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4. Ages at Initiation of Cigarette Smoking and Quit Attempts among Women: A Generation Effect.

Author

Morabia, Alfredo, Costanza, Michael C., Bernstein, Martine S., and Rielle, Jean-Charles

Abstract

Investigated whether age at initiation of regular smoking and likelihood of quitting smoking through age 35 years would differ among younger and older women. Data from annual population-based surveys of residents of Geneva, Switzerland, indicated that young female smokers had a higher propensity to quit than older women. There were no differences by age of smoking initiation. (SM)

Published
2002

11. Achieving energy balance at the population level through increases in physical activity

Author

Costanza, Michael C., Beer-Borst, Sigrid, and Morabia, Alfredo

Subjects
Bodywork -- Research, Exercise -- Research, Exercise -- Physiological aspects, Government, Health care industry
Abstract

Objectives. We estimated the amount of physical activity required for individuals to expend an additional 418.4 kJ (100 kcal) per day with the goal of achieving energy balance at the population level. Methods. Data on total daily energy expenditures were derived from a random sample of adults residing in Geneva, Switzerland, who completed a selfadministered physical activity frequency questionnaire. These data were used to simulate the effects of typical physical activity pyramid recommendations on average population energy expenditures for various activity intensities and rates of population compliance with pyramid recommendations. Results. If an average 418.4 kJ (100 kcal) per day increase in energy expenditures is to be achieved, assuming 100% compliance with physical activity pyramid recommendations, the bottom tier of the pyramid must correspond to everyday activities performed at moderate to high intensity levels (e.g., moderate walking or biking). Expected population gains in energy expenditures would be only 167.4 to 251.0 kJ (40 to 60 kcal) per day at a 50% compliance rate. Conclusions. Achieving population-level energy balance through increasing energy expenditures with physical activity increases alone would require profound structural and environmental changes promoting more active lifestyles. doi:10.2105/AJPH.2005.072058

Published
2007

12. The obesity epidemic as harbinger of a metabolic disorder epidemic: trends in overweight, hypercholesterolemia, and diabetes treatment in Geneva, Switzerland, 1993-2003

Author

Morabia, Alfredo and Costanza, Michael C.

Subjects
Europe -- Health aspects, Geneva, Switzerland (City) -- Health aspects, Geneva, Switzerland (City) -- Statistics, Obesity -- Forecasts and trends, Hypercholesterolemia -- Forecasts and trends, Diabetes -- Forecasts and trends, Metabolic diseases, Market trend/market analysis, Government, Health care industry
Abstract

Increases in obesity, hypercholesterolemia, and diabetes may be under way in Europe. We have reported the only data available from the 1990s for continuous monitoring of chronic disease risk factors in random samples of a general European population. In random surveys (1993-2003) of 6164 men and 6107 women in Geneva, overweight and obesity combined increased in both men and women; hypercholesterolemia prevalence also rose; diabetes treatment increased in men. Only population-based interventions can prevent the impending epidemic of obesity-related disorders.

Published
2005

13. Does walking 15 minutes per day keep the obesity epidemic away? Simulation of the efficacy of a populationwide campaign

Author

Morabia, Alfredo and Costanza, Michael C.

Subjects
Government, Health care industry
Abstract

Small physical activity increases may prevent weight gain in most populations. Geneva residents completed validated quantitative physical activity frequency questionnaires from 1997 to 2001. Fifteen minutes per day of moderate or brisk walking, or 30 minutes per day of slow walking, could increase physical activity at the population level; however, if the specific goal is to approach expending 420 kJ/d (100 kcal/d) through walking, the duration should be closer to 60 minutes for slow walking and 30 minutes for moderate or brisk walking.

Published
2004

14. Trends in risk factors for lifestyle-related diseases by socioeconomic position in Geneva, Switzerland, 1993-2000: health inequalities persist

Author

Galobardes, Bruna, Costanza, Michael C., Bernstein, Martine S., Delhumeau, Cecile, and Morabia, Alfredo

Subjects
Chronic diseases -- Risk factors, Life style -- Health aspects, Government, Health care industry
Abstract

Objectives. We report on trends in risk factors for lifestyle-related diseases among socioeconomic position (SEP) groups. Methods. We continuously surveyed the adult population of Geneva, Switzerland, for 8 years (1993-2000) with independent, cross-sectional surveys of representative samples (4207 men and 3987 women aged 35-74 years). Age-adjusted linear regression slopes estimated annual risk factor trends. Interaction terms were tested for trend differences between SEP groups. Results. Overall, low-SEP persons had the worst risk factor profiles. Eight-year trends indicate that (1) number of pack-years smoked decreased by half a pack-year among high-SEP female current smokers only; (2) obesity prevalence more than doubled from 5% to 11% among high-SEP men only; (3) systolic and diastolic blood pressures decreased similarly in all SEP groups; (4) unsaturated-to-saturated dietary fat ratio declined in the low-SEP group only; and (5) physical inactivity and current/former cigarette smoking prevalences remained unchanged in all SEP groups. Conclusions. Smoking, obesity, high blood pressure, and physical inactivity are more prevalent among low-SEP persons. Most socioeconomic risk factor differences remained stable in the 1990s. Thus, social inequalities in chronic disease morbidity and mortality will persist in the next decades.

Published
2003

29. Prevention of cigarette smoking through mass media intervention and school programs

Author

Flynn, Brian S., Worden, John K., Secker-Walker, Roger H., Badger, Gary J., Geller, Berta M., and Costanza, Michael C.

Subjects
Smoking -- Prevention, Smoking and youth -- Research, Teenagers, Mass media in health education -- Usage, Government, Health care industry
Abstract

Objectives. In this study we tested the ability of mass media interventions to enhance the efficacy of school cigarette smoking prevention programs. Methods. For 4, years students in one pair of communities received media interventions and school programs that had common educational objectives. Students in a matched pair of communities received only the school program. The combined cohort of 5458 students was surveyed at baseline in grades 4,5 and 6 and was followed up annually for 4 years. Results. Significant reductions in reported smoking, along with consisted effects on targeted mediating variables, were observed for the media-and-school group. For cigarettes per week the reduction was 41% (2.6 vs 4.4); for smoking cigarettes yesterday the reduction was 34% (8.6% vs 13.1%); and for smoking in the past week the reduction was 35% (12.8% vs 19.8%). No effects were observed for substance use behaviors not targeted by the interventions. Conclusions. These results provide evidence that mass media interventions are effective in preventing cigarette smoking when they are carefully targeted at high-risk youths and share educational objectives with school programs. (Am J Public Health 1992;82;827-834)

Published
1992

33. Undocumented migrants lack access to pregnancy care and prevention

Author

Andreoli Nicole, Delieutraz-Marchand Jacqueline, Costanza Michael C, Lourenco Ana P, Epiney Manuella, Wolff Hans, Dubuisson Jean-Bernard, Gaspoz Jean-Michel, and Irion Olivier

