Global Risk Factors Research Articles

Global incidence and risk factors for glaucoma: A systematic review and meta-analysis of prospective studies.

This study aims to estimate global incidence and assess risk factors for glaucoma subtypes. The literature search was performed in three English (PubMed, Embase, MEDLINE) and three Chinese (China National Knowledge Infrastructure, Wanfang, China Science and Technology Journal Database) databases to identify prospective studies on glaucoma incidence between 1 January 1990 and 29 November 2022. We used a multilevel mixed-effects meta-regression to estimate the age- and sex-specific incidence rate of primary open-angle glaucoma (POAG). The global and regional incidence rate of POAG in 2022 were respectively estimated. The annual cumulative incidence (ACI) of POAG and primary angle-closure glaucoma (PACG), and risk factors for POAG were pooled using a random-effects meta-analysis, respectively. The heterogeneity of the included articles was tested using the Q statistic and measured by I2 index. Publication bias was detected by funnel plots, Egger's regression test, and Begg's rank correlation test. A total of 9050 articles were identified in literature search, and 50 articles provided incidence data of glaucoma subtypes. In 2022, the global incidence rate of POAG was 23.46 (95% confidence interval (CI) = 15.68-32.91) per 10 000 person-years among 40-79 years. An increase from 5.51 (95% CI = 1.63-11.12) per 10 000 person-years in 40-44 years to 64.36 (95% CI = 49.82-80.70) per 10 000 person-years in 75-79 years was noted between the year 1990 and 2019. Across sociodemographic index (SDI) and World Health Organization (WHO) regions, the incidence rate was the highest in low SDI region and Africa, respectively. The pooled ACI of POAG was 0.21% (95% CI = 0.13%-0.30%). Six risk factors for POAG were identified, including intraocular pressure (IOP) treatment (meta-odds ratio (OR) = 3.69; 95% CI = 2.64-5.15), a family history of glaucoma (meta-OR = 2.49; 95% CI = 1.92-3.24), myopia (meta-OR = 2.08; 95% CI = 1.59-2.70), elevated IOP (meta-OR = 1.13; 95% CI = 1.11-1.15), advanced age (meta-OR = 1.07; 95% CI = 1.05-1.08), male (female: meta-OR = 0.76; 95% CI = 0.66-0.88). The pooled ACI of PACG was 0.05% (95% CI = 0.00%-0.16%). Significant disparities existed in incidence rates for glaucoma across geographic regions and age groups. Further research is needed to understand which risk factors drive glaucoma incidence in different socioeconomic strata for tailored health policy on preventing glaucoma. This study is registered with PROSPERO (number CRD42023434203).

The Global Burden and Risk Factors of Cardiovascular Diseases in Adolescent and Young Adults: A Systematic Review

The Global Burden and Risk Factors of Cardiovascular Diseases in Adolescent and Young Adults: A Systematic Review

Global Overview of Suicidal Behavior and Risk Factors among General Population during the COVID-19 Pandemic: A Systematic Review and a Meta-Regression.

The COVID-19 pandemic has significantly impacted mental health worldwide, leading to increased rates of suicidal behavior. This systematic review and meta-regression aim to investigate the global prevalence and risk factors associated with suicidal behaviors in the general population during the pandemic. The study included 202 articles from January 1, 2019, to October 31, 2023, sourced from databases such as Embase, MEDLINE, CINAHL, Web of Science, and Cochrane Library. The meta-analysis revealed a prevalence of 13.5% for suicidal ideation, 10.4% for suicide attempts, and a death rate of 0.5%, translating to 4.52 per 100,000 person-years. Significant risk factors identified include being transgender, young adults (18-44years), unmarried status, low education, retirement, living alone, low social support, a history of suicide attempts, substance use, depression, anxiety, PTSD, sleep problems, poor perceived physical health, loneliness, quarantine, and residing in the Americas or multiple regions. The findings underscore the urgent need for targeted mental health interventions during pandemics, focusing on high-risk groups such as young adults, transgender individuals, those with low social support, and people with mental health issues. This comprehensive analysis provides valuable insights for policymakers and healthcare providers to develop effective strategies to mitigate the heightened risk of suicide during global health crises.

