Abstract
SITUATION #1: UNDERSTANDING CARDIOVASCULAR EPIDEMIOLOGY IN BRAZIL 1. Mortality: Cardiovascular diseases — coronary heart disease (CHD) and stroke — are the main cause of death worldwide.1 Over recent decades, Brazil has witnessed a decline in mortality rates due to CHD and stroke.2,3 However, in 2012, these diseases were the first and the third commonest causes of premature death nationwide, respectively.1 Table 14-6 shows the proportion of deaths among individuals under the age of 70 years due to all cardiovascular diseases, CHD alone and the combination of stroke and hypertensive disorders, according to sex and race, in Brazil in 2012. The proportion of premature deaths due to CHD is higher than the proportion due to stroke for both sexes and all races. Men die due to all cardiovascular events earlier than women. According to skin color/race, the chance of death under the age of 70 years is highest for black individuals, followed by mixed race and white people. To understand this picture better, so as to enable effective intervention, more information concerning morbidity and risk factors is necessary. 2. Incidence and case-fatality: The morbidity due to cardiovascular diseases can be ascertained by determining the incidence and case-fatality rates. Population-based incidence rates have been obtained from studies limited to a single city.7 Case-fatality rates are easier to obtain from the organized hospital-based registries that have been created in Brazil.8-10 These registries are helpful in determining the levels of pre-hospital care, compliance with guidelines among the medical team and, especially, quality of procedures such as thrombolytic therapy, angioplasty and coronary revascularization. In addition, data on the adherence among IMD, DrPH. Titular Professor, Discipline of Internal Medicine, Faculdade de Medicina da Universidade de Sao Paulo (FMUSP), Sao Paulo, Brazil.
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