidus muscle (LMM) dysfunction is thought to be related to pain and/or disability in people with chronic low back pain (CLBP). Although psychosocial factors play a major role in pain/disability, they are seldom considered as confounders in analyzing the association between LMM and CLBP., Objectives: This study aimed to determine: (1) differences in psychological factors, insomnia, and LMM characteristics between people with and without CLBP; (2) associations between psychological factors, insomnia, or LMM characteristics and low back pain (LBP) intensity or LBP-related disability in people with CLBP; and (3) whether LMM characteristics are related to LBP symptoms in people with CLBP after considering confounders., Methods: Seventy-eight volunteers with CLBP and 73 without CLBP provided sociodemographic information, filled the 11-point numeric pain rating scale and Roland-Morris disability questionnaire (RMDQ). They completed the Hospital Anxiety and Depression Scale (HADS), Pain Catastrophizing Scale (PCS), Fear Avoidance Belief Questionnaire (FAB), and Insomnia Severity Index Scale (ISI). Resting and contracted thickness of LMM at L4-S1 levels were measured from brightness-mode ultrasound images. Percent thickness changes of LMM at L4-S1 levels during contraction were calculated. Resting LMM stiffness at L4-S1 was measured by shear wave elastography. Associations among LMM, psychosocial or insomnia parameters and clinical outcomes were analyzed by univariate and multivariate analyses., Results: People with CLBP demonstrated significantly higher LBP-intensity, RMDQ, HADS, FAB, PCS, and ISI scores than asymptomatic controls ( p < 0.05). The former also had significantly smaller percent thickness changes of LMM at L4/L5 during contraction. LBP-intensity was positively related to scores of PCS-total, PCS-helplessness, FAB-total, FAB-work, and ISI in people with CLBP ( p < 0.05). RMDQ scores were positively associated with the scores of HADS-total, HADS-depression, PCS-total, FAB-total, FAB-physical activity, PCS-helplessness, and ISI in people with CLBP ( p < 0.05). FAB-work and ISI scores together explained 24% of LBP-intensity. FAB-total scores alone explained 34% of variance of LBP-related disability in people with CLBP., Conclusion: More fear-avoidance belief or insomnia is related to greater LBP-intensity and/or LBP-related disability in people with CLBP. Although people with CLBP were thought to have aberrant LMM morphometry/function, no LMM characteristics were related to LBP-intensity or LBP-related disability after considering other confounders., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Pinto, Cheung, Samartzis, Karppinen, Zheng, Pang and Wong.)
Published: 2022
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48. Association of lumbar disc degeneration with low back pain in middle age in the Northern Finland Birth Cohort 1966.

Author: Mertimo T, Karppinen J, Niinimäki J, Blanco R, Määttä J, Kankaanpää M, and Oura P
Subjects: Birth Cohort, Finland epidemiology, Humans, Lumbar Vertebrae diagnostic imaging, Magnetic Resonance Imaging methods, Middle Aged, Intervertebral Disc Degeneration complications, Intervertebral Disc Degeneration diagnostic imaging, Intervertebral Disc Degeneration epidemiology, Low Back Pain diagnostic imaging, Low Back Pain epidemiology, Low Back Pain etiology
Abstract: Background: Although it has been suggested that lumbar disc degeneration (LDD) is a significant risk factor for low back pain (LBP), its role remains uncertain. Our objective was to clarify the association between LDD and LBP and whether mental distress modifies the association., Methods: Participants of a birth cohort underwent 1.5-T lumbar magnetic resonance imaging at the age of 47. The association between the sum score of LDD (Pfirrmann classification, range 0-15) and LBP (categorized into "no pain", "mild-to-moderate pain", "bothersome-and-frequent pain") was assessed using logistic regression analysis, with sex, smoking, body mass index, physical activity, occupational exposure, education, and presence of Modic changes and disc herniations as confounders. The modifying role of mental distress (according to the Hopkins Symptom Check List-25 [HSCL-25], the Beck Depression Inventory and the Generalized Anxiety Disorder Scale) in the association was analyzed using linear regression., Results: Of the study population (n = 1505), 15.2% had bothersome and frequent LBP, and 29.0% had no LBP. A higher LDD sum score increased the odds of belonging to the "mild-to-moderate pain" category (adjusted OR corresponding to an increase of one point in the LDD sum score 1.11, 95% CI 1.04-1.18, P = 0.003) and the "bothersome-and-frequent pain" category (adjusted OR 1.20, 95% CI 1.10-1.31, P < 0.001), relative to the "no pain" category. Mental distress significantly modified the association between LDD and LBP, as a linear positive association was consistently observed among individuals without mental distress according to HSCL-25 (adjusted B 0.16, 95% CI 0.07-0.26, P < 0.001), but not among individuals with higher mental distress., Conclusions: LDD was significantly associated with both mild-to-moderate and bothersome-and-frequent LBP. However, the co-occurrence of mental distress diminished the association between LDD and LBP bothersomeness. Our results strongly suggest that mental symptoms affect the pain experience., (© 2022. The Author(s).)
Published: 2022
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49. A Natural History of Erectile Dysfunction in Elderly Men: A Population-Based, Twelve-Year Prospective Study.