The burden of lung cancer attributable to ambient PM2.5 exposure: a systematic literature review

Abstract Background Lung cancer is recognized as one of the most common causes of cancer morbidity and mortality worldwide and is the second cause of death with highest years of life lost in highly developed regions. Ambient exposure to particulate matter (PM2.5) is the leading global environmental risk factor. Long-term exposure to PM2.5 is associated with several health outcomes, including lung cancer, ischemic heart disease, and chronic obstructive pulmonary disease. Aim To review and estimate the impact attributable to PM2.5 exposure due to lung cancer. Methods A systematic review and a meta-analysis were conducted to determine whether long-term exposure to PM2.5 increases the risk of lung cancer and to derive exposure-response relationships between PM2.5 and lung cancer. The literature search was performed in databases (i.e., Pubmed/Scopus) and studies published from January 1, 2010 onwards were considered. Studies describing the association between long-term exposure to the pollutant under research and the incidence, prevalence, and mortality of lung cancer, considering a relative measure of association were included, with no restriction in geographical area. Results In the literature review, 2215 articles were considered for the first step of data synthesis, all articles were screened, considering the screening of titles (first step), abstracts (second step) and full-text (third step) considering the inclusion criteria. In a second step the data was extracted from the included articles (n = 129) and considering the variables related to the characteristics of the study and the study population, exposure, and outcome measurement, and details of risk of bias assessment. Conclusions These findings provide data to synthesize effect size estimates using a Meta-Regression - Bayesian, Ensemble, Regularized, Trimmed (MR-BRT) model, important to provide evidence data on the impact of air pollution on human health, which is crucial for decision-making. Key messages • Long-term exposure to PM2.5 increases lung cancer risk so the estimating of the impact of the exposure is an urgent need to provide evidence-based data for air quality improvement. • Meta-analysis aims to establish a relation between PM2.5 exposure and the burden of lung cancer.

Impact of residential solid fuel usage and fuel conversion on children's lung function.

Solid fuel combustion exposure is a leading global health risk factor, yet evidence on its effects, especially on vulnerable children, is sparse. This large-scale, multi-center prospective study aimed to address this gap by involving 9997 schoolchildren across China between 2013 and 2015. Here we show that lung function levels exhibited a marginally significant decline among children exposed to solid fuel usage. Specifically, FVC and FEV1 decreased by 21.2 mL (95% CI: -15.7, 58.1) and 24.1 mL (-8.4, 56.6), respectively. Additionally, PEF, FEF25 and FEF75 decreased by 25.7 mL/s (-46.5, 98.0), 32.7 mL/s (-42.7, 108.2), and 35.4 mL/s (-5.9, 76.7), respectively. Persistent exposure to solid fuel usage in children led to greater lung damage. Children with allergy history were more susceptible to solid fuel exposure. Our study highlights the adverse impact of solid fuel usage on children and the need to promote clean fuel usage for this vulnerable population.

Particulate Matter-Induced Emerging Health Effects Associated with Oxidative Stress and Inflammation.

Environmental pollution continues to increase with industrial development and has become a threat to human health. Atmospheric particulate matter (PM) was designated as a Group 1 carcinogen by the International Agency for Research on Cancer in 2013 and is an emerging global environmental risk factor that is a major cause of death related to cardiovascular and respiratory diseases. PM is a complex composed of highly reactive organic matter, chemicals, and metal components, which mainly cause excessive production of reactive oxygen species (ROS) that can lead to DNA and cell damage, endoplasmic reticulum stress, inflammatory responses, atherosclerosis, and airway remodeling, contributing to an increased susceptibility to and the exacerbation of various diseases and infections. PM has various effects on human health depending on the particle size, physical and chemical characteristics, source, and exposure period. PM smaller than 5 μm can penetrate and accumulate in the alveoli and circulatory system, causing harmful effects on the respiratory system, cardiovascular system, skin, and brain. In this review, we describe the relationship and mechanism of ROS-mediated cell damage, oxidative stress, and inflammatory responses caused by PM and the health effects on major organs, as well as comprehensively discuss the harmfulness of PM.

