Epidemiological research on the incidence and prevalence of hypertension in the Portuguese population: A scoping review | Revista Portuguesa de Cardiologia (English edition)

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de âmbito" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1618 "Ancho" => 1002 "Tamanyo" => 213304 ] ] "descripcion" => array:1 [ "en" => "Methodology of the scoping review." ] ] ] "textoCompleto" => "IntroductionHypertension is the most important risk factor for cardiovascular and cerebrovascular disease, particularly myocardial infarction and stroke, which are major causes of morbidity and mortality throughout the world.<a class="elsevierStyleCrossRefs" href="#bib0005">1–3</a> In 2008, the global prevalence of hypertension in adults aged ≥25 years was 40%, despite falling between 1980 and 2008.<a class="elsevierStyleCrossRefs" href="#bib0020">4,5</a>For the last 30 years, Portugal has been among the countries with the highest levels of mean blood pressure (BP).<a class="elsevierStyleCrossRefs" href="#bib0030">6,7</a> In 2008, the prevalence of hypertension (or use of antihypertensive medication) in adults aged ≥25 years was estimated at 41.9% (46.5% in men and 37.4% in women).<a class="elsevierStyleCrossRef" href="#bib0040">8</a> Between 1980 and 2008 mean systolic BP fell, particularly in women.<a class="elsevierStyleCrossRef" href="#bib0040">8</a>Knowledge of the evolution, trends and current status of epidemiological measures of hypertension (incidence, prevalence and associated mortality) is important for planning, implementation and evaluation of public health measures.<a class="elsevierStyleCrossRef" href="#bib0045">9</a>A recent systematic review by Pereira et al. concluded that between 1990 and 2005, the prevalence of hypertension (defined as systolic and/or diastolic BP ≥140/90 mmHg) remained approximately constant in young adults and decreased in middle-aged and older adults, whereas the prevalence of self-reported hypertension increased by 0.4% per year in the same period.<a class="elsevierStyleCrossRef" href="#bib0050">10</a>Systematic reviews have generally been the preferred method of literature review, but the growing volume and importance of health research has led to the development of alternative forms of structured review, including scoping reviews, which are increasingly used in public health research.<a class="elsevierStyleCrossRef" href="#bib0055">11</a> Although these may appear simpler than a systematic review, scoping reviews retain a similar organization and transparency. They have been described as a technique to ‘map’ relevant literature on a particular subject in order to obtain an overall picture of current knowledge,<a class="elsevierStyleCrossRefs" href="#bib0055">11,12</a> and are mainly used to identify gaps in knowledge and/or to summarize the most important studies in a specific field.<a class="elsevierStyleCrossRef" href="#bib0065">13</a> The main difference from systematic reviews is that the latter aim to provide an initial evaluation of the quality of studies and a quantitative and qualitative summary of results, while scoping reviews do not set out to evaluate the quality of studies, but to give a qualitative review of the scope, methods and results of existing research.<a class="elsevierStyleCrossRef" href="#bib0070">14</a>So far as we know, no studies aimed at describing the scope and results in a particular area of health care research have been published in Portugal using the scoping review methodology. Such a review is of particular importance in relation to hypertension, given the prevalence of the disease and the need to identify any gaps in knowledge in order to define research priorities.ObjectivesThe aim of this study is to perform a scoping review on the prevalence and incidence of hypertension in the Portuguese population describing the scope (quantity, focus and nature)<a class="elsevierStyleCrossRefs" href="#bib0070">14,15</a> of research and to summarize the main results.MethodsThe review was conducted during June 2013 by two investigators working simultaneously. A panel of three experts (researchers with experience in health care, clinical practice, public health, epidemiology and health research) validated the methodology used (search terms, inclusion and exclusion criteria, information sources, and summary and analysis of the results).<a class="elsevierStyleCrossRef" href="#bib0060">12</a> The framework of the study was divided into the following stages (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>), in accordance with the methodology proposed by Arksey and O’Malley<a class="elsevierStyleCrossRef" href="#bib0070">14</a>: (1) identifying the research question; (2) identifying relevant studies; (3) selection of studies based on pre-established inclusion criteria; (4) data collection; and (5) summarizing and reporting the results.<elsevierMultimedia ident="fig0005"></elsevierMultimedia>Search strategiesWe included studies on the prevalence of hypertension based on data collected after 2005, those published after 2005 with an unspecified date of data collection, and those published after 2011 even if data collection was before 2005. The review thus covered publications not included in the 2012 review by Pereira et al.<a class="elsevierStyleCrossRef" href="#bib0050">10</a> of trends in hypertension prevalence in Portugal in 1990–2005, in order to update and widen the scope of knowledge, although some studies may appear in both reviews.Studies on the incidence of hypertension published between January 1995 and June 2013 were included, in order to cover the largest number of publications.The information sources used were the Portuguese Biblioteca do Conhecimento Online (B-on – Online Knowledge Library), run by the Fundação para a Computação Científica Nacional (Foundation for National Scientific Computation),<a class="elsevierStyleCrossRef" href="#bib0080">16</a> and PubMed, maintained by the US National Library of Medicine.<a class="elsevierStyleCrossRef" href="#bib0085">17</a>We searched for studies in Portuguese and English only (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>), combining the search terms with the Boolean operator AND. In B-on, the Portuguese search terms used were ‘prevalência’ AND ‘hipertensão’, and ‘incidência’ AND ‘hipertensão’. In PubMed the terms used were ‘prevalence’ AND ‘hypertension’ AND ‘Portugal’, and ‘incidence’ AND ‘hypertension’ AND ‘Portugal’.PubMed is known to be a good source of information for studies on chronic diseases.<a class="elsevierStyleCrossRef" href="#bib0090">18</a> We also searched B-on using Portuguese search terms only in order to include studies in Portuguese journals, since PubMed does not index all journals published in Portugal.Studies on hypertension in populations with specific characteristics, such as diabetic or obese individuals, were excluded. No inclusion criteria were established in terms of study design, type of publication, or age of the study population, and, as recommended for scoping reviews,<a class="elsevierStyleCrossRef" href="#bib0070">14</a> the quality of the study was not used as an inclusion criterion.Data collectionData on the following variables were collected and entered into a standard table: author(s), publication year, study location, sample size, BP measurement methods, main results, and stratification by gender and age. The information was entered into the table as the studies were selected and the data were subsequently analyzed in terms of quantity (number of studies), focus (populations, age-groups, diagnosed vs. self-reported hypertension, etc.), and nature (type of research).<a class="elsevierStyleCrossRefs" href="#bib0070">14,15</a>ResultsSearch strategies, study selection and data collectionA total of 527 publications were obtained, 295 studies on prevalence and 232 studies on incidence. Sixteen publications that met the inclusion criteria were selected for analysis, 14 on prevalence (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>) and two on incidence (<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>).<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Of the 14 selected publications on prevalence, 11 were found by searching PubMed and three in B-on. One of the two publications on incidence was found in PubMed and one in B-on.Research on prevalence of hypertension in PortugalThe selected studies on prevalence are original articles except for three: one undergraduate thesis, one master's thesis and one poster.Only three studies were national in scope, the others being regional, of which five covered the North region, three the Central region and three the Lisbon and Tagus Valley region.Data collection took place in the period 1999–2003 in one study, in the period 2005–2006 in two, in 2006 in two, in the period 2006–2007 in two, during 2007 in one, 2009 in one, and 2011 in one. The period of data collection was not specified in four studies.Three of the studies used samples based on the general population, two were of samples selected from consultations at a medical clinic, two of health center users, one of users of 60 pharmacies, five of students at educational institutions, and one of residents in seven old people's homes.With regard to the ages of the study populations, five of the selected studies were on children and/or adolescents, and nine were on adults – two in individuals aged 18–25 years, two aged ≥18 years, four aged ≥40 years and one aged ≥65 years.Of the five studies on children and/or adolescents, the largest was Maldonado et al.<a class="elsevierStyleCrossRef" href="#bib0095">19</a> (5381 participants) and the smallest was Silva et al.<a class="elsevierStyleCrossRef" href="#bib0100">20</a> (234 adolescents). The largest on adults was Perdigão et al.<a class="elsevierStyleCrossRef" href="#bib0105">21</a> (38 893 participants) and the smallest was Mendes et al.<a class="elsevierStyleCrossRef" href="#bib0110">22</a> (91 elderly adults).The studies on children and/or adolescents used similar definitions of hypertension and BP measurement methods (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>), all defining hypertension as systolic and/or diastolic BP at or above the 95th percentile and using digital devices to measure BP. In three of the studies the mean of three measurements was used, while a single measurement was used in two. In two studies BP was measured in both arms and the mean of values in the arm giving the highest reading was used in the analysis; the right arm was used in two studies; and this information was missing in one study.<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>Of the nine studies in adults, hypertension was self-reported in two, while in the other seven BP was measured and hypertension was defined as systolic and/or diastolic BP ≥140/90 mmHg (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>). In four of the latter studies, patients were only considered to have hypertension with BP ≥140/90 mmHg accompanied by antihypertensive medication. Three of these studies used digital BP monitors, two used mercury sphygmomanometers, one used an aneroid device and one used digital or mercury devices. In six studies it was not specified which arm was used for the measurements, only one study specifying the right arm. Four of these studies used the mean of two measurements, two the mean of two measurements or three if the difference between the first two was more than 5 mmHg, and in one study this information was missing.<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>Estimates of the prevalence of hypertension in children and/or adolescents ranged between 9.8% and 34%, in adults aged 18–25 years it varied between 6.9% and 24.9%, in adults aged ≥18 years it was 42.62%, in individuals aged ≥40 years it ranged between 23.5% and 54.80%, and in the only study on individuals aged ≥65 years it was 48.4%. There was no overall estimate of hypertension prevalence in Loubão et al.