Browsing by Author "Sakarya, S"
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Item Radiolabeling of Bleomycin-Glucuronide with 131I and Biodistribution Studies Using Xenograft Model of Human Colon Tumor in Balb/C MiceDemiroglu, H; Avcibasi, U; Ünak, P; Müftüler, FZB; Içhedef, ÇA; Gümüser, FG; Sakarya, SBleomycin-glucuronide (BLMG) is the glucuronide conjugate of BLM. In the present study, BLMG was primarily enzymatically synthesized by using a microsome preparate separated from rat liver, labeled with I-131 by iodogen method with the aim of generating a radionuclide-labeled prodrug, and investigated its bioaffinities with tumor-bearing Balb/C mice. Quality control procedures were carried out using thin-layer radiochromatography and high-performance liquid chromatography. Tumor growing was carried out by following Caco-2 cell inoculation into mice. Radiolabeling yield was found to be about 65%. Results indicated that I-131-labeled BLMG (I-131-BLMG) was highly stable for 24 hours in human serum. Biodistribution studies were carried out with male Albino Wistar rats and colorectal adenocarcinoma tumor-bearing female Balb/C mice. The biodistribution results in rats showed high uptake in the prostate, the large intestine, and the spinal cord. In addition to this, scintigraphic results agreed with those of biodistributional studies. Xenography studies with tumor-bearing mice demonstrated that tumor uptakes of I-131-BLM and I-131-BLMG were high in the first 30 minutes postinjection. Tumor-bearing animal studies demonstrated that I-131-BLMG was specially retained in colorectal adenocarcinoma with high tumor uptake. Therefore, I-131-BLMG can be proven to be a promising imaging and therapeutic agent, especially for colon cancer in nuclear medical applications.Item Investigation of Therapeutic Efficiency of Bleomycin and Bleomycin-Glucuronide Labeled with 131I on the Cancer Cell LinesEdiz, M; Avcibasi, U; Ünak, P; Müftüler, FZB; Medine, EI; Kilçar, AY; Demiroglu, H; Gümüser, FG; Sakarya, SThe aim of this study is to determine the incorporations of radiolabeled bleomycin (I-131-BLM) and bleomycin-glucuronide (I-131-BLMGLU) on PC-3 (human prostate carcinoma cell line), Caco-2 (human colon adenocarcinoma cell line), Hutu-80 (Human Duodenum adenocarcinoma cell line), and A549 (Human lung adenocarcinoma epithelial cell line) cancerous cell lines. For this purpose, BLM and BLMGLU enyzmatically synthesized were labeled with I-131, quality control studies were done and the incorporation yields of I-131-BLM and I-131-BLMGLU on these cell lines were measured. Quality-control studies showed that the radiolabeling yields were obtained as 95% and 90% for I-131-BLM and I-131-BLMGLU, respectively. Also, as a result of the cell culture studies, it was found that I-131-BLM and I-131-BLMGLU had higher incorporation on PC-3 cells than that of other cell lines. In addition to this, it was reported that the incorporation yield of I-131-BLMGLU was higher than that I-131-BLM. At the end of the study, cytotoxicities of BLM and BLMGLU on PC-3 cancerous cell line were inspected and fluorescent images of BLM and BLMGLU were taken on PC-3 cells by using fluorescein isothiocyanate. In conclusion, cell culture studies demonstrated that the incorporation values of I-131-BLMGLU on the four cell lines were about five to six times