Recommendations for implementing digital alcohol interventions in primary care: lessons learned from a Norwegian feasibility study.

Excessive alcohol consumption is a leading global risk factor for ill-health and premature death. Digital alcohol interventions can be effective at reducing alcohol consumption, but their widespread adoption is lagging behind. This study aimed to identify factors promoting or inhibiting the implementation of a digital alcohol intervention in Norwegian primary care, by using Normalization Process Theory (NPT). A mixed methods feasibility study combining quantitative and qualitative methods. A digital alcohol intervention called "Endre" was implemented across four GP practices in Stavanger and Oslo. Usage of the intervention was logged on the digital platform. General practitioners (GPs) reported their perceived uptake of the intervention via a web-based survey. The Normalization MeAsure Development (NoMAD) survey was used to measure support staff's perceived normalization of the intervention. Qualitative data were analyzed using the NPT framework, with quantitative data analyzed descriptively and using χ 2 and Wilcoxon signed-rank test for differences in current and future normalization. Thirty-seven GPs worked in the clinics and could recruit patients for the digital intervention. Thirty-six patients registered for the intervention. Nine patients dropped out early and 25 completed the intervention as intended. Low normalization scores at follow-up (n = 27) indicated that Endre did not become fully embedded in and across practices. Nonetheless, staff felt somewhat confident about their use of Endre and thought it may become a more integral part of their work in the future. Findings from six semi-structured group interviews suggested that limited implementation success may have been due to a lack of tailored implementation support, staff's lack of involvement, their diminished trust in Endre, and a lack of feedback on intervention usage. The outbreak of the Covid-19 pandemic further limited opportunities for GPs to use Endre. This study investigated the real-world challenges of implementing a digital alcohol intervention in routine clinical practice. Future research should involve support staff in both the development and implementation of digital solutions to maximize compatibility with professional workflows and needs. Integration of digital solutions may further be improved by including features such as dashboards that enable clinicians to access and monitor patient progress and self-reported outcomes.

Global differences and risk factors influencing drug hypersensitivity quality of life: A multicenter, multiethnic study of drug allergy across 3 continents

BackgroundPenicillin allergy labels are associated with many adverse outcomes. Fear and restriction of future medication use also impact health-related quality of life (HR-QoL). However, the impact of a drug allergy on HR-QoL and its associated factors remain unknown. ObjectiveTo investigate the impact of penicillin allergy labels and compare the factors associated with HR-QoL impairment among an international multi-center and multi-ethnic cohort. MethodsHR-QoL was measured using the 6-item Drug Hypersensitivity Quality of Life Questionnaire (DrHy-Q) and compared among patients labelled with penicillin allergy, before their allergy evaluation, from eight adult allergy/immunology clinics across Asia, Australasia, and North America. ResultsWe recruited 643 patients labelled with penicillin allergy (median age: 56 [IQR 39-67] years, male: female ratio: 1:2.2), with 273 (42.5%), 186 (28.9%) and 184 (28.6%) from Asia, North America and Australia; respectively. The median DrHy-Q score was 8.3 (IQR 0.0–29.2). All patients underwent penicillin allergy evaluation, and 96.0% (617/643) were delabelled following negative provocation tests. Patients who were female (8.3 vs. 4.2, p=0.003), had other concomitant antimicrobial allergy labels (20.8 vs. 4.2, p=0.004), and from Asia (33.3 vs. 4.2 [North America] vs. 0 [Australia], p<0.001) had significantly higher DrHy-Q scores, reflecting a reduced HR-QoL. Ethnicity, as well as other allergy variables, were not significant in multivariate analysis. ConclusionRegional differences, ethnicity, and other risk factors influence HR-QoL impairment among patients labelled with penicillin allergy. Future studies are needed to understand the contributions of regional socio-demographic factors and identify interventions to improve HR-QoL.

