Displaying publications 1 - 20 of 131 in total

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  1. Mente A, O'Donnell M, Rangarajan S, Dagenais G, Lear S, McQueen M, et al.
    Lancet, 2016 Jul 30;388(10043):465-75.
    PMID: 27216139 DOI: 10.1016/S0140-6736(16)30467-6
    BACKGROUND: Several studies reported a U-shaped association between urinary sodium excretion and cardiovascular disease events and mortality. Whether these associations vary between those individuals with and without hypertension is uncertain. We aimed to explore whether the association between sodium intake and cardiovascular disease events and all-cause mortality is modified by hypertension status.

    METHODS: In this pooled analysis, we studied 133,118 individuals (63,559 with hypertension and 69,559 without hypertension), median age of 55 years (IQR 45-63), from 49 countries in four large prospective studies and estimated 24-h urinary sodium excretion (as group-level measure of intake). We related this to the composite outcome of death and major cardiovascular disease events over a median of 4.2 years (IQR 3.0-5.0) and blood pressure.

    FINDINGS: Increased sodium intake was associated with greater increases in systolic blood pressure in individuals with hypertension (2.08 mm Hg change per g sodium increase) compared with individuals without hypertension (1.22 mm Hg change per g; pinteraction<0.0001). In those individuals with hypertension (6835 events), sodium excretion of 7 g/day or more (7060 [11%] of population with hypertension: hazard ratio [HR] 1.23 [95% CI 1.11-1.37]; p<0.0001) and less than 3 g/day (7006 [11%] of population with hypertension: 1.34 [1.23-1.47]; p<0.0001) were both associated with increased risk compared with sodium excretion of 4-5 g/day (reference 25% of the population with hypertension). In those individuals without hypertension (3021 events), compared with 4-5 g/day (18,508 [27%] of the population without hypertension), higher sodium excretion was not associated with risk of the primary composite outcome (≥ 7 g/day in 6271 [9%] of the population without hypertension; HR 0.90 [95% CI 0.76-1.08]; p=0.2547), whereas an excretion of less than 3 g/day was associated with a significantly increased risk (7547 [11%] of the population without hypertension; HR 1.26 [95% CI 1.10-1.45]; p=0.0009).

    INTERPRETATION: Compared with moderate sodium intake, high sodium intake is associated with an increased risk of cardiovascular events and death in hypertensive populations (no association in normotensive population), while the association of low sodium intake with increased risk of cardiovascular events and death is observed in those with or without hypertension. These data suggest that lowering sodium intake is best targeted at populations with hypertension who consume high sodium diets.

    FUNDING: Full funding sources listed at end of paper (see Acknowledgments).

