Coronary heart disease and stroke mortality trends in Brazil 2000-2018.

Patrícia Vasconcelos Leitão Moreira,Rafaela Lira Formiga Cavalcanti De Lima,Jevuks Matheus De Araújo,Rodrigo Pinheiro De Toledo Vianna,José Moreira Da Silva Neto,Sara Silva Ferreira,Rômulo Eufrosino De Alencar Rodrigues,Flávia Emília Leite Lima Ferreira,Martin O’Flaherty,Adélia Da Costa Pereira De Arruda Neta,Venkata Naga Srikanth Garikipati

doi:10.1371/journal.pone.0253639

Patrícia Vasconcelos Leitão Moreira, Rafaela Lira Formiga Cavalcanti De Lima + Show 9 more

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https://doi.org/10.1371/journal.pone.0253639

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Journal: PloS one	Publication Date: Sep 2, 2021
Citations: 9	License type: CC BY 4.0

Affiliation: Universidade Federal do Pará

Abstract

To analyse the mortality rate trend due to coronary heart disease (CHD) and stroke in the adult population in Brazil. From 2000 to 2018, a time trend study with joinpoint regression was conducted among Brazilian men and women aged 35 years and over. Age-adjusted and age, sex specific CHD and stroke trend rate mortality were measured. Crude mortality rates from CHD decreased in both sexes and in all age groups, except for males over 85 years old with an increase of 1.78%. The most accentuated declining occurred for age range 35 to 44 years for both men (52.1%) and women (53.2%) due to stroke and in men (33%) due to CHD, and among women (32%) aged 65 to 74 years due to CHD. Age-adjusted mortality rates for CHD and stroke decreased in both sexes, in the period from 2000 to 2018. The average annual rate for CHD went from 97.09 during 2000-2008 to 78.75 during 2016-2018, whereas the highest percentage of change was observed during 2008 to 2013 (APC -2.5%; 95% CI). The average annual rate for stroke decreased from 104.96 to 69.93, between 2000-2008 and 2016-2018, and the highest percentage of change occurred during the periods from 2008 to 2013 and 2016 to 2018 (APC 4.7%; 95% CI). The downward trend CHD and stroke mortality rates is continuing. Policy intervention directed to strengthen care provision and improve population diets and lifestyles might explain the continued progress, but there is no room for complacency.

Highlights

Cardiovascular diseases (CVD) represent a significant public health problem, because they are the leading cause of death and disability that affects adults at full productive age, accounting for 31% of global deaths [1, 2] and about 27.7% of deaths in Brazil [3]
Crude mortality rates from coronary heart disease (CHD) decreased in both sexes and in all age groups, except for males over 85 years old with an increase of 1.78%
Ageadjusted mortality rates for CHD and stroke decreased in both sexes, in the period from 2000 to 2018

Summary

Introduction

Cardiovascular diseases (CVD) represent a significant public health problem, because they are the leading cause of death and disability that affects adults at full productive age, accounting for 31% of global deaths [1, 2] and about 27.7% of deaths in Brazil [3] These diseases have an enormous economic impact on the country, resulting in losses of potential years of life and a high burden on the public health system, mainly in cost to the state [4,5,6,7]. Some studies have already analysed cardiovascular diseases mortality trends in Brazil, over longer time frames in the 90s [11], or focusing in large cities [12], from 1990 to 2009 [1] and 1980 to 2012 [13] They showed that CVD trends are characterized by a drop in mortality in more advanced age groups, resulting from the delay in deaths caused by chronic diseases [13]. The only existing study that used a similar methodology analysed the period 2000–2015, but focused only in the most populous cities, not the entire country [14]

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