The global risk trinity of hydrocarbon economies: Evidence from the method of moments quantile regression

This paper addresses the critical requirement to understand how global political and economic trends affect stock market dynamics in the Gulf Cooperation Council (GCC) region. Prompted by the region's economic dependency on oil and the growing integration of GCC markets into global financial systems, it investigates the impact of three global risk factors on both Islamic and conventional stock markets in the GCC: financial risk (US CDS and global interest rate volatility), commodity price risk (oil price volatility), and political risk (global geopolitical risk). The present research adopts the method of moments quantile regression to assess the asymmetrical effects of these risks across various market conditions from 2011 to 2021. The findings show significant disparities in stock market responses to global risks in bearish, bullish, and normal states, highlighting the nuances of market dynamics in the GCC. In the face of rising global hazards, Islamic assets may provide potential for portfolio diversification. Policy recommendations emphasize the necessity of incorporating global risk variables into investment strategies to reduce volatility and improve market stability in the GCC.

Security risk assessment of submerged floating tunnel based on fault tree and multistate fuzzy Bayesian network

To assess the global security risks of the submerged floating tunnel (SFT) in marine environments during operation and provide a basis for risk control, a security risk assessment method using a multistate fuzzy Bayesian network (MFBN) considering complex disaster-inducing factors is proposed. A fault tree model of SFT security risk is established to analyze the causal relationships between global risk and influence factors such as structural components and environmental loads. For root nodes, fuzzy probabilities for each state are obtained through expert knowledge. An improved similarity aggregation method is proposed to integrate expert opinions, mitigating the impact of significant option discrepancies. For non-root nodes, the Leaky Noisy-Max model is used to calculate complex conditional probabilities within the SFT. The probabilities of various security risk states and key risk factors could be determined through reasoning by MFBN. Additionally, a risk prediction method that incorporates domain expert opinions and leverages the BN's ability of updating node probabilities with new information was developed to forecast the security risks of the SFT under wave and current loads.

Prevalence and risk factors of sexual dysfunction in female participants with rheumatoid arthritis: a systematic review and meta-analysis.

The prevalence and risk factors of female sexual dysfunction (FSD) in female participants with rheumatoid arthritis (RA) were reported with inconsistent results. However, no systematic review and meta-analysis of pooled data provide reliable estimates of FSD prevalence in female participants with RA. To investigate the global prevalence and risk factors of FSD in female participants with RA and to analyze the association between FSD risk and RA. The study search of this systematic review and meta-analysis was conducted through PubMed, Cochrane Library, Web of Science, and Embase from the inception date to December 10, 2023. Random effects meta-analysis was performed to derive the pooled prevalence. Q and I2 tests were used to analyze heterogeneity among the studies. Subgroup analyses and meta-regression were used to detect the sources of heterogeneity. The pooled prevalence of FSD in female participants with RA was calculated, and odds ratios (ORs) and 95% CIs were used to assess the strength of the association between FSD-related risk factors and RA. A total of 13 studies were included in our analysis, involving 2327 participants. The pooled prevalence of FSD in female participants with RA was 49.1% (95% CI, 38.2%-60%). The participants with RA had a higher risk of FSD than healthy controls (OR, 3.10; 95% CI, 1.74-5.53). The significant risk factors of FSD in female participants with RA were depression status (OR, 1.42; 95% CI, 0.88-2.29) and menopause (OR, 5.46; 95% CI, 2.04-14.63). Female participants with RA had a significantly increased prevalence of FSD, indicating that sexual function in female participants with RA should be concerned by clinicians. The strength of this study is that it is the first meta-analysis to assess the global prevalence and risk factors of FSD in female participants with RA. A limitation is that the results, after the articles were pooled, showed significant heterogeneity and publication bias. The present systematic review and meta-analysis revealed that the overall prevalence of FSD in female participants with RA was 49.1%, indicating a significant association between FSD risk and RA among females. Moreover, menopause and depression status were significantly associated with FSD in female participants with RA.