Author: Saramies J, Koiranen M, Auvinen J, Uusitalo H, Hussi E, Becker S, Keinänen-Kiukaanniemi S, Tuomilehto J, and Suija K
Abstract: There is a wide variation in the development and course of erectile dysfunction (ED) in men, which confirms the need for prospective studies. We conducted a cross-sectional analysis among the general male population at the baseline ( n = 359) and in a follow-up survey ( n = 218) 12 years later. The prospective 12-year study included 189 men. ED was assessed using the International Index of Erectile Function questionnaire. The mean age of the participants was 62.0 years at the baseline, while at the 12-year follow-up it was 71.6 years. The crude prevalence of ED was 61.6% at the baseline and 78.9% at the follow-up, and the prevalence tended to increase with age. All of the men aged 75 years or more had at least mild ED. The incidence of ED in every thousand person years was 53.5. A total of 54.5% of the men experienced ED progression, while 39.2% reported no changes in erectile function, and 6.3% experienced ED regression during the 12-year study. The likelihood of ED progression was higher in the older compared with younger age group (odds ratio, OR 5.2 (95% CI: 1.1-26.2)), and the likelihood of ED regression was lower among men with increased depression symptoms (OR 0.3 (95% CI: 0.1-0.6)) and among men with a decreased interest in their sexual life (OR 0.1 (95% CI: 0.0-0.6)). Lifestyle factors such as the consumption of alcohol and smoking were not significantly associated with ED.
Published: 2022
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50. Weight-Related and Personal Risk Factors of Carpal Tunnel Syndrome in the Northern Finland Birth Cohort 1966.

Author: Lampainen K, Shiri R, Auvinen J, Karppinen J, Ryhänen J, and Hulkkonen S
Abstract: Background: Excess body mass is a risk factor for carpal tunnel syndrome (CTS), but the mechanisms of this are unclear. This study aimed to evaluate the association between CTS and personal risk factors of body mass index (BMI), waist circumference and waist-to-hip ratio (WHR)., Methods: The study sample consisted of the Northern Finland Birth Cohort 1966 ( n = 9246). At the age of 31 in 1997 and at the age of 46 in 2012, the participants underwent a clinical examination. Cohort A consisted of complete cases with a follow-up from 1997 to 2012 ( n = 4701), and Cohort B was followed up from 2012 to 2018 ( n = 4548). The data on diagnosed CTS were provided by the Care Register for Health Care until the end of 2018., Results: After an adjustment for confounding factors, BMI was associated with CTS among women (hazard ratio (HR) 1.47, 95% Cl 0.98-2.20 for overweight women and HR 2.22, 95% Cl 1.29-3.83 for obese women) and among both sexes combined (HR 1.35 95% Cl 0.96-1.90 for overweight and HR 1.98 95% Cl 1.22-3.22 for obese participants). Neither waist circumference nor WHR was associated with CTS., Conclusions: BMI is an independent risk factor for CTS and is more relevant for estimating the increased risk of CTS due to excess body mass than waist circumference or WHR.
Published: 2022
Full Text: View/download PDF

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