  2. Kuruppu N, Capon A
    Lancet, 2016 Jan 30;387(10017):430.
    PMID: 26869566 DOI: 10.1016/S0140-6736(16)00170-7
  3. McAdam D
    Lancet, 2016 Jan 30;387(10017):429-30.
    PMID: 26869565 DOI: 10.1016/S0140-6736(16)00169-0
  4. Csete J, Kamarulzaman A, Kazatchkine M, Altice F, Balicki M, Buxton J, et al.
    Lancet, 2016 Apr 02;387(10026):1427-1480.
    PMID: 27021149 DOI: 10.1016/S0140-6736(16)00619-X
  5. Pang T, Thiam DGY, Tantawichien T, Ismail Z, Yoksan S
    Lancet, 2015 May 02;385(9979):1725-1726.
    PMID: 25943934 DOI: 10.1016/S0140-6736(15)60888-1
  6. Leong DP, Teo KK, Rangarajan S, Lopez-Jaramillo P, Avezum A, Orlandini A, et al.
    Lancet, 2015 Jul 18;386(9990):266-73.
    PMID: 25982160 DOI: 10.1016/S0140-6736(14)62000-6
    Reduced muscular strength, as measured by grip strength, has been associated with an increased risk of all-cause and cardiovascular mortality. Grip strength is appealing as a simple, quick, and inexpensive means of stratifying an individual's risk of cardiovascular death. However, the prognostic value of grip strength with respect to the number and range of populations and confounders is unknown. The aim of this study was to assess the independent prognostic importance of grip strength measurement in socioculturally and economically diverse countries.
  7. Khatib R, McKee M, Shannon H, Chow C, Rangarajan S, Teo K, et al.
    Lancet, 2016 Jan 2;387(10013):61-9.
    PMID: 26498706 DOI: 10.1016/S0140-6736(15)00469-9
    WHO has targeted that medicines to prevent recurrent cardiovascular disease be available in 80% of communities and used by 50% of eligible individuals by 2025. We have previously reported that use of these medicines is very low, but now aim to assess how such low use relates to their lack of availability or poor affordability.
  8. Whitmee S, Haines A, Beyrer C, Boltz F, Capon AG, de Souza Dias BF, et al.
    Lancet, 2015 Nov 14;386(10007):1973-2028.
    PMID: 26188744 DOI: 10.1016/S0140-6736(15)60901-1
  9. Looi LM, Ganten D, McGrath PF, Gross M, Griffin GE
    Lancet, 2015 Mar 14;385(9972):943-4.
    PMID: 25743174 DOI: 10.1016/S0140-6736(15)60208-2
  10. Talukder S, Capon A, Nath D, Kolb A, Jahan S, Boufford J
    Lancet, 2015 Feb 28;385(9970):769.
    PMID: 25752169 DOI: 10.1016/S0140-6736(15)60428-7
  11. Bhoo-Pathy N, Pignol JP, Verkooijen HM
    Lancet, 2014 Nov 22;384(9957):1846.
    PMID: 25457914 DOI: 10.1016/S0140-6736(14)62239-X
  12. Touraine M, Gröhe H, Coffie RG, Sathasivam S, Juan M, Louardi el H, et al.
    Lancet, 2014 Sep 27;384(9949):1161-2.
    PMID: 25242037 DOI: 10.1016/S0140-6736(14)61419-7
  13. Noordin NM, Merican MI, Rahman HA, Lee SS, Ramly R
    Lancet, 2008 Sep 27;372(9644):1149-50.
    PMID: 18926274 DOI: 10.1016/S0140-6736(08)61479-8
  14. Ekman B, Pathmanathan I, Liljestrand J
    Lancet, 2008 Sep 13;372(9642):990-1000.
    PMID: 18790321 DOI: 10.1016/S0140-6736(08)61408-7
    For women and children, especially those who are poor and disadvantaged, to benefit from primary health care, they need to access and use cost-effective interventions for maternal, newborn, and child health. The challenge facing weak health systems is how to deliver such packages. Experiences from countries such as Iran, Malaysia, Sri Lanka, and China, and from projects in countries like Tanzania and India, show that outcomes in maternal, newborn, and child health can be improved through integrated packages of cost-effective health-care interventions that are implemented incrementally in accordance with the capacity of health systems. Such packages should include community-based interventions that act in combination with social protection and intersectoral action in education, infrastructure, and poverty reduction. Interventions need to be planned and implemented at the district level, which requires strengthening of district planning and management skills. Furthermore, districts need to be supported by national strategies and policies, and, in the case of the least developed countries, also by international donors and other partners. If packages for maternal, newborn and child health care can be integrated within a gradually strengthened primary health-care system, continuity of care will be improved, including access to basic referral care before and during pregnancy, birth, the postpartum period, and throughout childhood.
  15. Schottenfeld RS, Chawarski MC, Mazlan M
    Lancet, 2008 Jun 28;371(9631):2192-200.
    PMID: 18586174 DOI: 10.1016/S0140-6736(08)60954-X
    Expansion of access to effective treatments for heroin dependence is a worldwide health priority that will also reduce HIV transmission. We compared the efficacy of naltrexone, buprenorphine, and no additional treatment, in patients receiving detoxification and subsequent drug counselling, for maintenance of heroin abstinence, prevention of relapse, and reduction of HIV risk behaviours.
  16. Smith RD, Correa C, Oh C
    Lancet, 2009 Feb 21;373(9664):684-91.
    PMID: 19167054 DOI: 10.1016/S0140-6736(08)61779-1
    The World Trade Organization's Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) set global minimum standards for the protection of intellectual property, substantially increasing and expanding intellectual-property rights, and generated clear gains for the pharmaceutical industry and the developed world. The question of whether TRIPS generates gains for developing countries, in the form of increased exports, is addressed in this paper through consideration of the importance of pharmaceuticals in health-care trade, outlining the essential requirements, implications, and issues related to TRIPS, and TRIPS-plus, in which increased restrictions are imposed as part of bilateral free-trade agreements. TRIPS has not generated substantial gains for developing countries, but has further increased pharmaceutical trade in developed countries. The unequal trade between developed and developing countries (ie, exporting and importing high-value patented drugs, respectively) raises the issue of access to medicines, which is exacerbated by TRIPS-plus provisions, although many countries have not even enacted provision for TRIPS flexibilities. Therefore this paper focuses on options that are available to the health community for negotiation to their advantage under TRIPS, and within the presence of TRIPS-plus.
  17. Abegunde AT
    Lancet, 2004;364(9441):1217.
    PMID: 15464180
    Comment on: Singh B, Kim Sung L, Matusop A, Radhakrishnan A, Shamsul SS, Cox-Singh J, Thomas A, Conway DJ. A large focus of naturally acquired Plasmodium knowlesi infections in human beings. Lancet. 2004 Mar 27;363(9414):1017-24. PubMed PMID: 15051281.
  18. Hamid M, Bustamante-Manaog T, Truong VD, Akkhavong K, Fu H, Ma Y, et al.
    Lancet, 2005 Nov 19;366(9499):1758-60.
    PMID: 16298204 DOI: 10.1016/S0140-6736(05)67709-4
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