Spatio-temporal occurrence, burden, risk factors and modelling methods for estimating scrub typhus burden from global to subnational resolutions: a systematic review protocol.

Scrub typhus is a neglected life-threatening vector-borne disease mainly caused by the bacterium Orientia tsutsugamushi, which is occasionally transmitted to humans during feeding of larval mites. It has been estimated that more than 1 billion persons are potentially threatened and 1 million clinical cases occur annually across the world; however, it is unclear how this estimate was computed (and what the original source was) and much remains unknown regarding its global burden and risk factors. This systematic review aims to provide a comprehensive overview of the spatial-temporal distribution of scrub typhus, associated burden and risk factors at global, national and subnational resolutions, and to review the burden estimation models used at those different scales. A systematic search for literature on scrub typhus occurrence, risk factors and modelling methods will be conducted. PubMed and five other databases will be searched for published literature, and Google Scholar and nine other databases will be used to search for grey literatures. All titles/abstracts of the searched records will be separately assessed by two reviewers, who will then screen the full-text of potential records to decide eligibility. A pre-formatted spreadsheet will be used by one reviewer to extract data from qualifying research, with a second reviewer checking the results. Data will be tabulated, synthesized descriptively, and summarized narratively for each review question. Where appropriate, meta-analyses will be conducted. The risk of bias will be assessed, and potential publication bias will be detected. This review will provide a comprehensive understanding of the current occurrence, spatial-temporal distribution, and burden of scrub typhus, identify associated risk factors from global to subnational resolutions, consolidate the best practice modeling framework(s) to estimate the burden of scrub typhus at various geographic/temporal resolutions, and decompose the relative contributions of various risk factors at scale. CRD42022315209.

Blood pressure management strategies and podocyte health.

Hypertension (HTN) is one of the key global cardiovascular risk factors, which is tightly linked to kidney health and disease development. Podocytes, glomerular epithelial cells that play a pivotal role in maintenance of the renal filtration barrier, are significantly affected by increased glomerular capillary pressure in HTN. Damage or loss of these cells causes proteinuria, which marks the initiation of the HTN-driven renal damage. It goes without saying that effective BP management should not only mitigate cardiovascular risks but also preserve renal function by protecting podocyte integrity. This review offers a comprehensive examination of current blood pressure (BP) management strategies and their implications for podocyte structure and function and emphasizes strategies for the reduction of proteinuria in HTN. We explore primary and secondary antihypertensive agents, including ACE inhibitors, ARBs, calcium channel blockers, diuretics, as well as newer therapies (SGLT2 blocking and endothelin receptor antagonism), emphasizing their mechanistic roles in safeguarding podocytes and curtailing proteinuria.

A Comprehensive Review on Understanding Magnesium Disorders: Pathophysiology, Clinical Manifestations, and Management Strategies.

Magnesium is vital in a broad spectrum of physiological processes, including enzyme activity, energy production, and neuromuscular function. Despite its crucial role, magnesium disorders - comprising both deficiency (hypomagnesemia) and excess (hypermagnesemia) - are frequently underrecognized and inadequately managed in clinical practice. Magnesium deficiency is widespread, particularly among populations with chronic illnesses, the elderly, and those experiencing malnutrition, often leading to significant neuromuscular, cardiovascular, and metabolic complications. Conversely, hypermagnesemia, though less common, poses serious risks, especially in individuals with impaired renal function or those receiving high doses of magnesium supplements or medications. This review comprehensively examines magnesium disorders, detailing their pathophysiology, clinical manifestations, and management strategies. It highlights the essential functions of magnesium in maintaining cellular integrity, cardiovascular health, and bone structure and discusses the global prevalence and risk factors associated with magnesium imbalances. By offering insights into the current understanding of magnesium homeostasis and its disruptions, this review aims to enhance the awareness and treatment of magnesium-related conditions, ultimately improving patient outcomes across diverse clinical settings.