Subjects
Public aspects of medicine, RA1-1270
Abstract

Abstract Background Illegal migration is an increasing problem worldwide and the so-called undocumented migrants encounter major problems in access to prevention and health care. The objective of the study was to compare the use of preventive measures and pregnancy care of undocumented pregnant migrants with those of women from the general population of Geneva, Switzerland. Methods Prospective cohort study including pregnant undocumented migrants presenting to the University hospital from February 2005 to October 2006. The control group consisted of a systematic sample of pregnant women with legal residency permit wishing to deliver at the same public hospital during the same time period. Results 161 undocumented and 233 control women were included in the study. Mean ages were 29.4 y (SD 5.8) and 31.1 y (SD 4.8) (p < 0.02), respectively. 61% of undocumented women (controls 9%) were unaware of emergency contraception (OR 15.7 (8.8;28.2) and 75% of their pregnancies were unintended (controls 21%; OR 8.0 (4.7;13.5)). Undocumented women consulted for an initial pregnancy visit more than 4 weeks later than controls and only 63% had their first visit during the first trimester (controls 96%, p < 0.001); 18% had never or more than 3 years ago a cervical smear test (controls 2%, OR 5.7 (2.0;16.5)). Lifetime exposure to violence was similar in both groups, but undocumented migrants were more exposed during their pregnancy (11% vs 1%, OR 8.6 (2.4;30.6)). Complications during pregnancy, delivery and post-partum were similar in both groups. Conclusion Compared to women who are legal residents of Geneva, undocumented migrants have more unintended pregnancies and delayed prenatal care, use fewer preventive measures and are exposed to more violence during pregnancy. Not having a legal residency permit therefore suggests a particular vulnerability for pregnant women. This study underscores the need for better access to prenatal care and routine screening for violence exposure during pregnancy for undocumented migrants. Furthermore, health care systems should provide language- and culturally-appropriate education on contraception, family planning and cervical cancer screening.

Published
2008
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34. Gender differentials in the evolution of cigarette smoking habits in a general European adult population from 1993–2003

Author

Lopez Alan D, Salamun Julien, Costanza Michael C, and Morabia Alfredo

Subjects
Public aspects of medicine, RA1-1270
Abstract

Abstract Background Describe the recent evolution of cigarette smoking habits by gender in Geneva, where incidence rates of lung cancer have been declining in men but increasing in women. Methods Continuous cross-sectional surveillance of the general adult (35–74 yrs) population of Geneva, Switzerland for 11 years (1993–2003) using a locally-validated smoking questionnaire, yielding a representative random sample of 12,271 individuals (6,164 men, 6,107 women). Results In both genders, prevalence of current cigarette smoking was stable over the 11-year period, at about one third of men and one quarter of women, even though smoking began at an earlier age in more recent years. Older men were more likely to be former smokers than older women. Younger men, but not women, tended to quit smoking at an earlier age. Conclusion This continuous (1993–2003) risk factor surveillance system, unique in Europe, shows stable prevalence of smoking in both genders. However, sharp contrasts in age-specific prevalence of never and former smoking and of ages at smoking initiation indicate that smoking continues a long-term decline in men but has still not reached its peak in women.

Published
2006
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35. Binary classification of dyslipidemia from the waist-to-hip ratio and body mass index: a comparison of linear, logistic, and CART models

Author

Paccaud Fred and Costanza Michael C

Subjects
Abdominal obesity, classification and regression trees, external validation, dyslipidemia screening, positive and negative predictive values, sensitivity and specificity., Medicine (General), R5-920
Abstract

Abstract Background We sought to improve upon previously published statistical modeling strategies for binary classification of dyslipidemia for general population screening purposes based on the waist-to-hip circumference ratio and body mass index anthropometric measurements. Methods Study subjects were participants in WHO-MONICA population-based surveys conducted in two Swiss regions. Outcome variables were based on the total serum cholesterol to high density lipoprotein cholesterol ratio. The other potential predictor variables were gender, age, current cigarette smoking, and hypertension. The models investigated were: (i) linear regression; (ii) logistic classification; (iii) regression trees; (iv) classification trees (iii and iv are collectively known as "CART"). Binary classification performance of the region-specific models was externally validated by classifying the subjects from the other region. Results Waist-to-hip circumference ratio and body mass index remained modest predictors of dyslipidemia. Correct classification rates for all models were 60–80%, with marked gender differences. Gender-specific models provided only small gains in classification. The external validations provided assurance about the stability of the models. Conclusions There were no striking differences between either the algebraic (i, ii) vs. non-algebraic (iii, iv), or the regression (i, iii) vs. classification (ii, iv) modeling approaches. Anticipated advantages of the CART vs. simple additive linear and logistic models were less than expected in this particular application with a relatively small set of predictor variables. CART models may be more useful when considering main effects and interactions between larger sets of predictor variables.

Published
2004
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36. More insight into the fate of biomedical meeting abstracts: a systematic review

Author

Walder Bernhard, Costanza Michael C, von Elm Erik, and Tramèr Martin R

Subjects
Medicine (General), R5-920
Abstract

Abstract Background It has been estimated that about 45% of abstracts that are accepted for presentation at biomedical meetings will subsequently be published in full. The acceptance of abstracts at meetings and their fate after initial rejection are less well understood. We set out to estimate the proportion of abstracts submitted to meetings that are eventually published as full reports, and to explore factors that are associated with meeting acceptance and successful publication. Methods Studies analysing acceptance of abstracts at biomedical meetings or their subsequent full publication were searched in MEDLINE, OLDMEDLINE, EMBASE, Cochrane Library, CINAHL, BIOSIS, Science Citation Index Expanded, and by hand searching of bibliographies and proceedings. We estimated rates of abstract acceptance and of subsequent full publication, and identified abstract and meeting characteristics associated with acceptance and publication, using logistic regression analysis, survival-type analysis, and meta-analysis. Results Analysed meetings were held between 1957 and 1999. Of 14945 abstracts that were submitted to 43 meetings, 46% were accepted. The rate of full publication was studied with 19123 abstracts that were presented at 234 meetings. Using survival-type analysis, we estimated that 27% were published after two, 41% after four, and 44% after six years. Of 2412 abstracts that were rejected at 24 meetings, 27% were published despite rejection. Factors associated with both abstract acceptance and subsequent publication were basic science and positive study outcome. Large meetings and those held outside the US were more likely to accept abstracts. Abstracts were more likely to be published subsequently if presented either orally, at small meetings, or at a US meeting. Abstract acceptance itself was strongly associated with full publication. Conclusions About one third of abstracts submitted to biomedical meetings were published as full reports. Acceptance at meetings and publication were associated with specific characteristics of abstracts and meetings.

Published
2003

37. Clinical breast examination and breast self-examination: past and present effect on breast cancer survival

Author

Foster, Roger S., Jr., Worden, John K., Costanza, Michael C., and Solomon, Laura J.

Subjects
Breast cancer -- Prognosis, Breast examination -- Medical examination, Self-examination, Medical -- Evaluation, Cancer education -- Evaluation, Health
Abstract

Increasing attention to self-detection of breast masses and clinical breast examination during this century have contributed to a progressive reduction in the size of breast cancers at detection and a progressive improvement in survival. Mammography is more sensitive than breast palpation for the detection of breast cancer, however, mammography does not detect all palpable cancers and additional interval cancers become palpable between screenings. Breast self-examination, clinical breast examination, and mammography are complementary screening modalities. In populations where mammography is not available or is not appropriate as a screening modality, clinical breast examination and breast self-examination are particularly important. Cancer 1992; 69:1992-1998.

Published
1992

38. International Variability in Ages at Menarche, First Livebirth, and Menopause

Author

Morabia, Alfredo, Costanza, Michael C., Morabia, Alfredo, and Costanza, Michael C.