higher than I-131-BLM. Radiolabeled glucuronide derivatives can be used in cancer therapy and tumor imaging, depending on the properties of radioiodine for the beta-glucuronidase-rich tissues because glucuronidation leads to rapid and higher incorporation on adenocarcinoma cells.Item Determinants of prevalence, awareness, treatment and control of high LDL-C in TurkeySözmen, K; Ünal, B; Sakarya, S; Dinç, G; Yardim, N; Keskinkiliç, B; Ergör, GObjective: High blood cholesterol is one of the main modifiable risk factors for cardiovascular diseases (CVDs). The aim of the study is to determine the factors associated with the prevalence, awareness, treatment, and control of high low-density lipoprotein-cholesterol (LDL-C) among adults aged >= 20 years in Turkey. Methods: We used data from Chronic Diseases and Risk Factors Survey conducted in 2011-2012. The presence of high LDL-C, lipid-lowering treatment eligibility, and achievement of target LDL-C were defined according to the third Adult Treatment Panel guidelines on treatment of high cholesterol. Multivariate logistic regression analyses were performed to determine the associations between participant characteristics and high LDL-C prevalence, awareness, treatment, and control. Results: Framingham risk score categorization was performed for 13121 individuals aged >= 20 years. Approximately, 28% of the participants presented with high LDL-C. Among those with high LDL-C, 55.8% were aware of their situation; among those aware of high LDL-C, 46.9% were receiving lipid-lowering medication, and 50.6% of individuals who were receiving treatment achieved target LDL-C levels on the basis of their coronary heart disease (CHD) risk. Control of high LDL-C was negatively associated with the presence of diabetes mellitus (odds ratio: 0.36, 95% CI: 0.27-0.49, p<0.001). Conclusion: Despite the high awareness rates, there was a high proportion of adults who did not receive treatment or achieve recommended levels of LDL-C during treatment. The low treatment and control levels among individuals based on their CHD risk levels call for a better application of recommendations regarding personal preventive measures and treatments in Turkey.Item The effect of radiolabeled antibiotics on biofilm and microorganism within biofilmAvcibasi, U; Demiroglu, H; Sakarya, S; Ünak, P; Tekin, V; Ates, BThe aim of this study was to investigate the I-131 and I-127 labeled linezolid and moxifloxacin effects of minimum inhibitory concentration, and minimum bactericidal concentration on mature biofilm and microorganism within the biofilm. Linezolid and moxifloxacin were labeled with I-131 and I-127 and chromatography studies were carried out with thin layer radiochromatograpy and high-pressure liquid radiochromatography techniques. Specific activities of radiolabeled LZD and MXF was found to be 53.3 +/- 3.1 and 127.3 +/- 1.1 MBq/A mu mol for [I-131]LZD and 7.6 +/- 0.02 and 55.6 +/- 0.8 MBq/A mu mol for [I-131]MXF, respectively. The minimum inhibitory concentration and Time-Kill of Linezolid and moxifloxacin alone and their I-131 and I-127 labeled forms were tested with a standard strain of meticillin-susceptible StaphylocA +/- ccus aureus. MIC values of LNZ and MXF were 2.96 nmol/mL (1 A mu g/ml) and 0.141 nmol/mL (0.062 A mu g/ml). Time Kills of MXF and LZD were found to be 0.06 and 1 mu