<a class="elsevierStyleCrossRef" href="#bib0115">23</a> because the study population was divided into smokers and non-smokers.Only four of the studies on prevalence stratified the results into age-groups, 11 presented results stratified by gender, and only two were stratified by both age and gender. In the four studies stratified by age, prevalence increased with age.In studies solely on adolescents stratified by gender,<a class="elsevierStyleCrossRefs" href="#bib0100">20,24</a> prevalence was higher in males, while in the three studies in children and/or adolescents (aged 4–18 years, 5–18 years and 8 years), prevalence was higher in females in two studies and the same in one (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).In all studies on adults in which BP was measured, hypertension prevalence was higher in males, whereas it was lower in males in studies in which hypertension was self-reported.Research on incidence of hypertension in PortugalOf the two selected studies on the incidence of hypertension in the Portuguese population, one is an original article on adults aged ≥18 years and the other a report from the Portuguese general practitioner sentinel network on all age-groups (<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>).<elsevierMultimedia ident="tbl0020"></elsevierMultimedia>Only one of these studies, the original article, reports the method used to assess BP (digital device and mean of two measurements or three if the difference between the first two was more than 5 mmHg) (<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>) and defines hypertension as BP ≥140/90 mmHg and/or use of antihypertensive medication.<elsevierMultimedia ident="tbl0025"></elsevierMultimedia>This study, of 796 individuals in the Porto region, found an incidence of hypertension of 57.3/1000 population/year, while in the report of 34 981 individuals from all regions of Portugal the incidence was 6.54/1000 population/year. The incidence was lower in females in both studies.In the Porto study incidence rose with age in both sexes, while in the national study this was true up to the age of 54, after which it fell.DiscussionThe population that has been the subject of the largest number of studies on hypertension prevalence was that of the North region, particularly the city of Porto. No study has dealt exclusively with the Alentejo and Algarve regions, a gap in knowledge that should be filled by new studies or publication of existing data. However, the national studies by Cortez-Dias et al.<a class="elsevierStyleCrossRef" href="#bib0125">25</a> and Perdigão et al.<a class="elsevierStyleCrossRef" href="#bib0105">21</a> include estimates of measured and self-reported hypertension, respectively, for these regions: 51.54% and 44.57% (measured) and 23% and 18.3% (self-reported) for the Alentejo and the Algarve, respectively.We found long delays between data collection and publication of results (up to nine years).<a class="elsevierStyleCrossRef" href="#bib0130">26</a> This implies that studies on recent data may not yet have been published. For instance, the Portuguese HYpertension and SAlt Study (PHYSA), conducted by the Portuguese Society of Hypertension, collected data on a representative sample of 3720 residents of mainland Portugal in 2012 but had not published its results when this review was completed.<a class="elsevierStyleCrossRef" href="#bib0135">27</a>The studies on hypertension prevalence in children and/or adolescents used similar definitions of hypertension and BP measurement methods (at or above the 95th percentile and digital devices), in accordance with the US guidelines on high blood pressure in children and adolescents, which are used internationally.<a class="elsevierStyleCrossRef" href="#bib0140">28</a> This facilitates comparisons between the results of different studies and monitoring of developments in hypertension prevalence in these population groups. However, there were methodological differences between the studies: three made three BP measurements and two made only one, while two studies took measurements in both arms, two in the right arm, and one did not specify. According to the US guidelines BP should be measured in the right arm.<a class="elsevierStyleCrossRef" href="#bib0140">28</a>Of the nine studies on hypertension prevalence in adults, hypertension was self-reported in only two and BP was measured in the others. Hypertension was defined as BP ≥140/90 mmHg. Only five studies reported the type of measurement device used (which varied widely), and only one study specified which arm was used. These findings indicate inadequate description of methods, which hinders comparisons between studies. According to a recent review by Crim et al.,<a class="elsevierStyleCrossRef" href="#bib0145">29</a> surveillance definitions of hypertension vary in the literature, and clear definitions of measurement methods are crucial for monitoring its prevalence and incidence. Crim et al. propose standard definitions to be used in research in this area.According to the guideline of the Portuguese Directorate-General of Health (DGS) entitled “Hipertensão arterial: Definição e classificação” (“Hypertension: definition and classification”), a diagnosis of hypertension should be based on at least two measurements, in the arm that gives the higher BP reading.<a class="elsevierStyleCrossRefs" href="#bib0150">30,31</a> This was not followed in any of the studies in this scoping review; the studies by Cortez-Dias et al.<a class="elsevierStyleCrossRef" href="#bib0125">25</a> and Brandão et al.<a class="elsevierStyleCrossRef" href="#bib0160">32</a> describe the measurement method used except for the arm used, and state that they followed the American Heart Association guidelines,<a class="elsevierStyleCrossRef" href="#bib0165">33</a> which are similar to the recommendations of the DGS.Only two of the studies on hypertension prevalence present results stratified by both age and gender, which is a significant obstacle to an understanding of the epidemiology of the disease.<a class="elsevierStyleCrossRef" href="#bib0145">29</a>In all the studies on adults with results stratified by gender in which BP was measured, hypertension prevalence was lower in women, in agreement with the systematic review by Pereira et al.<a class="elsevierStyleCrossRef" href="#bib0050">10</a> and the World Health Organization figures for Portugal in 2008.<a class="elsevierStyleCrossRef" href="#bib0020">4</a>In the only study which presented self-reported hypertension prevalence and results stratified by gender, the prevalence was lower in men, as also reported by Pereira et al.<a class="elsevierStyleCrossRef" href="#bib0050">10</a>The fact that the studies on adults selected for this review use different BP measurement methods, not specified in many cases, and are infrequently stratified by age and gender, seriously hinders comparisons and analysis. This will of course have an effect on knowledge of the epidemiology of hypertension in Portugal and hence on implementation of health care policies and measures.The results of our study reveal the need for greater uniformity in measurement and reporting methods for research into hypertension, in order to improve the comparability, data collection and analysis of studies on the evolution and trends in hypertension in the Portuguese population. They also point up the need to perform a quantitative analysis of the variability of data resulting from the application of different BP measurement methods.Regarding hypertension incidence, the two selected studies were of very different populations: residents of the city of Porto, and the general Portuguese population. In the Porto study (1999–2003), incidence was 57.3/1000 population/year, while in the 2011 national report from the general practitioner sentinel network it was 6.54/1000 population/year. This discrepancy may reflect a fall in incidence between 2003 and 2011, or it may be due simply to differences in sample size, target populations and measurement methods.The existence of only two studies since 1995 on hypertension incidence in Portugal reveals a gap in knowledge in this area that should prompt future research.ConclusionsThe present scoping review of research into the prevalence and incidence of hypertension in the Portuguese population allows the following conclusions to be drawn: (i) in the last eight years, more studies have been published on populations in the North region; (ii) although the Alentejo and Algarve regions were included in two national studies, their populations have not been specifically targeted in any published studies; (iii) there have been long delays between data collection and publication of results on hypertension prevalence (up to nine years), which hinders comparison of these studies with others in which data collection was nearer to publication date; (iv) only two studies on hypertension incidence were published between 1995 and 2013, which reveals a gap in knowledge that needs to be filled; and (v) differences in blood pressure measurement methods, not specified in most studies, and the infrequency of stratification of results by gender and age, hinder comparison and analysis, and hence monitoring of trends in the incidence and prevalence of hypertension in Portugal.Conflicts of interestThe authors have no conflicts of interest to declare." "textoCompletoSecciones" => array:1 [ "secciones" => array:14 [ 0 => array:2 [ "identificador" => "xres381483" "titulo" => array:5 [ 0 => "Abstract" 1 => "Introduction and Objectives" 2 => "Methods" 3 => "Results" 4 => "Conclusions" ] ] 1 => array:2 [ "identificador" => "xpalclavsec360294" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres381482" "titulo" => array:5 [ 0 => "Resumo" 1 => "Introdução e objetivos" 2 => "Métodos" 3 => "Resultados" 4 => "Conclusões" ] ] 3 => array:2 [ "identificador" => "xpalclavsec360293" "titulo" => "Palavras-chave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Objectives" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Methods" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Search strategies" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Data collection" ] 9 => array:3 [ "identificador" => "sec0030" "titulo" => "Results" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0035" "titulo" => "Search strategies, study selection and data collection" ] 1 => array:2 [ "identificador" => "sec0040" "titulo" => "Research on prevalence of hypertension in Portugal" ] 2 => array:2 [ "identificador" => "sec0045" "titulo" => "Research on incidence of hypertension in Portugal" ] ] ] 10 => array:2 [ "identificador" => "sec0050" "titulo" => "Discussion" ] 11 => array:2 [ "identificador" => "sec0055" "titulo" => "Conclusions" ] 12 => array:2 [ "identificador" => "sec0060" "titulo" => "Conflicts of interest" ] 13 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2013-12-20" "fechaAceptado" => "2014-02-02" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec360294" "palabras" => array:5 [ 0 => "Hypertension" 1 => "Prevalence" 2 => "Incidence" 3 => "Review" 4 => "Portugal" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec360293" "palabras" => array:5 [ 0 => "Hipertensão arterial" 1 => "Prevalência" 2 => "Incidência" 3 => "Revisão" 4 => "Portugal" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "Introduction and ObjectivesPortugal is among the countries with the highest levels of mean blood pressure. The aim of the present study is to conduct a structured literature review describing the scope (quantity, focus and nature) of published epidemiological research on the prevalence and incidence of hypertension in the Portuguese population. MethodsThe scoping review was conducted during June 2013, using two information sources, B-on and PubMed, to search for published studies on the prevalence and incidence of hypertension with data collected between 2005–2013 and 1995–2013, respectively. ResultsWe identified 527 publications, of which 14 on the prevalence and two on the incidence of hypertension were selected. The results show more studies on populations in the North region of Portugal; an apparent lack of published studies specifically targeting the Alentejo and Algarve populations; long delays between data collection and publication of results (up to nine years); considerable variability in measurement methods; and infrequent data stratification by gender and age. ConclusionsDifferences in blood pressure measurement methods, not specified in most studies, the infrequency of stratification of results by gender and age, and the geographic asymmetry in coverage of the Portuguese population, hinder monitoring of the incidence and prevalence of hypertension in Portugal." ] "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "Introdução e objetivosPortugal é referido na literatura como um dos países com maiores níveis de tensão arterial média na população. O objetivo do presente estudo é realizar uma revisão estruturada da literatura acerca do âmbito (quantidade, foco e natureza) da investigação epidemiológica publicada sobre prevalência e incidência de hipertensão arterial na população portuguesa. MétodosA revisão de âmbito foi realizada em junho de 2013. Através da consulta das fontes de informação Pubmed e B-on foram pesquisados estudos sobre prevalência e incidência de hipertensão arterial cuja recolha de dados tivesse decorrido, respetivamente, entre 2005-2013 e 1995-2013. ResultadosObtiveram-se 527 publicações, das quais foram selecionadas 14 sobre prevalência e duas sobre incidência de hipertensão. Os resultados indicam maior número de estudos sobre populações da região Norte do país; a aparente inexistência de estudos específicos sobre as populações do Alentejo e Algarve; longos períodos de tempo entre a recolha de dados e a publicação dos resultados (até nove anos); variabilidade apreciável nos métodos utilizados para medir a tensão arterial; e a infrequente desagregação dos resultados por sexo e idade. ConclusõesOs diferentes métodos de medição da hipertensão arterial, omissos na maioria dos trabalhos analisados, a rara desagregação dos resultados por sexo e idade e a assimetria de cobertura geográfica da população dificultam a monitorização das tendências da frequência de hipertensão arterial em Portugal." ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Sousa-Uva M, Victorino P, Roquette R, et al. Investigação epidemiológica sobre prevalência e incidência de hipertensão arterial na população portuguesa – uma revisão de âmbito. Rev Port Cardiol. 2014;33:451–463." ] ] "multimedia" => array:6 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1618 "Ancho" => 1002 "Tamanyo" => 213304 ] ] "descripcion" => array:1 [ "en" => "Methodology of the scoping review." ] ] 1 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:2 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Publication type \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Data collection year \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Publication year \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Study location \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Location of data collection \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Maldonado et al.<a class="elsevierStyleCrossRef" href="#bib0170">34</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Original article \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Not specified \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2009 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Aveleira, Coimbra \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Aveleira Clinic \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Maldonado et al.<a class="elsevierStyleCrossRef" href="#bib0095">19</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Original article \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Not specified \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2011 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Aveleira, Coimbra \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Aveleira Clinic \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Oliveira-Martins<a class="elsevierStyleCrossRef" href="#bib0175">35</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Undergraduate thesis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2009 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2009 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Campanhã parish, Porto \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 public primary schools in Campanhã parish \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Rocha<a class="elsevierStyleCrossRef" href="#bib0120">24</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Master's thesis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Not specified \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2010 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lisbon \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 secondary schools in the Lisbon region (five public, three private) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Silva et al.<a class="elsevierStyleCrossRef" href="#bib0100">20</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Original article \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2006 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2012 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lisbon \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Camilo Castelo Branco secondary school, Carnaxide, Lisbon \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Dores et al.<a class="elsevierStyleCrossRef" href="#bib0180">36</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Original article \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2006 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2010 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lisbon \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Not specified \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Brandão et al.<a class="elsevierStyleCrossRef" href="#bib0160">32</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Original article \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2005–2006 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2008 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Aveiro \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nursing Laboratory of the School of Health Studies, University of Aveiro \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cortez-Dias et al.<a class="elsevierStyleCrossRef" href="#bib0125">25</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Original article \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2006 and 2007 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2009 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Portugal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Health care centers of 719 general practitioners \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Loubão et al.<a class="elsevierStyleCrossRef" href="#bib0115">23</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Original article \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2007 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2010 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Barão do Corvo, Vila Nova de Gaia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Health center, Barão do Corvo \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Machado et al.<a class="elsevierStyleCrossRef" href="#bib0185">37</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Original article \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Not specified \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2010 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Porto \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 parishes of the city of Porto \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Oliveira-Martins et al.<a class="elsevierStyleCrossRef" href="#bib0190">38</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Original article \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2005–2006 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2011 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mainland Portugal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60 pharmacies in all five Portuguese health regions (North, Central, Lisbon and Tagus Valley, Alentejo and Algarve) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Perdigão et al.<a class="elsevierStyleCrossRef" href="#bib0105">21</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Original article \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2006–2007 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2011 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Portugal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">North, Central, Lisbon and Tagus Valley, Alentejo, Algarve, Madeira and the Azores \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Alves et al.<a class="elsevierStyleCrossRef" href="#bib0130">26</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Original article \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1999–2003 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2012 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Porto \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Porto \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mendes et al.<a class="elsevierStyleCrossRef" href="#bib0110">22</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Poster \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2011 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2012 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Bragança municipality \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Seven old people's homes in Bragança municipality \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab581526.png" ] ] 1 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Study design \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Study population \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Age-groups \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Sample size \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Maldonado et al.<a class="elsevierStyleCrossRef" href="#bib0170">34</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Observational cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Healthy adolescents from the Central region of Portugal followed in sports medicine consultations in Aveleira \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5–18 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1618 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Maldonado et al.