Abstract

The occurrences and timing of reproduction-related events, such as menarche, first birth, and menopause, play major roles in a woman's life. There is a lack of comparative information on the overall patterns of the ages at and the timing between these events among different populations of the world. This study describes the variability in reproductive factors across populations in Europe, the Americas, Asia, Australia, and Africa. The study sample consisted of 18,997 women from 13 centers in 11 countries interviewed between 1979 and 1988 who comprised the control group in a World Health Organization international, multicenter case-control study of female cancers. All were surveyed with the same questionnaire and methodology. Overall, a typical woman in this study reached menarche at age 14 years and delivered her first live child 8 years later, at age 22. She was 50 years old at natural menopause and had had 36 years of reproductive life. The median ages at menarche varied across centers from 13 to 16 years. For all centers, the median age at first livebirth was 20 or more years, with the largest observed median (25 years) occurring in China. The median delay from menarche to first livebirth ranged from 5 to 11 years. Among the centers, the median age at natural menopause ranged between 49 and 52 years. In most populations, younger women had a first birth at a later age than did older women. This tendency was more accentuated in some populations. These results reveal, perhaps for the first time, the variability of reproductive histories across different populations in a large variety of geographic and cultural settings. Except for menopause, international variability is substantial for both biologically related variables (age at menarche) and culturally related variables (age at first birth). There is a generational effect, characterized by more variability of age at first birth and delay to first birth in the younger than in the older generations. Am J Epidemiol 19

Published
2017

39. Relative Contributions of Genes, Environment, and Interactions to Blood Lipid Concentrations in a General Adult Population

Author

Costanza, Michael C., Cayanis, Eftihia, Ross, Barbara M., Flaherty, Maria Sol, Alvin, Gabriela B., Das, Kamna, Morabia, Alfredo, Costanza, Michael C., Cayanis, Eftihia, Ross, Barbara M., Flaherty, Maria Sol, Alvin, Gabriela B., Das, Kamna, and Morabia, Alfredo

Abstract

The authors evaluated the contributions of nine genetic (G) variants (selected from 275 single nucleotide polymorphisms in 11 reverse cholesterol transport pathway genes), five environmental (E) factors (selected from 10), and G × G, E × E, and G × E interactions in explaining population variance of blood lipid concentrations. Total cholesterol, triglycerides, and high density lipoprotein (HDL) cholesterol were measured, and low density lipoprotein (LDL) cholesterol and HDL cholesterol/LDL cholesterol ratio were calculated in a population-based random sample of 1,543 men and women in Geneva, Switzerland, aged 35-74 years in 1999-2001. Explained variances (R2) for HDL cholesterol/LDL cholesterol ratio, HDL cholesterol, and LDL cholesterol, respectively, were 34%, 33%, and 19%, decomposed into main effects of G (6%, 4%, and 5%) and E (25%, 28%, and 11%), with just 3%, 2%, and 3% due to G × G, E × E, and G × E interactions, respectively. Risk factor clustering was only moderate: 70% of study subjects had ≤3 variants, 75% had ≤2 environmental exposures, and 69% had ≤5 of both types of factors. Multiple genes with weak associations, together with more dominating environmental factors, are involved in determining blood lipid concentrations. Interactions added little explained variance. Increasing trends in hypercholesterolemia are attributable to environmental changes affecting populations as a whole. Reducing obesity and smoking and moderating alcohol intake in entire populations should remain the primary strategies for lipid control

Published
2017

40. Experimental approach to measuring functional food consumption for risk factor surveillance

Author

Beer-Borst, Sigrid, Costanza, Michael C., Morabia, Alfredo, Beer-Borst, Sigrid, Costanza, Michael C., and Morabia, Alfredo

Abstract

Objective To develop and integrate the assessment of functional foods (FuF; manufactured foods with altered composition carrying a health claim) consumption into an existing risk factor surveillance system. Design FuF market research followed by an experimental FuF intake study incorporated into an ongoing community-based survey. Concurrent completion of a self-administered semi-quantitative FFQ and a self-administered, qualitative FuF frequency questionnaire (FuFFQ) followed by a face-to-face control step using FuF photographs and combined food group-based data analyses. Setting ‘Bus Santé' risk factor surveillance programme, Geneva/Switzerland. Subjects Population-based random sample of 639 residents (52 % women, aged 35-74 years) surveyed from September 2003 to April 2004. Results Local Geneva/French neighbourhood market research identified 148 FuF in five major FuF food groups which were compiled into a functional ingredient database. Prior to the face-to-face verification, 210 (33 %) individuals categorized themselves as FuF consumers, 429 (67 %) as non-consumers. The control step revealed that 70 % of the 639 participants were already familiar with the FuF concept, and thus were correctly self-categorized as FuF consumers or non-consumers. For the remaining 30 % of participants the true FuF consumption status was established, resulting in a final number of 285 FuF consumers (45 %; 12 % net increase) and 354 (55 %) non-consumers. Conclusions The developed self-administered, brief, qualitative food group-based FuF frequency check list in combination with an FFQ and a photo-assisted control step provides a flexible assessment tool for measuring FuF consumption in the context of a specific fluctuating FuF market and may be applicable to other population settings and times

Published
2017

41. Association of extreme blood lipid profile phenotypic variation with 11 reverse cholesterol transport genes and 10 non-genetic cardiovascular disease risk factors

Author

Morabia, Alfredo, Cayanis, Eftihia, Costanza, Michael C., Ross, Barbara M., Flaherty, Maria Sol, Alvin, Gabriela B., Das, Kamna, Gilliam, T. Conrad, Morabia, Alfredo, Cayanis, Eftihia, Costanza, Michael C., Ross, Barbara M., Flaherty, Maria Sol, Alvin, Gabriela B., Das, Kamna, and Gilliam, T. Conrad

Abstract

This study explored the genetic basis of the combination of extreme blood levels of HDL-C and LDL-C, a well-studied endophenotype for CVD, which has several attractive features as a target for genetic analysis: (1) the trait is moderately heritable; (2) non-genetic risk factors account for a significant but still limited portion of the phenotypic variance; (3) it is known to be moderated by a number of gene products. We exhaustively surveyed 11 candidate genes for allelic variation in a random population-based sample characterized for known CVD risk factors and blood lipid profiles. With the goal of generating specific etiological hypotheses, we compared two groups of subjects with extreme lipid phenotypes, from the same source population, using a case-control design. Cases (n=186) were subjects, within the total sample of 1708 people, who scored in the upper tertile of LDL-C and the lowest tertile of HDL-C, while controls (n=185) scored in the lowest tertile of LDL-C and the upper tertile of HDL-C. We used logistic regression and a four-tiered, systematic model building strategy with internal cross-validation and bootstrapping to investigate the relationships between the trait and 275 genetic variants in the presence of 10 non-genetic risk factors. Our results implicate a subset of nine genetic variants, spanning seven candidate genes, together with five environmental risk factors, in the etiology of extreme lipoprotein phenotypes. We propose a model involving these 14 genetic and non-genetic risk factors for evaluation in future independent studies

Published
2017

44. No physical activity X CETP 1b.-629 interaction effects on lipid profile

Author

Bernstein, Martine S., Costanza, Michael C., James, Richard W., Morris, Michael A., Cambien, Francois, Raoux, Segolene, and Morabia, Alfredo

Subjects
Exercise -- Physiological aspects, Cholesterol, HDL -- Physiological aspects, Cholesterol metabolism -- Physiological aspects, Proteolipids -- Measurement, Proteolipids -- Physiological aspects, Lipoproteins -- Measurement, Lipoproteins -- Physiological aspects, Statistics -- Analysis, Health, Sports and fitness
Abstract

Results reveal that there apperas to be no change in the effects of the cholesteryl ester transfer protein (CETP) 1b.-629 A-C polymorphism on blood lipid concentrations with physicial activity levels in a mostly sedantary population. Before stratification into CETP subgroups, higher high-density lipoprotein-C is associated with a greater percentage of high-intensity in men.