g, respectively. Antibiotics labeled with beta-emitting radioactive molecule may be a new theranostics strategy for biofilm infections.Item Determinants of Breast and Cervical Cancer Screening Uptake Among Women in TurkeySözmen, K; Unal, B; Sakarya, S; Dinc, G; Yardim, N; Keskinkilic, B; Ergör, GThe aim of the study was to assess the influence of sociodemographic characteristics on breast and cervical cancer screening among women 30 years and older in Turkey. We used data from the National Chronic Diseases and Risk Factors Survey conducted by the Ministry of Health in 2011. Multivariate logistic regression analysis was used to assess the association of sociodemographic factors, lifestyle variables, and cancer screening. Overall, 22.0% of women ever had a Pap smear test for cervical cancer screening and 19.0% ever had a mammography for breast cancer screening(n = 6846). Individuals with a university degree, social security, doing moderate physical activity, and consuming 5 portions of fruit or vegetable/day were more likely to receive Pap smear test and mammography. Residing in the eastern region and living in rural area was associated with lower likelihood of receiving both types of screening.Item Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19.1 million participantsZhou, B; Bentham, J; Di Cesare, M; Bixby, H; Danaei, G; Cowan, MJ; Paciorek, CJ; Singh, G; Hajifathalian, K; Bennett, JE; Taddei, C; Bilano, V; Carrillo-Larco, RM; Djalalinia, S; Khatibzadeh, S; Lugero, C; Peykari, N; Zhang, WZ; Lu, Y; Stevens, GA; Riley, LM; Bovet, P; Elliott, P; Gu, DF; Ikeda, N; Jackson, RT; Joffres, M; Kengne, AP; Laatikainen, T; Lam, TH; Laxmaiah, A; Liu, J; Miranda, JJ; Mondo, CK; Neuhauser, HK; Sundström, J; Smeeth, L; Soric, M; Woodward, M; Ezzati, M; Abarca-Gómez, L; Abdeen, ZA; Rahim, HA; Abu-Rmeileh, NM; Acosta-Cazares, B; Adams, R; Aekplakorn, W; Afsana, K; Aguilar-Salinas, CA; Agyemang, C; Ahmadvand, A; Ahrens, W; Al Raddadi, R; Al Woyatan, R; Ali, MM; Alkerwi, A; Aly, E; Amouyel, P; Amuzu, A; Andersen, LB; Anderssen, SA; Angquist, L; Anjana, RM; Ansong, D; Aounallah-Skhiri, H; Araújo, J; Ariansen, I; Aris, T; Arlappa, N; Aryal, K; Arveiler, D; Assah, FK; Assunçao, MCF; Avdicová, M; Azevedo, A; Azizi, F; Babu, BV; Bahijri, S; Balakrishna, N; Bandosz, P; Banegas, JR; Barbagallo, CM; Barceló, A; Barkat, A; Barros, AJD; Barros, MV; Bata, I; Batieha, AM; Baur, LA; Beaglehole, R; Ben Romdhane, H; Benet, M; Benson, LS; Bernabe-Ortiz, A; Bernotiene, G; Bettiol, H; Bhagyalaxmi, A; Bharadwaj, S; Bhargava, SK; Bi, YF; Bikbov, M; Bjerregaard, P; Bjertness, E; Bjökelund, C; Blokstra, A; Bo, S; Bobak, M; Boeing, H; Boggia, JG; Boissonnet, CP; Bongard, V; Bovet, P; Braeckman, L; Brajkovich, I; Branca, F; Breckenkamp, J; Brenner, H; Brewster, LM; Bruno, G; Bueno-de-Mesquita, HB; Bugge, A; Burns, C; Bursztyn, M; de León, AC; Cameron, C; Can, G; Candido, APC; Capuano, V; Cardoso, VC; Carlsson, AC; Carvalho, MJ; Casanueva, FF; Casanueva, FF; Casas, JP; Caserta, CA; Chamukuttan, S; Chan, AW; Chan, Q; Chaturvedi, HK; Chaturvedi, N; Chen, CJ; Chen, FF; Chen, HS; Chen, S; Chen, ZM; Cheng, CY; Dekkaki, IC; Chetrit, A; Chiolero, A; Chiou, ST; Chirita-Emandi, A; Cho, B; Cho, Y; Chudek, J; Cifkova, R; Claessens, F; Clays, E; Concin, H; Cooper, C; Cooper, R; Coppinger, TC; Costanzo, S; Cottel, D; Cowell, C; Craig, CL; Crujeiras, AB; Cruz, JJ; D'Arrigo, G; d'Orsi, E; Dallongeville, J; Damasceno, A; Danaei, G; Dankner, R; Dantoft, TM; Dauchet, L; De