<a class="elsevierStyleCrossRef" href="#bib0095">19</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Observational cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Healthy adolescents from the Central region of Portugal followed in sports medicine consultations in Aveleira \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4–18 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5381 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Oliveira-Martins<a class="elsevierStyleCrossRef" href="#bib0175">35</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Observational cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Children born in 2001 attending the 2nd year of the 1st cycle of primary education in 11 public schools in Campanhã parish, Porto \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">339 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Rocha<a class="elsevierStyleCrossRef" href="#bib0120">24</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Observational cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Secondary school students in eight schools in the Lisbon region (five public, three private) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15–18 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">854 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Silva et al.<a class="elsevierStyleCrossRef" href="#bib0100">20</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Observational cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Adolescents attending Camilo Castelo Branco secondary school, Carnaxide, Lisbon, academic year 2005/2006 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16–19 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">234 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Dores et al.<a class="elsevierStyleCrossRef" href="#bib0180">36</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Observational cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Students at universities in Lisbon, at the Faculty of Medical Sciences of the New University of Lisbon (FCM-UNL), the Higher Institute of Applied Psychology (ISPA) and the School of Engineering of the Technical University of Lisbon (IST) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18–25 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">402 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Brandão et al.<a class="elsevierStyleCrossRef" href="#bib0160">32</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Observational cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Students on undergraduate courses at Aveiro University during the 2005/2006 academic year \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18–25 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">378 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cortez-Dias et al.<a class="elsevierStyleCrossRef" href="#bib0125">25</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Observational cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Representative sample of adults resident in mainland Portugal and the islands of Madeira and the Azores treated at primary health care centers \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">≥18 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 856 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Loubão et al.<a class="elsevierStyleCrossRef" href="#bib0115">23</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Observational cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Users of the Barão do Corvo Health Center \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">≥18 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">502 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Machado et al.<a class="elsevierStyleCrossRef" href="#bib0185">37</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Observational cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Representative sample of residents of Porto \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">≥40 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">900 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Oliveira-Martins et al.<a class="elsevierStyleCrossRef" href="#bib0190">38</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Observational cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Users of 60 pharmacies in all five Portuguese health regions (North, Central, Lisbon and Tagus Valley, Alentejo and Algarve) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">≥40 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1042 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Perdigão et al.<a class="elsevierStyleCrossRef" href="#bib0105">21</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Observational cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Representative sample of individuals of both sexes resident in mainland Portugal or in Madeira or the Azores aged ≥40 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">≥40 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">38 893 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Alves et al.<a class="elsevierStyleCrossRef" href="#bib0130">26</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Observational cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Representative sample of residents of Porto \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">≥40 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mendes et al.<a class="elsevierStyleCrossRef" href="#bib0110">22</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Observational cross-sectional study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Individuals institutionalized in seven old people's homes in Bragança municipality \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">≥65 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">91 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab581523.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Results of searches for studies on prevalence of hypertension, in ascending order of age of participants." ] ] 2 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "DBP: diastolic blood pressure; P95: 95th percentile; SBP: systolic blood pressure. ‘X’ indicates definition or measurement method specified. ‘NS’ indicates definition or measurement method not specified." "tablatextoimagen" => array:1 [ 0 => array:1 [ "tablaImagen" => array:1 [ 0 => array:4 [ "imagenFichero" => "fx1.jpeg" "imagenAlto" => 914 "imagenAncho" => 2600 "imagenTamanyo" => 236551 ] ] ] ] ] "descripcion" => array:1 [ "en" => "Definitions and measurement methods in the selected studies on hypertension prevalence in children and/or adolescents." ] ] 3 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "‘X’ indicates definition or measurement method specified. ‘NS’ indicates definition or measurement method not specified. ‘NA’ indicates definition or measurement method not applicable." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><elsevierMultimedia class="elsevierStyleLink" ident="fx2a"></elsevierMultimedia> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><elsevierMultimedia class="elsevierStyleLink" ident="fx2b"></elsevierMultimedia> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab581525.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Definitions and measurement methods in the selected studies on hypertension prevalence in adults." ] ] 4 => array:7 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Publication type \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Data collection year \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Publication year \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Study location \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Location of data collection \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Study design \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Study population \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Age-groups \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Sample size \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pereira et al.<a class="elsevierStyleCrossRef" href="#bib0195">39</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Original article \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1999–2003 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2012 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Porto \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Porto \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Observational analytical cohort study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Residents of Porto \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">≥18 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">796 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Branco et al.<a class="elsevierStyleCrossRef" href="#bib0200">40</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Report \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2011 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2012 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lisbon \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">North, Central, Lisbon and Tagus Valley, Alentejo and Algarve, Azores, Madeira \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Observational analytical cohort 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Epidemiological research on the incidence and prevalence of hypertension in the Portuguese population: A scoping review

Investigação epidemiológica sobre prevalência e incidência de hipertensão arterial na população portuguesa – uma revisão de âmbito

Mafalda Sousa Uva

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mafalda.uva@insa.min-saude.pt

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, Paulo Victorino, Rita Roquette, Ausenda Machado, Carlos Matias Dias

Departamento de Epidemiologia, Instituto Nacional Doutor Ricardo Jorge, Lisboa, Portugal

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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Hypertension is the most important risk factor for cardiovascular and cerebrovascular disease&#44; particularly myocardial infarction and stroke&#44; which are major causes of morbidity and mortality throughout the world&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;3</span></a> In 2008&#44; the global prevalence of hypertension in adults aged &#8805;25 years was 40&#37;&#44; despite falling between 1980 and 2008&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">For the last 30 years&#44; Portugal has been among the countries with the highest levels of mean blood pressure &#40;BP&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;7</span></a> In 2008&#44; the prevalence of hypertension &#40;or use of antihypertensive medication&#41; in adults aged &#8805;25 years was estimated at 41&#46;9&#37; &#40;46&#46;5&#37; in men and 37&#46;4&#37; in women&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> Between 1980 and 2008 mean systolic BP fell&#44; particularly in women&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Knowledge of the evolution&#44; trends and current status of epidemiological measures of hypertension &#40;incidence&#44; prevalence and associated mortality&#41; is important for planning&#44; implementation and evaluation of public health measures&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">A recent systematic review by Pereira et al&#46; concluded that between 1990 and 2005&#44; the prevalence of hypertension &#40;defined as systolic and&#47;or diastolic BP &#8805;140&#47;90 mmHg&#41; remained approximately constant in young adults and decreased in middle-aged and older adults&#44; whereas the prevalence of self-reported hypertension increased by 0&#46;4&#37; per year in the same period&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Systematic reviews have generally been the preferred method of literature review&#44; but the growing volume and importance of health research has led to the development of alternative forms of structured review&#44; including scoping reviews&#44; which are increasingly used in public health research&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> Although these may appear simpler than a systematic review&#44; scoping reviews retain a similar organization and transparency&#46; They