Published
2003

45. Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: A comparative risk assessment

Author

Danaei, G, Lu, Y, Singh, G, Carnahan, E, Stevens, G, Cowan, M, Farzadfar, F, Lin, J, Finucane, M, Rao, M, Khang, Y, Riley, L, Arian, D, Lim, S, Ezzati, M, Aamodt, G, Abdeen, Z, Abdella, N, Rahim, H, Addo, J, Aekplakorn, W, Afifi, M, Agabiti-Rosei, E, Salinas, C, Agyemang, C, Ali, M, Al-Nsour, M, Al-Nuaim, A, Ambady, R, Angelantonio, E, Aro, P, Azizi, F, Babu, B, Bahalim, A, Barbagallo, C, Barbieri, M, Barceló, A, Barreto, S, Barros, H, Bautista, L, Benetos, A, Bjerregaard, P, Björkelund, C, Bo, S, Bobak, M, Bonora, E, Botana, M, Bovet, P, Breckenkamp, J, Breteler, M, Broda, G, Brown, I, Bursztyn, M, de León, A, Campos, H, Cappuccio, F, Capuano, V, Casiglia, E, Castellano, M, Castetbon, K, Cea, L, Chang, C, Chaouki, N, Chatterji, S, Chen, C, Chen, Z, Choi, J, Chua, L, Cífková, R, Cobiac, L, Cooper, R, Corsi, A, Costanza, M, Craig, C, Dankner, R, Dastgiri, S, Delgado, E, Dinc, G, Doi, Y, Dong, G, Dorsi, E, Dragano, N, Drewnowski, A, Eggertsen, R, Elliott, P, Engeland, A, Erem, C, Esteghamati, A, Fall, C, Fan, J, Ferreccio, C, Fezeu, L, Firmo, J, Florez, H, Fornés, N, Fowkes, F, Franceschini, G, Frisk, F, Fuchs, F, Fuller, E, Getz, L, Giampaoli, S, Gómez, L, Gomez-Zumaquero, J, Iversen, S, Grant, J, Carvajal, R, Gulliford, M, Gupta, R, Gupta, P, Gureje, O, Gutierrez, H, Hansen, T, Hata, J, He, J, Heim, N, Heinrich, J, Hemmingsson, T, Hennis, A, Herman, W, Herrera, V, Ho, S, Holdsworth, M, Frisman, G, Hopman, W, Hussain, A, Husseini, A, Ibrahim, M, Ikeda, N, Jacobsen, B, Jaddou, H, Jafar, T, Janghorbani, M, Jasienska, G, Joffres, M, Jonas, J, Kadiki, O, Kalter-Leibovici, O, Kamadjeu, R, Kaptoge, S, Karalis, I, Kastarinen, M, Katz, J, Keinan-Boker, L, Kelly, P, Khalilzadeh, O, Kiechl, S, Kim, K, Kiyohara, Y, Kobayashi, J, Krause, M, Kubínová, R, Kurjata, P, Kusuma, Y, Lam, T, Langhammer, A, Lawes, C, Le, C, Lee, J, Lévy-Marchal, C, Lewington, S, Li, Y, Lim, T, Lin, X, Lin, C, Lin, H, Lind, L, Lissner, L, Liu, X, Lopez-Jaramillo, P, Lorbeer, R, Ma, G, Ma, S, Macià, F, Maclean, D, Maggi, S, Magliano, D, Makdisse, M, Mancia, G, Mannami, T, Marques-Vidal, P, Mbanya, J, McFarlane-Anderson, N, Miccoli, R, Miettola, J, Minh, H, Miquel, J, Miranda, J, Mohamed, M, Mohan, V, Mohanna, S, Mokdad, A, Mollentze, W, Morales, D, Morgan, K, Lorenza M Muiesan, N, Muntoni, S, Nabipour, I, Nakagami, T, Nangia, V, Nemesure, B, Neovius, M, Nerhus, K, Nervi, F, Neuhauser, H, Nguyen, M, Ninomiya, T, Noale, M, Oh, S, Ohkubo, T, Olivieri, O, Önal, A, Onat, A, Oróstegui, M, Ouedraogo, H, Pan, W, Panagiotakos, D, Panza, F, Park, Y, Passos, V, Pednekar, M, Pelizzari, P, Peres, M, Cynthia Pérez, N, Pérez-Fernández, R, Pichardo, R, Phua, H, Pistelli, F, Plans, P, Polakowska, M, Poulter, N, Prabhakaran, D, Qiao, Q, Rafiei, M, Raitakari, O, Ramos, L, Rampal, S, Rampal, L, Rasmussen, F, Reddy, K, Redon, J, Revilla, L, Reyes-García, V, Roaeid, R, Robinson, C, Rodriguez-Artalejo, F, Rojas-Martinez, R, Ronkainen, K, Rosero-Bixby, L, Roth, G, Sachdev, H, Sánchez, J, Sanisoglu, S, Sans, S, Sarraf-Zadegan, N, Scazufca, M, Schaan, B, Schapochnik, N, Schelleman, H, Schneider, I, Schooling, C, Schwarz, B, Sekuri, C, Sereday, M, Serra-Majem, L, Shaw, J, Shera, A, Shi, Z, Shiri, R, Shu, X, Silva, D, Silva, E, Simons, L, Smith, M, Söderberg, S, Soebardi, S, Solfrizzi, V, Sonestedt, E, Soysal, A, Stattin, P, Stein, A, Stergiou, G, Stessman, J, Sudo, A, Suka, M, Sundh, V, Sundquist, K, Sundström, J, Swai, A, Tai, E, Tambs, K, Tesfaye, F, Thomas, G, Thorogood, M, Tilvis, R, Tobias, M, Torheim, L, Trenkwalder, P, Tuomilehto, J, Tur, J, Tzourio, C, Uhernik, A, Ukoli, F, Unwin, N, Hoorn, S, Vanderpump, M, Varo, J, Veierød, M, Velásquez-Meléndez, G, Verschuren, M, Viet, L, Villalpando, S, Vioque, J, Vollenweider, P, Volpato, S, Wang, N, Wang, Y, Ward, M, Waspadji, S, Lennart X Welin, N, Whitlock, G, Wilhelmsen, L, Willeit, J, Woodward, M, Wormser, D, André J Xavier, N, Xu, F, Xu, L, Yamamoto, A, Yang, G, Yang, X, Yeh, L, Yoon, J, You, Q, Yu, Z, Zhang, J, Zhang, L, Zheng, W, Zhou, M, Danaei, Goodarz, Lu, Yuan, Singh, Gitanjali M, Carnahan, Emily, Stevens, Gretchen A, Cowan, Melanie J, Farzadfar, Farshad, Lin, John K, Finucane, Mariel M, Rao, Mayuree, Khang, Young-Ho, Riley, Leanne M, Arian, Dariush Mozaff, Lim, Stephen S, Ezzati, Majid, Aamodt, Geir, Abdeen, Ziad, Abdella, Nabila A, Rahim, Hanan F Abdul, Addo, Juliet, Aekplakorn, Wichai, Afifi, Mustafa M, Agabiti-Rosei, Enrico, Salinas, Carlos A Aguilar, Agyemang, Charles, Ali, Mohammed K, Ali, Mohamed M, Al-Nsour, Mohannad, Al-Nuaim, Abdul R, Ambady, Ramachandran, Angelantonio, Emanuele Di, Aro, Pertti, Azizi, Fereidoun, Babu, Bontha V, Bahalim, Adil N, Barbagallo, Carlo M, Barbieri, Marco A, Barceló, Alberto, Barreto, Sandhi M, Barros, Henrique, Bautista, Leonelo E, Benetos, Athanase, Bjerregaard, Peter, Björkelund, Cecilia, Bo, Simona, Bobak, Martin, Bonora, Enzo, Botana, Manuel A, Bovet, Pascal, Breckenkamp, Juergen, Breteler, Monique