Abstract

INTRODUCTION: To better understand trends in the main cause of death in Brazil, we sought to analyze the burden of cardiovascular risk factors (RF) and cardiovascular diseases (CVD) attributable to specific RFs in Brazil from 1990 to 2019, using the estimates from the GBD 2019 study. METHODS: To estimate RF exposure, the Summary Exposure Value (SEV) was used, whereas for disease burden attributed to RF, mortality and disability-adjusted life-years (DALY) due to CVD were used. For comparisons over time and between states, we compared age-standardized rates. The sociodemographic index (SDI) was used as a marker of socioeconomic conditions. RESULTS: In 2019, 83% of CVD mortality in Brazil was attributable to RF. For SEV, there was a reduction in smoking and environmental RF, but an increase in metabolic RF. High systolic blood pressure and dietary risks continue to be the main RF for CVD mortality and DALY. While there was a decline in age-standardized mortality rates attributable to the evaluated RF, there was also a stability or increase in crude mortality rates, with the exception of smoking. It is important to highlight the increase in the risk of death attributable to a high body mass index. Regarding the analysis per state, SEVs and mortality attributable to RF were higher in those states with lower SDIs. CONCLUSIONS: Despite the reduction in CVD mortality and DALY rates attributable to RF, the stability or increase in crude rates attributable to metabolic RFs is worrisome, requiring investments and a renewal of health policies.

Highlights

  • To better understand trends in the main cause of death in Brazil, we sought to analyze the burden of cardiovascular risk factors (RF) and cardiovascular diseases (CVD) attributable to specific RFs in Brazil from 1990 to 2019, using the estimates from the Global Burden of Disease (GBD) 2019 study

  • Among the Cardiovascular diseases (CVDss), responsible for 27.3% of the deaths in Brazil in 2017, ischemic heart disease (IHD) and stroke are the main causes of death, contributing respectively with 32.1% and 28.2% of the deaths caused by CVDs in 20193

  • CVDss were responsible for 28.2% (95% UI 26.0%-29.4%) of deaths in Brazil in 2019, 82.6% (95% UI 80.0%-85.2%) of which were attributable to the RF assessed by the GBD (Supplementary Material Figure 1)

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Summary

Introduction

To better understand trends in the main cause of death in Brazil, we sought to analyze the burden of cardiovascular risk factors (RF) and cardiovascular diseases (CVD) attributable to specific RFs in Brazil from 1990 to 2019, using the estimates from the GBD 2019 study. While there was a decline in age-standardized mortality rates attributable to the evaluated RF, there was a stability or increase in crude mortality rates, with the exception of smoking. Regarding the analysis per state, SEVs and mortality attributable to RF were higher in those states with lower SDIs. Conclusions: Despite the reduction in CVD mortality and DALY rates attributable to RF, the stability or increase in crude rates attributable to metabolic RFs is worrisome, requiring investments and a renewal of health policies. In 2019, the risk factor estimates were revised and updated[6]

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