have been described as a technique to &#8216;map&#8217; relevant literature on a particular subject in order to obtain an overall picture of current knowledge&#44;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11&#44;12</span></a> and are mainly used to identify gaps in knowledge and&#47;or to summarize the most important studies in a specific field&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> The main difference from systematic reviews is that the latter aim to provide an initial evaluation of the quality of studies and a quantitative and qualitative summary of results&#44; while scoping reviews do not set out to evaluate the quality of studies&#44; but to give a qualitative review of the scope&#44; methods and results of existing research&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">So far as we know&#44; no studies aimed at describing the scope and results in a particular area of health care research have been published in Portugal using the scoping review methodology&#46; Such a review is of particular importance in relation to hypertension&#44; given the prevalence of the disease and the need to identify any gaps in knowledge in order to define research priorities&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Objectives</span><p id="par0035" class="elsevierStylePara elsevierViewall">The aim of this study is to perform a scoping review on the prevalence and incidence of hypertension in the Portuguese population describing the scope &#40;quantity&#44; focus and nature&#41;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">14&#44;15</span></a> of research and to summarize the main results&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Methods</span><p id="par0040" class="elsevierStylePara elsevierViewall">The review was conducted during June 2013 by two investigators working simultaneously&#46; A panel of three experts &#40;researchers with experience in health care&#44; clinical practice&#44; public health&#44; epidemiology and health research&#41; validated the methodology used &#40;search terms&#44; inclusion and exclusion criteria&#44; information sources&#44; and summary and analysis of the results&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> The framework of the study was divided into the following stages &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41;&#44; in accordance with the methodology proposed by Arksey and O&#8217;Malley<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a>&#58; &#40;1&#41; identifying the research question&#59; &#40;2&#41; identifying relevant studies&#59; &#40;3&#41; selection of studies based on pre-established inclusion criteria&#59; &#40;4&#41; data collection&#59; and &#40;5&#41; summarizing and reporting the results&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Search strategies</span><p id="par0045" class="elsevierStylePara elsevierViewall">We included studies on the prevalence of hypertension based on data collected after 2005&#44; those published after 2005 with an unspecified date of data collection&#44; and those published after 2011 even if data collection was before 2005&#46; The review thus covered publications not included in the 2012 review by Pereira et al&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> of trends in hypertension prevalence in Portugal in 1990&#8211;2005&#44; in order to update and widen the scope of knowledge&#44; although some studies may appear in both reviews&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Studies on the incidence of hypertension published between January 1995 and June 2013 were included&#44; in order to cover the largest number of publications&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The information sources used were the Portuguese <span class="elsevierStyleItalic">Biblioteca do Conhecimento Online</span> &#40;B-on &#8211; Online Knowledge Library&#41;&#44; run by the <span class="elsevierStyleItalic">Funda&#231;&#227;o para a Computa&#231;&#227;o Cient&#237;fica Nacional</span> &#40;Foundation for National Scientific Computation&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> and PubMed&#44; maintained by the US National Library of Medicine&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">We searched for studies in Portuguese and English only &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41;&#44; combining the search terms with the Boolean operator AND&#46; In B-on&#44; the Portuguese search terms used were &#8216;preval&#234;ncia&#8217; AND &#8216;hipertens&#227;o&#8217;&#44; and &#8216;incid&#234;ncia&#8217; AND &#8216;hipertens&#227;o&#8217;&#46; In PubMed the terms used were &#8216;prevalence&#8217; AND &#8216;hypertension&#8217; AND &#8216;Portugal&#8217;&#44; and &#8216;incidence&#8217; AND &#8216;hypertension&#8217; AND &#8216;Portugal&#8217;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">PubMed is known to be a good source of information for studies on chronic diseases&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> We also searched B-on using Portuguese search terms only in order to include studies in Portuguese journals&#44; since PubMed does not index all journals published in Portugal&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Studies on hypertension in populations with specific characteristics&#44; such as diabetic or obese individuals&#44; were excluded&#46; No inclusion criteria were established in terms of study design&#44; type of publication&#44; or age of the study population&#44; and&#44; as recommended for scoping reviews&#44;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> the quality of the study was not used as an inclusion criterion&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Data collection</span><p id="par0075" class="elsevierStylePara elsevierViewall">Data on the following variables were collected and entered into a standard table&#58; author&#40;s&#41;&#44; publication year&#44; study location&#44; sample size&#44; BP measurement methods&#44; main results&#44; and stratification by gender and age&#46; The information was entered into the table as the studies were selected and the data were subsequently analyzed in terms of quantity &#40;number of studies&#41;&#44; focus &#40;populations&#44; age-groups&#44; diagnosed vs&#46; self-reported hypertension&#44; etc&#46;&#41;&#44; and nature &#40;type of research&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">14&#44;15</span></a></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Search strategies&#44; study selection and data collection</span><p id="par0080" class="elsevierStylePara elsevierViewall">A total of 527 publications were obtained&#44; 295 studies on prevalence and 232 studies on incidence&#46; Sixteen publications that met the inclusion criteria were selected for analysis&#44; 14 on prevalence &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41; and two on incidence &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Of the 14 selected publications on prevalence&#44; 11 were found by searching PubMed and three in B-on&#46; One of the two publications on incidence was found in PubMed and one in B-on&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Research on prevalence of hypertension in Portugal</span><p id="par0090" class="elsevierStylePara elsevierViewall">The selected studies on prevalence are original articles except for three&#58; one undergraduate thesis&#44; one master&#39;s thesis and one poster&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Only three studies were national in scope&#44; the others being regional&#44; of which five covered the North region&#44; three the Central region and three the Lisbon and Tagus Valley region&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Data collection took place in the period 1999&#8211;2003 in one study&#44; in the period 2005&#8211;2006 in two&#44; in 2006 in two&#44; in the period 2006&#8211;2007 in two&#44; during 2007 in one&#44; 2009 in one&#44; and 2011 in one&#46; The period of data collection was not specified in four studies&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Three of the studies used samples based on the general population&#44; two were of samples selected from consultations at a medical clinic&#44; two of health center users&#44; one of users of 60 pharmacies&#44; five of students at educational institutions&#44; and one of residents in seven old people&#39;s homes&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">With regard to the ages of the study populations&#44; five of the selected studies were on children and&#47;or adolescents&#44; and nine were on adults &#8211; two in individuals aged 18&#8211;25 years&#44; two aged &#8805;18 years&#44; four aged &#8805;40 years and one aged &#8805;65 years&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Of the five studies on children and&#47;or adolescents&#44; the largest was Maldonado et al&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> &#40;5381 participants&#41; and the smallest was Silva et al&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> &#40;234 adolescents&#41;&#46; The largest on adults was Perdig&#227;o et al&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> &#40;38 893 participants&#41; and the smallest was Mendes et al&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> &#40;91 elderly adults&#41;&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">The studies on children and&#47;or adolescents used similar definitions of hypertension and BP measurement methods &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#44; all defining hypertension as systolic and&#47;or diastolic BP at or above the 95th percentile and using digital devices to measure BP&#46; In three of the studies the mean of three measurements was used&#44; while a single measurement was used in two&#46; In two studies BP was measured in both arms and the mean of values in the arm giving the highest reading was used in the analysis&#59; the right arm was used in two studies&#59; and this information was missing in one study&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0125" class="elsevierStylePara elsevierViewall">Of the nine studies in adults&#44; hypertension was self-reported in two&#44; while in the other seven BP was measured and hypertension was defined as systolic and&#47;or diastolic BP &#8805;140&#47;90 mmHg &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; In four of the latter studies&#44; patients were only considered to have hypertension with BP &#8805;140&#47;90 mmHg accompanied by antihypertensive medication&#46; Three of these studies used digital BP monitors&#44; two used mercury sphygmomanometers&#44; one used an aneroid device and one used digital or mercury devices&#46; In six studies it was not specified which arm was used for the measurements&#44; only one study specifying the right arm&#46; Four of these studies used the mean of two measurements&#44; two the mean of two measurements or three if the difference between the first two was more than 5 mmHg&#44; and in one study this information was missing&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0130" class="elsevierStylePara elsevierViewall">Estimates of the prevalence of hypertension in children and&#47;or adolescents ranged between 9&#46;8&#37; and 34&#37;&#44; in adults aged 18&#8211;25 years it varied between 6&#46;9&#37; and 24&#46;9&#37;&#44; in adults aged &#8805;18 years it was 42&#46;62&#37;&#44; in individuals aged &#8805;40 years it ranged between 23&#46;5&#37; and 54&#46;80&#37;&#44; and in the only study on individuals aged &#8805;65 years it was 48&#46;4&#37;&#46; There was no overall estimate of hypertension prevalence in Loub&#227;o et al&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> because