M, Broda, Grazyna, Brown, Ian J, Bursztyn, Michael, de León, Antonio Cabrera, Campos, Hannia, Cappuccio, Francesco P, Capuano, Vincenzo, Casiglia, Edoardo, Castellano, Maurizio, Castetbon, Katia, Cea, Luis, Chang, Chih-Jen, Chaouki, Noureddine, Chatterji, Somnath, Chen, Chien-Jen, Chen, Zhengming, Choi, Jin-Su, Chua, Lily, Cífková, Renata, Cobiac, Linda J, Cooper, Richard S, Corsi, Anna Maria, Costanza, Michael C, Craig, Cora L, Dankner, Rachel S, Dastgiri, Saeed, Delgado, Elias, Dinc, Gonul, Doi, Yasufumi, Dong, Guang-Hui, Dorsi, Eleonora, Dragano, Nico, Drewnowski, Adam, Eggertsen, Robert, Elliott, Paul, Engeland, Anders, Erem, Cihangir, Esteghamati, Alireza, Fall, Caroline H D, Fan, Jian-Gao, Ferreccio, Catterina, Fezeu, Leopold, Firmo, Josélia O, Florez, Hermes J, Fornés, Nélida S, Fowkes, F Gerry R, Franceschini, Guido, Frisk, Fredrik, Fuchs, Flávio D, Fuller, Eva L, Getz, Linn, Giampaoli, Simona, Gómez, Luis F, Gomez-Zumaquero, Juan M, Iversen, Sidsel Graff, Grant, Janet F, Carvajal, Ramiro Guerrero, Gulliford, Martin C, Gupta, Rajeev, Gupta, Prakash C, Gureje, Oye, Gutierrez, Hialy R, Hansen, Tine W, Hata, Jun, He, Jiang, Heim, Noor, Heinrich, Joachim, Hemmingsson, Tomas, Hennis, Anselm, Herman, William H, Herrera, Victor M, Ho, Suzanne, Holdsworth, Michelle, Frisman, Gunilla Hollman, Hopman, Wilma M, Hussain, Akhtar, Husseini, Abdullatif, Ibrahim, M Mohsen, Ikeda, Nayu, Jacobsen, Bjarne K, Jaddou, Hashem Y, Jafar, Tazeen H, Janghorbani, Mohsen, Jasienska, Grazyna, Joffres, Michel R, Jonas, Jost B, Kadiki, Othman A, Kalter-Leibovici, Ofra, Kamadjeu, Raoul M, Kaptoge, Stephen, Karalis, Ioannis, Kastarinen, Mika J, Katz, Joanne, Keinan-Boker, Lital, Kelly, Paul, Khalilzadeh, Omid, Kiechl, Stefan, Kim, Ki Woong, Kiyohara, Yutaka, Kobayashi, Junji, Krause, Maressa P, Kubínová, Ružena, Kurjata, Pawel, Kusuma, Yadlapalli S, Lam, Tai H, Langhammer, Arnulf, Lawes, Carlene M M, Le, Cai, Lee, Jeannette, Lévy-Marchal, Claire, Lewington, Sarah, Li, Yanping, Li, Yuqiu, Lim, T O, Lin, Xu, Lin, Cheng-Chieh, Lin, Hsien-Ho, Lind, Lars, Lissner, Lauren, Liu, Xiaoqing, Lopez-Jaramillo, Patricio, Lorbeer, Roberto, Ma, Guansheng, Ma, Stefan, Macià, Francesc, Maclean, David R, Maggi, Stefania, Magliano, Dianna J, Makdisse, Marcia, Mancia, Giuseppe, Mannami, Toshifumi, Marques-Vidal, Pedro, Mbanya, Jean Claude N, McFarlane-Anderson, Norma, Miccoli, Roberto, Miettola, Juhani, Minh, Hoang V, Miquel, Juan F, Miranda, J Jaime, Mohamed, Mostafa K, Mohan, V., Mohanna, Salim, Mokdad, Ali, Mollentze, Willem F, Morales, Dante D, Morgan, Karen, Lorenza M Muiesan, null, Muntoni, Sergio, Nabipour, Iraj, Nakagami, Tomoko, Nangia, Vinay, Nemesure, Barbara, Neovius, Martin, Nerhus, Kjersti A, Nervi, Flavio, Neuhauser, Hannelore, Nguyen, Minh, Ninomiya, Toshiharu, Noale, Marianna, Oh, Sang W, Ohkubo, Takayoshi, Olivieri, Oliviero, önal, Ayse Emel, Onat, Altan, Oróstegui, Myriam, Ouedraogo, Hermann, Pan, Wen-Harn, Panagiotakos, Demosthenes B, Panza, Francesco, Park, Yongsoo, Passos, Valeria M A, Pednekar, Mangesh S, Pelizzari, Pamela M, Peres, Marco A, Cynthia Pérez, null, Pérez-Fernández, Román, Pichardo, Rafael, Phua, Hwee Pin, Pistelli, Francesco, Plans, Pedro, Polakowska, Maria, Poulter, Neil, Prabhakaran, Dorairaj, Qiao, Qing, Rafiei, Masoud, Raitakari, Olli T, Ramos, Luiz R, Rampal, Sanjay, Rampal, Lekhraj, Rasmussen, Finn, Reddy, Kanala K R, Redon, Josep, Revilla, Luis, Reyes-García, Victoria, Roaeid, Ragab B, Robinson, Carolyn A, Rodriguez-Artalejo, Fernando, Rojas-Martinez, Rosalba, Ronkainen, Kimmo, Rosero-Bixby, Luis, Roth, Gregory A, Sachdev, Harshpal S, Sánchez, José R, Sanisoglu, Selim Y, Sans, Susana, Sarraf-Zadegan, Nizal, Scazufca, Marcia, Schaan, Beatriz D, Schapochnik, Norberto, Schelleman, Hedi, Schneider, Ione J C, Schooling, C Mary, Schwarz, Bernhard, Sekuri, Cevad, Sereday, Martha S, Serra-Majem, Lluís, Shaw, Jonathan, Shera, Abdul S, Shi, Zumin, Shiri, Rahman, Shu, Xiao Ou, Silva, Diego Augusto Santos, Silva, Eglé, Simons, Leon A, Smith, Margaret, Söderberg, Stefan, Soebardi, Suharko, Solfrizzi, Vincenzo, Sonestedt, Emily, Soysal, Ahmet, Stattin, Pär, Stein, Aryeh D, Stergiou, George S, Stessman, Jochanan, Sudo, Akihiro, Suka, Machi, Sundh, Valter, Sundquist, Kristina, Sundström, Johan, Swai, Andrew B, Tai, E Shyong, Tambs, Kristian, Tesfaye, Fikru, Thomas, George N, Thorogood, Margaret, Tilvis, Reijo S, Tobias, Martin, Torheim, Liv E, Trenkwalder, Peter, Tuomilehto, Jaakko O, Tur, Josep A, Tzourio, Christophe, Uhernik, Ana I, Ukoli, Flora A, Unwin, Nigel, Hoorn, Stephen Vander, Vanderpump, Mark P, Varo, Jose Javier, Veierød, Marit B, Velásquez-Meléndez, Gustavo, Verschuren, Monique, Viet, Lucie, Villalpando, Salvador, Vioque, Jesus, Vollenweider, Peter, Volpato, Stefano, Wang, Ningli, Wang, Ya X, Ward, Mark, Waspadji, Sarwono, Lennart X Welin, null, Whitlock, Gary, Wilhelmsen, Lars, Willeit, Johann, Woodward, Mark, Wormser, David, André J