Backer, G; de Gaetano, G; De Henauw, S; De Smedt, D; Deepa, M; Dehghan, A; Delisle, H; Deschamps, V; Dhana, K; Di Castelnuovo, AF; Dias-da-Costa, JS; Diaz, A; Dickerson, TT; Djalalinia, S; Do, HTP; Dobson, AJ; Donfrancesco, C; Donoso, SP; Döring, A; Doua, K; Drygas, W; Dulskiene, V; Dzakula, A; Dzerve, V; Dziankowska-Zaborszczyk, E; Eggertsen, R; Ekelund, U; El Ati, J; Ellert, U; Elliott, P; Elosua, R; Erasmus, RT; Erem, C; Eriksen, L; Escobedo-de la Peña, J; Evans, A; Faeh, D; Fall, CH; Farzadfar, F; Felix-Redondo, FJ; Ferguson, TS; Fernández-Bergés, D; Ferrante, D; Ferrari, M; Ferreccio, C; Ferrieres, J; Finn, JD; Fischer, K; Föger, B; Foo, LH; Forslund, AS; Forsner, M; Fortmann, SP; Fouad, HM; Francis, DK; Franco, MD; Franco, OH; Frontera, G; Fuchs, FD; Fuchs, SC; Fujita, Y; Furusawa, T; Gaciong, Z; Gareta, D; Garnett, SP; Gaspoz, JM; Gasull, M; Gates, L; Gavrila, D; Geleijnse, JM; Ghasemian, A; Ghimire, A; Giampaoli, S; Gianfagna, F; Giovannelli, J; Goldsmith, RA; Gonçalves, H; Gross, MG; Rivas, JPG; Gottrand, F; Graff-Iversen, S; Grafnetter, D; Grajda, A; Gregor, RD; Grodzicki, T; Grontved, A; Gruden, G; Grujic, V; Gu, DF; Guan, OP; Gudnason, V; Guerrero, R; Guessous, I; Guimaraes, AL; Gulliford, MC; Gunnlaugsdottir, J; Gunter, M; Gupta, PC; Gureje, O; Gurzkowska, B; Gutierrez, L; Gutzwiller, F; Hadaegh, F; Halkjær, J; Hambleton, IR; Hardy, R; Harikumar, R; Hata, J; Hayes, AJ; He, J; Hendriks, ME; Henriques, A; Cadena, LH; Herqutanto; Herrala, S; Heshmat, R; Hihtaniemi, IT; Ho, SY; Ho, SC; Hobbs, M; Hofman, A; Dinc, GH; Hormiga, CM; Horta, BL; Houti, L; Howitt, C; Htay, TT; Htet, AS; Hu, YH; Huerta, JM; Husseini, AS; Huybrechts, I; Hwalla, N; Iacoviello, L; Iannone, AG; Ibrahim, MM; Ikram, MA; Irazola, VE; Islam, M; Ivkovic, V; Iwasaki, M; Jackson, RT; Jacobs, JM; Jafar, T; Jamrozik, K; Janszky, I; Jasienska, G; Jelakovic, B; Jiang, CQ; Johansson, M; Jonas, JB; Jorgensen, T; Joshi, P; Juolevi, A; Jurak, G; Juresa, V; Kaaks, R; Kafatos, A; Kalter-Leibovici, O; Kamaruddin, NA; Kasaeian, A; Katz, J; Kauhanen, J; Kaur, P; Kavousi, M; Kazakbaeva, G; Keil, U; Boker, LK; Keinänen-Kiukaanniemi, S; Kelishadi, R; Kemper, HCG; Kengne, AP; Kersting, M; Key, T; Khader, YS; Khalili, D; Khang, YH; Khaw, KT; Kiechl, S; Killewo, J; Kim, J; Klumbiene, J; Kolle, E; Kolsteren, P; Korrovits, P; Koskinen, S; Kouda, K; Koziel, S; Kristensen, PL; Krokstad, S; Kromhout, D; Kruger, HS; Kubinova, R; Kuciene, R; Kuh, D; Kujala, UM; Kula, K; Kulaga, Z; Kumar, RK; Kurjata, P; Kusuma, YS; Kuulasmaa, K; Kyobutungi, C; Laatikainen, T; Lachat, C; Landrove, O; Lanska, V; Lappas, G; Larijani, B; Laugsand, LE; Laxmaiah, A; Bao, KLN; Le, TD; Leclercq, C; Lee, J; Lee, J; Lehtimäki, T; Lekhraj, R; León-Muñoz, LM; Levitt, NS; Li, YP; Lilly, CL; Lim, WY; Lima-Costa, MF; Lin, HH; Lin, X; Linneberg, A; Lissner, L; Litwin, M; Liu, J; Lorbeer, R; Lotufo, PA; Lozano, JE; Luksiene, D; Lundqvist, A; Lunet, N; Lytsy, P; Ma, GS; Ma, J; Machado-Coelho, GLL; Machi, S; Maggi, S; Magliano, DJ; Majer, M; Makdisse, M; Malekzadeh, R; Malhotra, R; Rao, KM; Malyutina, S; Manios, Y; Mann, JI; Manzato, E; Margozzini, P; Marques-Vidal, P; Marrugat, J; Martorell, R; Mathiesen, EB; Matijasevich, A; Matsha, TE; Mbanya, JCN; Posso, AJM; McFarlane, SR; McFarlane, SR; McGarvey, ST; McLachlan, S; McLean, RM; McNulty, BA; Khir, ASM; Mediene-Benchekor, S; Medzioniene, J; Meirhaeghe, A; Meisinger, C; Menezes, AMB; Menon, GR; Meshram, II; Metspalu, A; Mi, J; Mikkel, K; Miller, JC; Miquel, JF; Miranda, JJ; Misigoj-Durakovic, M; Mohamed, MK; Mohammad, K; Mohammadifard, N; Mohan, V; Yusoff, MFM; Moller, NC; Molnár, D; Momenan, A; Mondo, CK; Monyeki, KDK; Moreira, LB; Morejon, A; Moreno, LA; Morgan, K; Moschonis, G; Mossakowska, M; Mostafa, A; Mota, J; Motlagh, ME; Motta, J; Muiesan, ML; Müller-Nurasyid, M; Murphy, N; Mursu, J; Musil, V; Nagel, G; Naidu, BM; Nakamura, H; Námsná, J; Nang, EEK; Nangia, VB; Narake, S; Navarrete-Muñoz, EM; Ndiaye, NC; Neal, WA; Nenko, I; Nervi, F; Neuhauser, HK; Nguyen, ND; Nguyen, QN; Nieto-Martínez, RE; Niiranen, TJ; Ning, G; Ninomiya, T; Nishtar, S; Noale, M; Noboa, OA; Noorbala, AA; Norat, T; Noto, D; Al Nsour, M; O'Reilly, D; Oh, K; Olinto, MTA; Oliveira, IO; Omar, MA; Onat, A; Ordunez, P; Osmond, C; Ostojic, SM; Otero, JA; Overvad, K; Owusu-Dabo, E; Paccaud, FM; Padez, C; Pahomova, E; Pajak, A; Palli, D; Palmieri, L; Panda-Jonas, S; Panza, F; Papandreou, D; Parnell, WR; Parsaeian, M; Pecin, I; Pednekar, MS; Peer, N; Peeters, PH; Peixoto, SV; Pelletier, C; Peltonen, M; Pereira, AC; Pérez, RM; Peters, A; Petkeviciene, J; Peykari, N; Pham, ST; Pigeot, I; Pikhart, H; Pilav, A; Pilotto, L; Pitakaka, F; Plans-Rubió, P; Polakowska, M; Polasek, O; Porta, M; Portegies, MLP; Pourshams, A; Pradeepa, R; Prashant, M; Price, JF; Puiu, M; Punab, M; Qasrawi, RF; Qorbani, M; Radic, I; Radisauskas, R; Rahman, M; Raitakari, O; Raj, M; Rao, SR; Ramos, E; Rampal, S; Reina, DAR; Rasmussen, F; Redon, J; Reganit, PFM; Ribeiro, R; Riboli, E; Rigo, F; de Wit, TFR; Ritti-Dias, RM; Robinson, SM; Robitaille, C; Rodríguez-Artalejo, F; Rodriguez-Villamizar, LA; Rojas-Martinez, R; Rosengren, A; Rubinstein, A; Rui, O; Ruiz-Betancourt, BS; Horimoto, ARVR; Rutkowski, M; Sabanayagam, C; Sachdev, HS; Saidi, O; Sakarya, S; Salanave, B; Martinez, ES; Salmerón, D; Salomaa, V; Salonen, JT; Salvetti, M; Sánchez-Abanto, J; Sans, S; Santos, D; Santos, IS; dos Santos, RN; Santos, R; Saramies, JL; Sardinha, LB; Margolis, GS; Sarrafzadegan, N; Saum, KU; Savva, SC; Scazufca, M; Schargrodsky, H; Schneider, IJ; Schultsz, C; Schutte, AE; Sen, A; Senbanjo, IO; Sepanlou, SG; Sharma, SK; Shaw, JE; Shibuya, K; Shin, DW; Shin, YC; Siantar, R; Sibai, AM; Silva, DAS; Simon, M; Simons, J; Simons, LA; Sjötröm, M; Skovbjerg, S; Slowikowska-Hilczer, J; Slusarczyk, P; Smeeth, L; Smith, MC; Snijder, MB; So, HK; Sobngwi, E; Söderberg, S; Solfrizzi, V; Sonestedt, E; Song, Y; Sorensen, TIA; Soric, M; Jeróme, CS; Soumare, A; Staessen, JA; Starc, G; Stathopoulou, MG; Stavreski, B; Steene-Johannessen, J; Stehle, P; Stein, AD; Stergiou, GS; Stessman, J; Stieber, J; Stöckl, D; Stocks, T; Stokwiszewski, J; Stronks, K; Strufaldi, MW; Sun, CA; Sundström, J; Sung, YT; Suriyawongpaisal, P; Sy, RG; Tai, ES; Tammesoo, ML; Tamosiunas, A; Tang, L; Tang, X; Tanser, F; Tao, Y; Tarawneh, MR; Tarqui-Mamani, CB; Taylor, A; Theobald, H; Thijs, L; Thuesen, BH; Tjonneland, A; Tolonen, HK; Topbas, M; Topór-Madry, R; Tormo, MJ; Torrent, M; Traissac, P; Trichopoulos, D; Trichopoulou, A; Trinh, OTH; Trivedi, A; Tshepo, L; Tulloch-Reid, MK; Tuomainen, TP; Turley, ML; Tynelius, P; Tzourio, C; Ueda, P; Ugel, E; Ulmer, H; Uusitalo, HMT; Valdivia, G; Valvi, D; van