the study population was divided into smokers and non-smokers&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Only four of the studies on prevalence stratified the results into age-groups&#44; 11 presented results stratified by gender&#44; and only two were stratified by both age and gender&#46; In the four studies stratified by age&#44; prevalence increased with age&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">In studies solely on adolescents stratified by gender&#44;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20&#44;24</span></a> prevalence was higher in males&#44; while in the three studies in children and&#47;or adolescents &#40;aged 4&#8211;18 years&#44; 5&#8211;18 years and 8 years&#41;&#44; prevalence was higher in females in two studies and the same in one &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">In all studies on adults in which BP was measured&#44; hypertension prevalence was higher in males&#44; whereas it was lower in males in studies in which hypertension was self-reported&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Research on incidence of hypertension in Portugal</span><p id="par0150" class="elsevierStylePara elsevierViewall">Of the two selected studies on the incidence of hypertension in the Portuguese population&#44; one is an original article on adults aged &#8805;18 years and the other a report from the Portuguese general practitioner sentinel network on all age-groups &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0155" class="elsevierStylePara elsevierViewall">Only one of these studies&#44; the original article&#44; reports the method used to assess BP &#40;digital device and mean of two measurements or three if the difference between the first two was more than 5 mmHg&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>&#41; and defines hypertension as BP &#8805;140&#47;90 mmHg and&#47;or use of antihypertensive medication&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0160" class="elsevierStylePara elsevierViewall">This study&#44; of 796 individuals in the Porto region&#44; found an incidence of hypertension of 57&#46;3&#47;1000 population&#47;year&#44; while in the report of 34 981 individuals from all regions of Portugal the incidence was 6&#46;54&#47;1000 population&#47;year&#46; The incidence was lower in females in both studies&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">In the Porto study incidence rose with age in both sexes&#44; while in the national study this was true up to the age of 54&#44; after which it fell&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Discussion</span><p id="par0170" class="elsevierStylePara elsevierViewall">The population that has been the subject of the largest number of studies on hypertension prevalence was that of the North region&#44; particularly the city of Porto&#46; No study has dealt exclusively with the Alentejo and Algarve regions&#44; a gap in knowledge that should be filled by new studies or publication of existing data&#46; However&#44; the national studies by Cortez-Dias et al&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> and Perdig&#227;o et al&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> include estimates of measured and self-reported hypertension&#44; respectively&#44; for these regions&#58; 51&#46;54&#37; and 44&#46;57&#37; &#40;measured&#41; and 23&#37; and 18&#46;3&#37; &#40;self-reported&#41; for the Alentejo and the Algarve&#44; respectively&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">We found long delays between data collection and publication of results &#40;up to nine years&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> This implies that studies on recent data may not yet have been published&#46; For instance&#44; the Portuguese HYpertension and SAlt Study &#40;PHYSA&#41;&#44; conducted by the Portuguese Society of Hypertension&#44; collected data on a representative sample of 3720 residents of mainland Portugal in 2012 but had not published its results when this review was completed&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a></p><p id="par0180" class="elsevierStylePara elsevierViewall">The studies on hypertension prevalence in children and&#47;or adolescents used similar definitions of hypertension and BP measurement methods &#40;at or above the 95th percentile and digital devices&#41;&#44; in accordance with the US guidelines on high blood pressure in children and adolescents&#44; which are used internationally&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> This facilitates comparisons between the results of different studies and monitoring of developments in hypertension prevalence in these population groups&#46; However&#44; there were methodological differences between the studies&#58; three made three BP measurements and two made only one&#44; while two studies took measurements in both arms&#44; two in the right arm&#44; and one did not specify&#46; According to the US guidelines BP should be measured in the right arm&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a></p><p id="par0185" class="elsevierStylePara elsevierViewall">Of the nine studies on hypertension prevalence in adults&#44; hypertension was self-reported in only two and BP was measured in the others&#46; Hypertension was defined as BP &#8805;140&#47;90 mmHg&#46; Only five studies reported the type of measurement device used &#40;which varied widely&#41;&#44; and only one study specified which arm was used&#46; These findings indicate inadequate description of methods&#44; which hinders comparisons between studies&#46; According to a recent review by Crim et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> surveillance definitions of hypertension vary in the literature&#44; and clear definitions of measurement methods are crucial for monitoring its prevalence and incidence&#46; Crim et al&#46; propose standard definitions to be used in research in this area&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">According to the guideline of the Portuguese Directorate-General of Health &#40;DGS&#41; entitled &#8220;<span class="elsevierStyleItalic">Hipertens&#227;o arterial&#58; Defini&#231;&#227;o e classifica&#231;&#227;o</span>&#8221; &#40;&#8220;Hypertension&#58; definition and classification&#8221;&#41;&#44; a diagnosis of hypertension should be based on at least two measurements&#44; in the arm that gives the higher BP reading&#46;<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">30&#44;31</span></a> This was not followed in any of the studies in this scoping review&#59; the studies by Cortez-Dias et al&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> and Brand&#227;o et al&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">32</span></a> describe the measurement method used except for the arm used&#44; and state that they followed the American Heart Association guidelines&#44;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">33</span></a> which are similar to the recommendations of the DGS&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Only two of the studies on hypertension prevalence present results stratified by both age and gender&#44; which is a significant obstacle to an understanding of the epidemiology of the disease&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a></p><p id="par0200" class="elsevierStylePara elsevierViewall">In all the studies on adults with results stratified by gender in which BP was measured&#44; hypertension prevalence was lower in women&#44; in agreement with the systematic review by Pereira et al&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> and the World Health Organization figures for Portugal in 2008&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0205" class="elsevierStylePara elsevierViewall">In the only study which presented self-reported hypertension prevalence and results stratified by gender&#44; the prevalence was lower in men&#44; as also reported by Pereira et al&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0210" class="elsevierStylePara elsevierViewall">The fact that the studies on adults selected for this review use different BP measurement methods&#44; not specified in many cases&#44; and are infrequently stratified by age and gender&#44; seriously hinders comparisons and analysis&#46; This will of course have an effect on knowledge of the epidemiology of hypertension in Portugal and hence on implementation of health care policies and measures&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">The results of our study reveal the need for greater uniformity in measurement and reporting methods for research into hypertension&#44; in order to improve the comparability&#44; data collection and analysis of studies on the evolution and trends in hypertension in the Portuguese population&#46; They also point up the need to perform a quantitative analysis of the variability of data resulting from the application of different BP measurement methods&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">Regarding hypertension incidence&#44; the two selected studies were of very different populations&#58; residents of the city of Porto&#44; and the general Portuguese population&#46; In the Porto study &#40;1999&#8211;2003&#41;&#44; incidence was 57&#46;3&#47;1000 population&#47;year&#44; while in the 2011 national report from the general practitioner sentinel network it was 6&#46;54&#47;1000 population&#47;year&#46; This discrepancy may reflect a fall in incidence between 2003 and 2011&#44; or it may be due simply to differences in sample size&#44; target populations and measurement methods&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">The existence of only two studies since 1995 on hypertension incidence in Portugal reveals a gap in knowledge in this area that should prompt future research&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conclusions</span><p id="par0230" class="elsevierStylePara elsevierViewall">The present scoping review of research into the prevalence and incidence of hypertension in the Portuguese population allows the following conclusions to be drawn&#58; &#40;i&#41; in the last eight years&#44; more studies have been published on populations in the North region&#59; &#40;ii&#41; although the Alentejo and Algarve regions were included in two national studies&#44; their populations have not been specifically targeted in any published studies&#59; &#40;iii&#41; there have been long delays between data collection and publication of results on hypertension prevalence &#40;up to nine years&#41;&#44; which hinders comparison of these studies with others in which data collection was nearer to publication date&#59; &#40;iv&#41; only two studies on hypertension incidence were published between 1995 and 2013&#44; which reveals a gap in knowledge that needs to be filled&#59; and &#40;v&#41; differences in blood pressure measurement methods&#44; not specified in most studies&#44; and the infrequency of stratification of results by gender and age&#44; hinder comparison and analysis&#44; and hence monitoring of trends in the incidence and prevalence of hypertension in Portugal&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflicts of interest</span><p id="par0235" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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              "titulo" => "Research on incidence of hypertension in Portugal"