Xavier, null, Xu, Fei, Xu, Liang, Yamamoto, Akira, Yang, Gonghuan, Yang, Xiaoguang, Yeh, Li-Chia, Yoon, Jin-Sang, You, Qisheng, Yu, Zhijie, Zhang, Jian, Zhang, Lei, Zheng, Wei, Zhou, Maigeng, Danaei, G, Lu, Y, Singh, G, Carnahan, E, Stevens, G, Cowan, M, Farzadfar, F, Lin, J, Finucane, M, Rao, M, Khang, Y, Riley, L, Arian, D, Lim, S, Ezzati, M, Aamodt, G, Abdeen, Z, Abdella, N, Rahim, H, Addo, J, Aekplakorn, W, Afifi, M, Agabiti-Rosei, E, Salinas, C, Agyemang, C, Ali, M, Al-Nsour, M, Al-Nuaim, A, Ambady, R, Angelantonio, E, Aro, P, Azizi, F, Babu, B, Bahalim, A, Barbagallo, C, Barbieri, M, Barceló, A, Barreto, S, Barros, H, Bautista, L, Benetos, A, Bjerregaard, P, Björkelund, C, Bo, S, Bobak, M, Bonora, E, Botana, M, Bovet, P, Breckenkamp, J, Breteler, M, Broda, G, Brown, I, Bursztyn, M, de León, A, Campos, H, Cappuccio, F, Capuano, V, Casiglia, E, Castellano, M, Castetbon, K, Cea, L, Chang, C, Chaouki, N, Chatterji, S, Chen, C, Chen, Z, Choi, J, Chua, L, Cífková, R, Cobiac, L, Cooper, R, Corsi, A, Costanza, M, Craig, C, Dankner, R, Dastgiri, S, Delgado, E, Dinc, G, Doi, Y, Dong, G, Dorsi, E, Dragano, N, Drewnowski, A, Eggertsen, R, Elliott, P, Engeland, A, Erem, C, Esteghamati, A, Fall, C, Fan, J, Ferreccio, C, Fezeu, L, Firmo, J, Florez, H, Fornés, N, Fowkes, F, Franceschini, G, Frisk, F, Fuchs, F, Fuller, E, Getz, L, Giampaoli, S, Gómez, L, Gomez-Zumaquero, J, Iversen, S, Grant, J, Carvajal, R, Gulliford, M, Gupta, R, Gupta, P, Gureje, O, Gutierrez, H, Hansen, T, Hata, J, He, J, Heim, N, Heinrich, J, Hemmingsson, T, Hennis, A, Herman, W, Herrera, V, Ho, S, Holdsworth, M, Frisman, G, Hopman, W, Hussain, A, Husseini, A, Ibrahim, M, Ikeda, N, Jacobsen, B, Jaddou, H, Jafar, T, Janghorbani, M, Jasienska, G, Joffres, M, Jonas, J, Kadiki, O, Kalter-Leibovici, O, Kamadjeu, R, Kaptoge, S, Karalis, I, Kastarinen, M, Katz, J, Keinan-Boker, L, Kelly, P, Khalilzadeh, O, Kiechl, S, Kim, K, Kiyohara, Y, Kobayashi, J, Krause, M, Kubínová, R, Kurjata, P, Kusuma, Y, Lam, T, Langhammer, A, Lawes, C, Le, C, Lee, J, Lévy-Marchal, C, Lewington, S, Li, Y, Lim, T, Lin, X, Lin, C, Lin, H, Lind, L, Lissner, L, Liu, X, Lopez-Jaramillo, P, Lorbeer, R, Ma, G, Ma, S, Macià, F, Maclean, D, Maggi, S, Magliano, D, Makdisse, M, Mancia, G, Mannami, T, Marques-Vidal, P, Mbanya, J, McFarlane-Anderson, N, Miccoli, R, Miettola, J, Minh, H, Miquel, J, Miranda, J, Mohamed, M, Mohan, V, Mohanna, S, Mokdad, A, Mollentze, W, Morales, D, Morgan, K, Lorenza M Muiesan, N, Muntoni, S, Nabipour, I, Nakagami, T, Nangia, V, Nemesure, B, Neovius, M, Nerhus, K, Nervi, F, Neuhauser, H, Nguyen, M, Ninomiya, T, Noale, M, Oh, S, Ohkubo, T, Olivieri, O, Önal, A, Onat, A, Oróstegui, M, Ouedraogo, H, Pan, W, Panagiotakos, D, Panza, F, Park, Y, Passos, V, Pednekar, M, Pelizzari, P, Peres, M, Cynthia Pérez, N, Pérez-Fernández, R, Pichardo, R, Phua, H, Pistelli, F, Plans, P, Polakowska, M, Poulter, N, Prabhakaran, D, Qiao, Q, Rafiei, M, Raitakari, O, Ramos, L, Rampal, S, Rampal, L, Rasmussen, F, Reddy, K, Redon, J, Revilla, L, Reyes-García, V, Roaeid, R, Robinson, C, Rodriguez-Artalejo, F, Rojas-Martinez, R, Ronkainen, K, Rosero-Bixby, L, Roth, G, Sachdev, H, Sánchez, J, Sanisoglu, S, Sans, S, Sarraf-Zadegan, N, Scazufca, M, Schaan, B, Schapochnik, N, Schelleman, H, Schneider, I, Schooling, C, Schwarz, B, Sekuri, C, Sereday, M, Serra-Majem, L, Shaw, J, Shera, A, Shi, Z, Shiri, R, Shu, X, Silva, D, Silva, E, Simons, L, Smith, M, Söderberg, S, Soebardi, S, Solfrizzi, V, Sonestedt, E, Soysal, A, Stattin, P, Stein, A, Stergiou, G, Stessman, J, Sudo, A, Suka, M, Sundh, V, Sundquist, K, Sundström, J, Swai, A, Tai, E, Tambs, K, Tesfaye, F, Thomas, G, Thorogood, M, Tilvis, R, Tobias, M, Torheim, L, Trenkwalder, P, Tuomilehto, J, Tur, J, Tzourio, C, Uhernik, A, Ukoli, F, Unwin, N, Hoorn, S, Vanderpump, M, Varo, J, Veierød, M, Velásquez-Meléndez, G, Verschuren, M, Viet, L, Villalpando, S, Vioque, J, Vollenweider, P, Volpato, S, Wang, N, Wang, Y, Ward, M, Waspadji, S, Lennart X Welin, N, Whitlock, G, Wilhelmsen, L, Willeit, J, Woodward, M, Wormser, D, André J Xavier, N, Xu, F, Xu, L, Yamamoto, A, Yang, G, Yang, X, Yeh, L, Yoon, J, You, Q, Yu, Z, Zhang, J, Zhang, L, Zheng, W, Zhou, M, Danaei, Goodarz, Lu, Yuan, Singh, Gitanjali M, Carnahan, Emily, Stevens, Gretchen A, Cowan, Melanie J, Farzadfar, Farshad, Lin, John K, Finucane, Mariel M, Rao, Mayuree, Khang, Young-Ho, Riley, Leanne M, Arian, Dariush Mozaff, Lim, Stephen S, Ezzati, Majid, Aamodt, Geir, Abdeen, Ziad, Abdella, Nabila A, Rahim, Hanan F Abdul, Addo, Juliet, Aekplakorn, Wichai, Afifi, Mustafa M, Agabiti-Rosei, Enrico, Salinas, Carlos A Aguilar, Agyemang, Charles, Ali, Mohammed K, Ali, Mohamed M, Al-Nsour, Mohannad, Al-Nuaim, Abdul R, Ambady, Ramachandran, Angelantonio, Emanuele Di, Aro, Pertti, Azizi, Fereidoun, Babu, Bontha V, Bahalim, Adil N, Barbagallo, Carlo M, Barbieri, Marco A, Barceló, Alberto, Barreto, Sandhi M, Barros, Henrique, Bautista, Leonelo E, Benetos, Athanase, Bjerregaard, Peter, Björkelund, Cecilia, Bo, Simona, Bobak, Martin, Bonora, Enzo, Botana, Manuel A, Bovet, Pascal, Breckenkamp, Juergen, Breteler, Monique M, Broda, Grazyna, Brown, Ian J, Bursztyn, Michael, de León, Antonio