der Schouw, YT; Van Herck, K; van Rossem, L; van Valkengoed, IGM; Vanderschueren, D; Vanuzzo, D; Vatten, L; Vega, T; Velasquez-Melendez, G; Veronesi, G; Verschuren, WMM; Verstraeten, R; Victora, CG; Viet, L; Viikari-Juntura, E; Vineis, P; Vioque, J; Virtanen, JK; Visvikis-Siest, S; Viswanathan, B; Vollenweider, P; Vrdoljak, A; Vrijheid, M; Wade, AN; Wagner, A; Walton, J; Mohamud, WNW; Wang, MD; Wang, Q; Wang, YX; Wannamethee, SG; Wareham, N; Wederkopp, N; Weerasekera, D; Whincup, PH; Widhalm, K; Widyahening, IS; Wiecek, A; Wijga, AH; Wilks, RJ; Willeit, P; Williams, EA; Wilsgaard, T; Wojtyniak, B; Wong, TY; Wong-McClure, RA; Woo, J; Woodward, M; Wu, AG; Wu, FC; Wu, SL; Xu, HQ; Yan, WL; Yang, XG; Ye, XW; Yiallouros, PK; Yoshihara, A; Younger-Coleman, NO; Yusoff, AF; Zambon, S; Zdrojewski, T; Zeng, Y; Zhao, D; Zhao, WH; Zheng, Y; Zhu, D; Zimmermann, E; Cisneros, JZBackground 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. Copyright (C) The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license.Item 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 participantsZhou, 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; Sundström, J; Varghese, C; Widyahening, IS; Zdrojewski, T; Ezzati, M; Abarca-Gómez, 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; 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; Araújo, J; Ariansen, I; Aris, T; Arku, RE; Arlappa, N; Aryal, KK; Aspelund, T; Assah, FK; Assunçao, MCF; Auvinen, J; Avdicová, M; Azevedo, A; Azimi-Nezhad, M; Azizi, F; Azmin, M; Babu, BV; Bahijri, S; Balakrishna, N; Balanova, Y; Bamoshmoosh, M; Banach, M; Banadinovic, M; Bandosz, P; Banegas, JR; Baran, J; Barbagallo, CM; Barceló, 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; Bennett, JE; 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; Björkelund, 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; Briceño, Y; Brito, M; Bruno, G; Bueno-de-Mesquita, HB; Bueno, G; Bugge, A; Burns, C; Bursztyn, M; de León, AC; Cacciottolo, J; Cameron, C; Can, G; Candido, APC; Capanzana, MV; Capková, 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; Cifkova, R; 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; Damasceno, A; Danaei, G; 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 Jr; 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; Do, HTP; Dobson, AJ; Donfrancesco, C; Donoso, SP; Döring, A; Dorobantu, M; Dörr, 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; Elliott, P; Elosua, R; Erasmus, RT; Erbel, R; Erem, C; Eriksen, L; Eriksson, JG; Escobedo-de la Peña, J; Eslami, S; Esmaeili, A; Evans, A; Faeh, D; Fakhretdinova, AA; 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Victora, CG; Viet, L; Villalpando, S; Vineis, P; Vioque, J; Virtanen, JK; Visvikis-Siest, S; Viswanathan, B; Vlasoff, T; Vollenweider, P; Voutilainen, A; Wade, AN; Walton, J; Wambiya, EOA; Bebakar, WMW; Mohamud, WNW; Wanderley, RD