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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0010">Introduction and Objectives</span><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Portugal is among the countries with the highest levels of mean blood pressure&#46; The aim of the present study is to conduct a structured literature review describing the scope &#40;quantity&#44; focus and nature&#41; of published epidemiological research on the prevalence and incidence of hypertension in the Portuguese population&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">The scoping review was conducted during June 2013&#44; using two information sources&#44; B-on and PubMed&#44; to search for published studies on the prevalence and incidence of hypertension with data collected between 2005&#8211;2013 and 1995&#8211;2013&#44; respectively&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">We identified 527 publications&#44; of which 14 on the prevalence and two on the incidence of hypertension were selected&#46; The results show more studies on populations in the North region of Portugal&#59; an apparent lack of published studies specifically targeting the Alentejo and Algarve populations&#59; long delays between data collection and publication of results &#40;up to nine years&#41;&#59; considerable variability in measurement methods&#59; and infrequent data stratification by gender and age&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Differences in blood pressure measurement methods&#44; not specified in most studies&#44; the infrequency of stratification of results by gender and age&#44; and the geographic asymmetry in coverage of the Portuguese population&#44; hinder monitoring of the incidence and prevalence of hypertension in Portugal&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0035">Introdu&#231;&#227;o e objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Portugal &#233; referido na literatura como um dos pa&#237;ses com maiores n&#237;veis de tens&#227;o arterial m&#233;dia na popula&#231;&#227;o&#46; O objetivo do presente estudo &#233; realizar uma revis&#227;o estruturada da literatura acerca do &#226;mbito &#40;quantidade&#44; foco e natureza&#41; da investiga&#231;&#227;o epidemiol&#243;gica publicada sobre preval&#234;ncia e incid&#234;ncia de hipertens&#227;o arterial na popula&#231;&#227;o portuguesa&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A revis&#227;o de &#226;mbito foi realizada em junho de 2013&#46; Atrav&#233;s da consulta das fontes de informa&#231;&#227;o Pubmed e B-on foram pesquisados estudos sobre preval&#234;ncia e incid&#234;ncia de hipertens&#227;o arterial cuja recolha de dados tivesse decorrido&#44; respetivamente&#44; entre 2005-2013 e 1995-2013&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Obtiveram-se 527 publica&#231;&#245;es&#44; das quais foram selecionadas 14 sobre preval&#234;ncia e duas sobre incid&#234;ncia de hipertens&#227;o&#46; Os resultados indicam maior n&#250;mero de estudos sobre popula&#231;&#245;es da regi&#227;o Norte do pa&#237;s&#59; a aparente inexist&#234;ncia de estudos espec&#237;ficos sobre as popula&#231;&#245;es do Alentejo e Algarve&#59; longos per&#237;odos de tempo entre a recolha de dados e a publica&#231;&#227;o dos resultados &#40;at&#233; nove anos&#41;&#59; variabilidade apreci&#225;vel nos m&#233;todos utilizados para medir a tens&#227;o arterial&#59; e a infrequente desagrega&#231;&#227;o dos resultados por sexo e idade&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#245;es</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Os diferentes m&#233;todos de medi&#231;&#227;o da hipertens&#227;o arterial&#44; omissos na maioria dos trabalhos analisados&#44; a rara desagrega&#231;&#227;o dos resultados por sexo e idade e a assimetria de cobertura geogr&#225;fica da popula&#231;&#227;o dificultam a monitoriza&#231;&#227;o das tend&#234;ncias da frequ&#234;ncia de hipertens&#227;o arterial em Portugal&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Sousa-Uva M&#44; Victorino P&#44; Roquette R&#44; et al&#46; Investiga&#231;&#227;o epidemiol&#243;gica sobre preval&#234;ncia e incid&#234;ncia de hipertens&#227;o arterial na popula&#231;&#227;o portuguesa &#8211; uma revis&#227;o de &#226;mbito&#46; Rev Port Cardiol&#46; 2014&#59;33&#58;451&#8211;463&#46;</p>"
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                  \t\t\t\t" style="border-bottom: 2px solid black">Study&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Publication type&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Publication year&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Study location&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Location of data collection&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Maldonado et al&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">34</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Original article&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Not specified&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Aveleira&#44; Coimbra&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Aveleira Clinic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Maldonado et al&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Original article&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Not specified&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Aveleira&#44; Coimbra&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Aveleira Clinic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Oliveira-Martins<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">35</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Undergraduate thesis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Campanh&#227; parish&#44; Porto&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 public primary schools in Campanh&#227; parish&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Rocha<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Master&#39;s thesis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Not specified&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2010&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lisbon&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 secondary schools in the Lisbon region &#40;five public&#44; three private&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Silva et al&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Original article&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2012&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lisbon&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Camilo Castelo Branco secondary school&#44; Carnaxide&#44; Lisbon&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dores et al&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">36</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Original article&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2010&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lisbon&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Not specified&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Brand&#227;o et al&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">32</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Original article&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2005&#8211;2006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Aveiro&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nursing Laboratory of the School of Health Studies&#44; University of Aveiro&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cortez-Dias et al&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Original article&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2006 and 2007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Portugal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Health care centers of 719 general practitioners&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Loub&#227;o et al&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Original article&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2010&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Bar&#227;o do Corvo&#44; Vila Nova de Gaia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Health center&#44; Bar&#227;o do Corvo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Machado et al&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">37</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Original article&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Not specified&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2010&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Porto&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 parishes of the city of Porto&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Oliveira-Martins et al&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">38</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Original article&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2005&#8211;2006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mainland Portugal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60 pharmacies in all five Portuguese health regions &#40;North&#44; Central&#44; Lisbon and Tagus Valley&#44; Alentejo and Algarve&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Perdig&#227;o et al&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Original article&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2006&#8211;2007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Portugal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">North&#44; Central&#44; Lisbon and Tagus Valley&#44; Alentejo&#44; Algarve&#44; Madeira and the Azores&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alves et al&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Original article&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1999&#8211;2003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2012&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Porto&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Porto&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mendes et al&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Poster&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2012&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Bragan&#231;a municipality&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Seven old people&#39;s homes in Bragan&#231;a municipality&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab581526.png"
              ]
            ]