Cabrera, Campos, Hannia, Cappuccio, Francesco P, Capuano, Vincenzo, Casiglia, Edoardo, Castellano, Maurizio, Castetbon, Katia, Cea, Luis, Chang, Chih-Jen, Chaouki, Noureddine, Chatterji, Somnath, Chen, Chien-Jen, Chen, Zhengming, Choi, Jin-Su, Chua, Lily, Cífková, Renata, Cobiac, Linda J, Cooper, Richard S, Corsi, Anna Maria, Costanza, Michael C, Craig, Cora L, Dankner, Rachel S, Dastgiri, Saeed, Delgado, Elias, Dinc, Gonul, Doi, Yasufumi, Dong, Guang-Hui, Dorsi, Eleonora, Dragano, Nico, Drewnowski, Adam, Eggertsen, Robert, Elliott, Paul, Engeland, Anders, Erem, Cihangir, Esteghamati, Alireza, Fall, Caroline H D, Fan, Jian-Gao, Ferreccio, Catterina, Fezeu, Leopold, Firmo, Josélia O, Florez, Hermes J, Fornés, Nélida S, Fowkes, F Gerry R, Franceschini, Guido, Frisk, Fredrik, Fuchs, Flávio D, Fuller, Eva L, Getz, Linn, Giampaoli, Simona, Gómez, Luis F, Gomez-Zumaquero, Juan M, Iversen, Sidsel Graff, Grant, Janet F, Carvajal, Ramiro Guerrero, Gulliford, Martin C, Gupta, Rajeev, Gupta, Prakash C, Gureje, Oye, Gutierrez, Hialy R, Hansen, Tine W, Hata, Jun, He, Jiang, Heim, Noor, Heinrich, Joachim, Hemmingsson, Tomas, Hennis, Anselm, Herman, William H, Herrera, Victor M, Ho, Suzanne, Holdsworth, Michelle, Frisman, Gunilla Hollman, Hopman, Wilma M, Hussain, Akhtar, Husseini, Abdullatif, Ibrahim, M Mohsen, Ikeda, Nayu, Jacobsen, Bjarne K, Jaddou, Hashem Y, Jafar, Tazeen H, Janghorbani, Mohsen, Jasienska, Grazyna, Joffres, Michel R, Jonas, Jost B, Kadiki, Othman A, Kalter-Leibovici, Ofra, Kamadjeu, Raoul M, Kaptoge, Stephen, Karalis, Ioannis, Kastarinen, Mika J, Katz, Joanne, Keinan-Boker, Lital, Kelly, Paul, Khalilzadeh, Omid, Kiechl, Stefan, Kim, Ki Woong, Kiyohara, Yutaka, Kobayashi, Junji, Krause, Maressa P, Kubínová, Ružena, Kurjata, Pawel, Kusuma, Yadlapalli S, Lam, Tai H, Langhammer, Arnulf, Lawes, Carlene M M, Le, Cai, Lee, Jeannette, Lévy-Marchal, Claire, Lewington, Sarah, Li, Yanping, Li, Yuqiu, Lim, T O, Lin, Xu, Lin, Cheng-Chieh, Lin, Hsien-Ho, Lind, Lars, Lissner, Lauren, Liu, Xiaoqing, Lopez-Jaramillo, Patricio, Lorbeer, Roberto, Ma, Guansheng, Ma, Stefan, Macià, Francesc, Maclean, David R, Maggi, Stefania, Magliano, Dianna J, Makdisse, Marcia, Mancia, Giuseppe, Mannami, Toshifumi, Marques-Vidal, Pedro, Mbanya, Jean Claude N, McFarlane-Anderson, Norma, Miccoli, Roberto, Miettola, Juhani, Minh, Hoang V, Miquel, Juan F, Miranda, J Jaime, Mohamed, Mostafa K, Mohan, V., Mohanna, Salim, Mokdad, Ali, Mollentze, Willem F, Morales, Dante D, Morgan, Karen, Lorenza M Muiesan, null, Muntoni, Sergio, Nabipour, Iraj, Nakagami, Tomoko, Nangia, Vinay, Nemesure, Barbara, Neovius, Martin, Nerhus, Kjersti A, Nervi, Flavio, Neuhauser, Hannelore, Nguyen, Minh, Ninomiya, Toshiharu, Noale, Marianna, Oh, Sang W, Ohkubo, Takayoshi, Olivieri, Oliviero, önal, Ayse Emel, Onat, Altan, Oróstegui, Myriam, Ouedraogo, Hermann, Pan, Wen-Harn, Panagiotakos, Demosthenes B, Panza, Francesco, Park, Yongsoo, Passos, Valeria M A, Pednekar, Mangesh S, Pelizzari, Pamela M, Peres, Marco A, Cynthia Pérez, null, Pérez-Fernández, Román, Pichardo, Rafael, Phua, Hwee Pin, Pistelli, Francesco, Plans, Pedro, Polakowska, Maria, Poulter, Neil, Prabhakaran, Dorairaj, Qiao, Qing, Rafiei, Masoud, Raitakari, Olli T, Ramos, Luiz R, Rampal, Sanjay, Rampal, Lekhraj, Rasmussen, Finn, Reddy, Kanala K R, Redon, Josep, Revilla, Luis, Reyes-García, Victoria, Roaeid, Ragab B, Robinson, Carolyn A, Rodriguez-Artalejo, Fernando, Rojas-Martinez, Rosalba, Ronkainen, Kimmo, Rosero-Bixby, Luis, Roth, Gregory A, Sachdev, Harshpal S, Sánchez, José R, Sanisoglu, Selim Y, Sans, Susana, Sarraf-Zadegan, Nizal, Scazufca, Marcia, Schaan, Beatriz D, Schapochnik, Norberto, Schelleman, Hedi, Schneider, Ione J C, Schooling, C Mary, Schwarz, Bernhard, Sekuri, Cevad, Sereday, Martha S, Serra-Majem, Lluís, Shaw, Jonathan, Shera, Abdul S, Shi, Zumin, Shiri, Rahman, Shu, Xiao Ou, Silva, Diego Augusto Santos, Silva, Eglé, Simons, Leon A, Smith, Margaret, Söderberg, Stefan, Soebardi, Suharko, Solfrizzi, Vincenzo, Sonestedt, Emily, Soysal, Ahmet, Stattin, Pär, Stein, Aryeh D, Stergiou, George S, Stessman, Jochanan, Sudo, Akihiro, Suka, Machi, Sundh, Valter, Sundquist, Kristina, Sundström, Johan, Swai, Andrew B, Tai, E Shyong, Tambs, Kristian, Tesfaye, Fikru, Thomas, George N, Thorogood, Margaret, Tilvis, Reijo S, Tobias, Martin, Torheim, Liv E, Trenkwalder, Peter, Tuomilehto, Jaakko O, Tur, Josep A, Tzourio, Christophe, Uhernik, Ana I, Ukoli, Flora A, Unwin, Nigel, Hoorn, Stephen Vander, Vanderpump, Mark P, Varo, Jose Javier, Veierød, Marit B, Velásquez-Meléndez, Gustavo, Verschuren, Monique, Viet, Lucie, Villalpando, Salvador, Vioque, Jesus, Vollenweider, Peter, Volpato, Stefano, Wang, Ningli, Wang, Ya X, Ward, Mark, Waspadji, Sarwono, Lennart X Welin, null, Whitlock, Gary, Wilhelmsen, Lars, Willeit, Johann, Woodward, Mark, Wormser, David, André J Xavier, null, Xu, Fei, Xu, Liang, Yamamoto, Akira, Yang, Gonghuan, Yang, Xiaoguang, Yeh, Li-Chia, Yoon, Jin-Sang, You, Qisheng, Yu, Zhijie, Zhang, Jian, Zhang, Lei, Zheng, Wei, and Zhou, Maigeng