Jr; Wang, MD; Wang, NL; Wang, Q; Wang, XJ; Wang, YX; Wang, YW; Wannamethee, SG; Wareham, N; Wei, WB; Weres, A; Werner, B; Whincup, PH; Widhalm, K; Widyahening, IS; Wiecek, A; Wilks, RJ; Willeit, J; Willeit, P; Williams, EA; Wilsgaard, T; Wojtyniak, B; Wong-McClure, RA; Wong, A; Wong, TY; Woo, J; Woodward, M; Wu, FC; Wu, SL; Wyszynska, J; Xu, HQ; Xu, L; Yaacob, NA; Yan, WL; Yang, L; Yang, XG; Yang, Y; Yasuharu, T; Ye, XW; Yiallouros, PK; Yoosefi, M; Yoshihara, A; You, SL; Younger-Coleman, NO; Yusoff, AF; Zainuddin, AA; Zakavi, SR; Zamani, F; Zambon, S; Zampelas, A; Zapata, ME; Zaw, KK; Zdrojewski, T; Zejglicova, K; Vrkic, TZ; Zeng, Y; Zhang, LX; Zhang, ZY; Zhao, D; Zhao, MH; Zhen, SQ; Zheng, YF; Zholdin, B; Zhu, D; Zins, M; Zitt, E; Zocalo, Y; Zoghlami, N; Cisneros, JZBackground 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. Copyright (C) 2021 World Health Organization; licensee Elsevier.Item 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 participantsZhou, B; Bentham, J; Di Cesare, M; Bixby, H; Danaei, G; Hajifathalian, K; Taddei, C; Carrillo-Larco, RM; Djalalinia, S; Khatibzadeh, S; Lugero, C; Peykari, N; Zhang, WZ; Bennett, J; Bilano, V; Stevens, GA; Cowan, MJ; Riley, LM; Chen, ZM; Hambleton, IR; Jackson, RT; Kengne, AP; Khang, YH; Laxmaiah, A; Liu, J; Malekzadeh, R; Neuhauser, HK; Soric, M; Starc, G; Sundström, J; Woodward, M; Ezzati, M; Abarca-Gómez, L; Abdeen, ZA; Abu-Rmeileh, NM; Acosta-Cazares, B; Adams, RJ; Aekplakorn, W; Afsana, K; Aguilar-Salinas, CA; Agyemang, C; Ahmad, NA; Ahmadvand, A; Ahrens, W; Ajlouni, K; Akhtaeva, N; Al-Raddadi, R; Ali, MM; Ali, O; Alkerwi, A; Aly, E; Amarapurkar, DN; Amouyel, P; Amuzu, A; Andersen, LB; Anderssen, SA; 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Zampelas, A; Zdrojewski, T; Zeng, Y; Zhao, D; Zhao, WH; Zheng, W; Zheng, YF; Zhu, D; Zhussupov, B; Zimmermann, E; Cisneros, JZBackground: 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.Item Gender differences in sense of coherence among university students during the COVID-19 pandemic in TurkeyKayi, I; Uzunköprü, G; Dadaczynski, K; Soylar, P; Otludil, B; Dündar, P; Bakirci, N; Okan, O; Sakarya, SNon-pharmaceutical interventions (NPIs) implemented to mitigate the COVID-19 pandemic halted everyday life in higher education along with social and psychological impacts. The objective of our study was to explore the factors related to sense of coherence (SoC) from a gender perspective among university students in Turkey. This is a cross-sectional survey conducted online with a convenience sampling method as part of the international COVID-Health Literacy (COVID-HL) Consortium. SoC was measured by a nine-item questionnaire that was adapted to the Turkish language, including socio-demographic information and health status, including psychological well-being, psychosomatic complaints, and future anxiety (FA). 1595 students from four universities, of whom 72% were female, participated in the study. Cronbach's alpha for the SoC scale was 0.75. Based on the median split of the individual scores, levels of SoC showed no statistically significant difference according to gender. Logistic regression analysis indicated that higher SoC was associated with medium and high subjective social status, studying in private universities, high psychological well-being, low FA, and none/one psychosomatic complaint. While results were similar among female students, type of university and psychological well-being showed no statistically significant association with SoC among males. Our results indicate that structural (subjective social status) and contextual (type of university) factors, along with gender-based variations, are associated with SoC among university students in Turkey.