The Awareness and Control Measures for Hypertension among the Elderly Population in a South-South Community, Nigeria

High blood pressure also known as hypertension is the second global risk factor for disease. The study assessed the awareness and control measures of hypertension among elderly individuals in a South- South Community, Nigeria. The study surveyed 92 elderly individuals using a descriptive design, using a self-structured questionnaire, and analyzing data using SPSS version 24. Findings established 60.13± 0.45 as the mean age of the respondents; 49(53.3%) were females and 29(31.5%) were business executives. 85(92.4%) of participants know that hypertension is an increase in one’s blood pressure. 60(65.2%) of participants know that regular checking of blood pressure is a preventive strategy against hypertension. 80(87%) of participants understand that adherence to hypertensive drugs as prescribed by the doctor is one of the ways to control blood pressure. 66(71.7%) of the participants agree that taking food low in salt can help to control blood pressure. 69 (75%) of participants agree that the availability of time to go for regular blood pressure check-ups is very important. This study concluded that there is a high level of awareness of hypertension and a cause for concern, as majority of the participants has inadequate practice of control measures of hypertension.

The Global Impact of Multisystemic Vulnerabilities on Criminal Variety: A Cross-Continental Study in Young Adults.

Previous research has shown a robust association between different childhood and adolescent vulnerabilities and youth offending. However, these investigations have primarily focused on youths from high-income Western countries. Consequently, the generalizability of these findings to better inform global justice policies remains uncertain. This study aimed to address this gap by examining the relationship between individual, familial, and contextual vulnerabilities and criminal versatility during young adulthood, accounting for sociodemographic factors and cross-national differences. Data were derived from a diverse sample of 4,182 young adults (67% female; mean age = 18.96; SD = 0.81) residing in 10 countries across 5 continents who participated in the International Study of Pro/Antisocial Behavior in Young Adults. The Psychosocial and Family Vulnerability Questionnaire and the Adverse Childhood Experiences questionnaire were used to assess social and family adversity, and past-year criminal diversity was measured with the Criminal Variety Index. Results indicate that child maltreatment, substance abuse, and delinquent peers are global risk factors for criminal variety. Moreover, they are independent across males and females and among youths living in countries that are ranked differently on the Human Development Index (HDI). In addition, some childhood vulnerabilities showed different predictive ability across sexes (e.g., school failure), and across countries ranked differently on the HDI (e.g., family dysfunction). These findings suggest that certain childhood factors contribute to criminal behavior through transcultural mechanisms. Moreover, they highlight the importance of developing evidence-based policies that focus on transcultural risk factors to globally prevent criminal behavior.

Impact of Global Risk Factors on the Islamic Stock Market: New Evidence from Wavelet Analysis

Impact of Global Risk Factors on the Islamic Stock Market: New Evidence from Wavelet Analysis

Dynamics of combatting market-driven epidemics: Insights from U.S. reduction of cigarette, sugar, and prescription opioid consumption.

Misuse and overconsumption of certain consumer products have become major global risk factors for premature deaths, with their total costs in trillions of dollars. Progress in reducing such deaths has been slow and difficult. To address this challenge, this review introduces the definition of market-driven epidemics (MDEs), which arise when companies aggressively market products with proven harms, deny these harms, and resist mitigation efforts. MDEs are a specific within the broader landscape of commercial determinants of health. We selected three illustrative MDE products reflecting different consumer experiences: cigarettes (nicotine delivery product), sugar (food product), and prescription opioids (medical product). Each met the MDE case definition with proven adverse health impacts, well-documented histories, longitudinal product consumption and health impact data, and sustained reduction in product consumption. Based on these epidemics, we describe five MDE phases: market expansion, evidence of harm, corporate resistance, mitigation, and market adaptation. From the peak of consumption to the most recent data, U.S. cigarette sales fell by 82%, sugar consumption by 15%, and prescription opioid prescriptions by 62%. For each, the consumption tipping point occurred when compelling evidence of harm, professional alarm, and an authoritative public health voice and/or public mobilization overcame corporate marketing and resistance efforts. The gap between suspicion of harm and the consumption tipping point ranged from one to five decades-much of which was attributable to the time required to generate sufficient evidence of harm. Market adaptation to the reduced consumption of target products had both negative and positive impacts. To our knowledge, this is the first comparative analysis of three successful efforts to change the product consumption patterns and the associated adverse health impacts of these products. The MDE epidemiological approach of shortening the latent time to effective mitigation provides a new method to reduce the impacts of harmful products.