Abstract

Background: High blood pressure, blood glucose, serum cholesterol, and BMI are risk factors for cardiovascular diseases and some of these factors also increase the risk of chronic kidney disease and diabetes. We estimated mortality from cardiovascular diseases, chronic kidney disease, and diabetes that was attributable to these four cardiometabolic risk factors for all countries and regions from 1980 to 2010. Methods: We used data for exposure to risk factors by country, age group, and sex from pooled analyses of population-based health surveys. We obtained relative risks for the effects of risk factors on cause-specific mortality from meta-analyses of large prospective studies. We calculated the population attributable fractions for each risk factor alone, and for the combination of all risk factors, accounting for multicausality and for mediation of the effects of BMI by the other three risks. We calculated attributable deaths by multiplying the cause-specific population attributable fractions by the number of disease-specific deaths. We obtained cause-specific mortality from the Global Burden of Diseases, Injuries, and Risk Factors 2010 Study. We propagated the uncertainties of all the inputs to the final estimates. Findings: In 2010, high blood pressure was the leading risk factor for deaths due to cardiovascular diseases, chronic kidney disease, and diabetes in every region, causing more than 40% of worldwide deaths from these diseases; high BMI and glucose were each responsible for about 15% of deaths, and high cholesterol for more than 10%. After accounting for multicausality, 63% (10·8 million deaths, 95% CI 10·1-11·5) of deaths from these diseases in 2010 were attributable to the combined effect of these four metabolic risk factors, compared with 67% (7·1 million deaths, 6·6-7·6) in 1980. The mortality burden of high BMI and glucose nearly doubled from 1980 to 2010. At the country level, age-standardised death rates from these diseases attributable to the c

Published
2014

46. Low prevalence of atrial fibrillation in asymptomatic adults in Geneva, Switzerland

Author

Schmutz, Mathieu, Beer-Borst, Sigrid, Meiltz, Alexandre, Urban, Philip, Gaspoz, Jean-Michel, Costanza, Michael C, Morabia, Alfredo, and Zimmermann, Marc

Abstract

Aims To determine the prevalence of atrial fibrillation (AF) in a population-based sample of adults. Methods and results Between January 2005 and December 2007 individuals aged >/=50 years, residents of the city of Geneva, who had participated in a previous random survey were invited for follow-up examination. AF was assessed on a single resting 6-lead ECG. Reported prevalences were standardized for the age distribution of Canton Geneva. Overall participation was 72.8%. Twenty-nine cases of AF (22 men) were diagnosed among 3285 subjects (1696 men). The crude prevalence of AF (95% CI) was 0.88% (0.86, 0.90) overall, but higher in men [1.30% (1.26, 1.34)] than in women [0.44% (0.41, 0.47)]. The age-standardized AF prevalence was slightly higher [overall: 0.94% (0.91, 0.97), men: 1.23% (1.19, 1.27), women: 0.54% (0.47, 0.61)]. AF prevalence increased with age in both sexes. A 'history of suspected arterial embolism' (brain or legs) was higher in the AF cases (10.3 vs. 3.3%; P = 0.03). Conclusion This population-based survey of a general Swiss population indicates that the prevalence of AF remains below 1%. These results are less alarming than those from previous studies based on patients seeking medical care.

Published
2009
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47. Come on, Come on, Do the Loco-Motion

Author

Morabia, Alfredo, Morabia, Alfredo, Costanza, Michael C., Morabia, Alfredo, Morabia, Alfredo, and Costanza, Michael C.

Abstract

This themed issue of Preventive Medicine comprises articles following our call for papers on Self-Transportation, Public Transportation, and Health. Prevention-wise, the logic is that using self- or public transportation is likely to increase physical activity and counter the overall trend toward obesity that most populations of the world are now experiencing. The problem is that in countries for which data are available, both the cycling fraction of road traffic and the number of miles walked are declining (Dora, 1999; Haines et al., 2000). The harvest of papers has been rewarding. They show how far we currently are in the process of assembling evidence in support of the self/public transportation and health connection, but they also reflect the deficits in the experimental evidence needed to demonstrate that improving access to public transportation and modifying the built environment to stimulate walking and biking are going to make a meaningful difference in terms of public health.

Published
2008

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