            1 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Study design&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Study population&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Age-groups&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Sample size&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Maldonado et al&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">34</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Observational cross-sectional study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Healthy adolescents from the Central region of Portugal followed in sports medicine consultations in Aveleira&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#8211;18 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1618&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Maldonado et al&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Observational cross-sectional study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Healthy adolescents from the Central region of Portugal followed in sports medicine consultations in Aveleira&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#8211;18 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5381&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Oliveira-Martins<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">35</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Observational cross-sectional study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Children born in 2001 attending the 2nd year of the 1st cycle of primary education in 11 public schools in Campanh&#227; parish&#44; Porto&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">339&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Rocha<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Observational cross-sectional study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Secondary school students in eight schools in the Lisbon region &#40;five public&#44; three private&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#8211;18 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">854&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Silva et al&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Observational cross-sectional study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adolescents attending Camilo Castelo Branco secondary school&#44; Carnaxide&#44; Lisbon&#44; academic year 2005&#47;2006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#8211;19 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">234&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dores et al&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">36</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Observational cross-sectional study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Students at universities in Lisbon&#44; at the Faculty of Medical Sciences of the New University of Lisbon &#40;FCM-UNL&#41;&#44; the Higher Institute of Applied Psychology &#40;ISPA&#41; and the School of Engineering of the Technical University of Lisbon &#40;IST&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#8211;25 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">402&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Brand&#227;o et al&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">32</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Observational cross-sectional study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Students on undergraduate courses at Aveiro University during the 2005&#47;2006 academic year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#8211;25 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">378&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cortez-Dias et al&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Observational cross-sectional study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Representative sample of adults resident in mainland Portugal and the islands of Madeira and the Azores treated at primary health care centers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8805;18 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 856&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Loub&#227;o et al&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Observational cross-sectional study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Users of the Bar&#227;o do Corvo Health Center&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8805;18 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">502&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Machado et al&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">37</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Observational cross-sectional study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Representative sample of residents of Porto&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8805;40 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">900&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Oliveira-Martins et al&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">38</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Observational cross-sectional study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Users of 60 pharmacies in all five Portuguese health regions &#40;North&#44; Central&#44; Lisbon and Tagus Valley&#44; Alentejo and Algarve&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8805;40 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1042&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Perdig&#227;o et al&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Observational cross-sectional study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Representative sample of individuals of both sexes resident in mainland Portugal or in Madeira or the Azores aged &#8805;40 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8805;40 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38 893&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alves et al&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Observational cross-sectional study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Representative sample of residents of Porto&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8805;40 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mendes et al&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Observational cross-sectional study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Individuals institutionalized in seven old people&#39;s homes in Bragan&#231;a municipality&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8805;65 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Results of searches for studies on prevalence of hypertension&#44; in ascending order of age of participants&#46;</p>"
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">DBP&#58; diastolic blood pressure&#59; P95&#58; 95th percentile&#59; SBP&#58; systolic blood pressure&#46; &#8216;X&#8217; indicates definition or measurement method specified&#46; &#8216;NS&#8217; indicates definition or measurement method not specified&#46;</p>"
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar1045" class="elsevierStyleSimplePara elsevierViewall">&#8216;X&#8217; indicates definition or measurement method specified&#46; &#8216;NS&#8217; indicates definition or measurement method not specified&#46; &#8216;NA&#8217; indicates definition or measurement method not applicable&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Study&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Publication type&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Data collection year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Publication year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Study location&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Location of data collection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Study design&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Study population&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Age-groups&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Sample size&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pereira et al&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">39</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Original article&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1999&#8211;2003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2012&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Porto&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Porto&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Observational analytical cohort study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Residents of Porto&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8805;18 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">796&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Branco et al&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">40</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Report&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2012&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lisbon&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">North&#44; Central&#44; Lisbon and Tagus Valley&#44; Alentejo and Algarve&#44; Azores&#44; Madeira&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Observational analytical cohort study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">All patients of members of the general practitioner sentinel network&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">All&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34 981&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Results of searches for studies on incidence of hypertension&#46;</p>"
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    "bibliografia" => array:2 [
      "titulo" => "References"
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          "identificador" => "bibs0005"
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            0 => array:3 [
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Causes of death 2008&#58; data sources and methods"
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                          "etal" => false
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                            0 => "World Health Organization"
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                      "Libro" => array:3 [
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Article information

ISSN: 21742049
Original language: English

DOI:10.1016/j.repce.2014.02.008

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Year/Month	Html	Pdf	Total

2024 November	6	5	11
2024 October	45	29	74
2024 September	62	21	83
2024 August	59	31	90
2024 July	36	29	65
2024 June	37	23	60
2024 May	34	22	56
2024 April	39	26	65
2024 March	52	23	75
2024 February	31	28	59
2024 January	38	30	68
2023 December	41	24	65
2023 November	39	25	64
2023 October	46	16	62
2023 September	29	24	53
2023 August	39	17	56
2023 July	58	7	65
2023 June	63	20	83
2023 May	71	25	96
2023 April	46	8	54
2023 March	51	22	73
2023 February	56	35	91
2023 January	56	16	72
2022 December	69	19	88
2022 November	64	28	92
2022 October	77	27	104
2022 September	119	50	169
2022 August	78	52	130
2022 July	75	46	121
2022 June	60	30	90
2022 May	36	34	70
2022 April	41	28	69
2022 March	49	41	90
2022 February	41	35	76
2022 January	38	30	68
2021 December	44	35	79
2021 November	70	37	107
2021 October	51	45	96
2021 September	39	30	69
2021 August	41	39	80
2021 July	33	37	70
2021 June	41	25	66
2021 May	45	28	73
2021 April	81	63	144
2021 March	95	16	111
2021 February	99	18	117
2021 January	56	13	69
2020 December	48	5	53
2020 November	60	11	71
2020 October	39	8	47
2020 September	67	22	89
2020 August	30	6	36
2020 July	57	8	65
2020 June	64	8	72
2020 May	127	7	134
2020 April	123	14	137
2020 March	169	12	181
2020 February	228	41	269
2020 January	43	8	51
2019 December	72	11	83
2019 November	55	5	60
2019 October	80	9	89
2019 September	85	10	95
2019 August	46	3	49
2019 July	78	19	97
2019 June	62	10	72
2019 May	78	14	92
2019 April	69	20	89
2019 March	45	8	53
2019 February	63	13	76
2019 January	38	10	48
2018 December	74	10	84
2018 November	261	12	273
2018 October	581	18	599
2018 September	156	14	170
2018 August	82	6	88
2018 July	38	7	45
2018 June	46	7	53
2018 May	58	14	72
2018 April	63	8	71
2018 March	107	5	112
2018 February	67	1	68
2018 January	121	4	125
2017 December	212	7	219
2017 November	51	9	60
2017 October	43	11	54
2017 September	37	16	53
2017 August	41	18	59
2017 July	19	12	31
2017 June	35	13	48
2017 May	38	10	48
2017 April	34	6	40
2017 March	71	53	124
2017 February	38	5	43
2017 January	45	4	49
2016 December	50	14	64
2016 November	29	6	35
2016 October	50	4	54
2016 September	30	7	37
2016 August	9	2	11
2016 July	18	2	20
2016 June	14	5	19
2016 May	19	2	21
2016 April	42	1	43
2016 March	61	25	86
2016 February	76	26	102
2016 January	74	18	92
2015 December	70	15	85
2015 November	50	11	61
2015 October	69	16	85
2015 September	60	15	75
2015 August	45	9	54
2015 July	48	11	59
2015 June	48	7	55
2015 May	43	13	56
2015 April	59	22	81
2015 March	34	10	44
2015 February	30	13	43
2015 January	48	12	60
2014 December	46	20	66
2014 November	42	17	59
2014 October	47	12	59
2014 September	22	12	34

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