Adherence to optimal medical therapy and control of cardiovascular risk factors in patients after ST elevation myocardial infarction in Mexico.

In developing countries, there is a notable scarcity of real-world data on adherence to optimal medical therapy (OMT) and its correlation with major cardiovascular adverse events (MACEs) after ST-elevation myocardial infarction (STEMI). Our study focuses on addressing this gap by evaluating adherence to OMT, examining its influence on the risk of MACEs after STEMI, and assessing subsequent cardiovascular risk factor control in Mexico. We conducted a prospective observational study of post-STEMI patients after hospital discharge. Adherence to treatment was assessed over a median of 683 days (interquartile range: 478-833) using the Simplified Medication Adherence Questionnaire (SMAQ). Patients were followed up for 4.5 years to monitor MACEs (cardiovascular death, cardiogenic shock, recurrent myocardial infarction, and heart failure). We included 349 patients with a mean age of 58.08 years (±10.9), predominantly male (89.9%). Hypertension (42.4%), smoking (34.3%), type 2 diabetes mellitus (31.2%), obesity (22.92%), and dyslipidemia (21.4%) were highly prevalent. Adherence to OMT per SMAQ was 44.7%. The baseline clinical characteristics of adherent and non-adherent patients did not significantly differ. OMT prescription rates were as follows: acetylsalicylic acid, 91.1%; P2Y12 inhibitors, 76.5%; and high-intensity statins, 86.6%. While non-adherent patients had a numerically higher rate of MACEs (73 vs. 49 first events), there was no statistically significant difference (hazard ratio 1.30, 95% confidence interval 0.90-1.88). In this real-world study of patients after STEMI, we observed low adherence to OMT, a low proportion of global cardiovascular risk factor control, and a numerically higher incidence of recurrent major adverse cardiovascular events in non-adherent patients. Strategies to improve adherence to OMT and risk factor control are needed.

Global burden and risk factors of chronic kidney disease in adolescents and young adults: a study from 1990 to 2019.

Few studies have evaluated the global burden of chronic kidney disease (CKD) in adolescents and young adults (AYAs). Age-standardized rates of incidence (ASIR), mortality (ASMR), and disability-adjusted life-years (ASDR) were used to describe the CKD burden in AYAs. The estimated annual percentage changes (EAPCs) were calculated to evaluate the temporal trends from 1990 to 2019. Risk factors were calculated by population attributable fractions. In 2019, the ASIR, ASMR, and ASDR of CKD in AYAs were 32.21 (95% uncertainty interval [UI], 23.73-40.81) per 100,000, 2.86 (2.61-3.11) per 100,000 and 236.85 (209.03-268.91) per 100,000, respectively. The ASIR was higher among females than males, whereas the ASMR was higher among males than females in 2019. From 1990 to 2019, significant increases in ASIR were found for CKD (EAPC, 0.98%; 95% confidence interval [CI], 0.95%-1.01%), although the ASMR had decreased (EAPC, -0.40%; 95% CI, -0.56% to -0.24%). The largest increase in ASIR was observed in countries with a middle sociodemographic index (SDI) (EAPC, 1.30%; 95% CI, 1.28%-1.33%), while the largest increase in ASMR was observed in high SDI. Globally, the proportional contribution of risk factors for CKD mortality varied across regions, with the highest proportions of high fasting plasma glucose being 14.04% in low SDI, compared with 24.01% in high SDI. CKD is a growing global health problem in AYAs, especially in countries with a middle SDI. Targeted measures are needed to address the rising burden of CKD in AYAs, focusing on prevention, early diagnosis, and reducing disparities.