Abstract
The aim of the present study was to analyze the mortality trend due to ischemic heart disease (IHD) among older adults, identify changes in the trend and determine the correlation with influenza vaccine coverage (2000 to 2012) in the state of São Paulo between 1980 and 2012. An ecological time series study was conducted involving secondary data from Brazilian information systems. Linear and polynomial regression models as well as joinpoint regression were used to estimate the trends. Pearson's correlation coefficient was used to evaluate the correlation between age-standardized mortality coefficients and vaccine coverage. A decreasing tendency in mortality due to IHD occurred in both sexes, higher mortality rates were found for males and greater reductions were found in the period after the vaccination campaigns. However, no statistically significant changes occurred in the year coinciding with or near the onset of the campaigns. In the overall sample, no evidence of a linear correlation was found between the mortality coefficients and vaccination coverage. Other factors directly associated with morbidity and mortality due to ischemic heart disease may have influenced the trend.
Highlights
Cardiovascular disease exerts considerable impact on morbidity and mortality rates throughout the world
The mortality rate among men was higher in all years and the standardized male/female mortality coefficient ratio increased throughout the period (p < 0.001), with a mean coefficient of 1.34 male deaths for each female death, which demonstrates the importance of ischemic heart disease (IHD) in the male population, especially over time (Table 1)
The results of the present study demonstrate a significant reduction in mortality due to ischemic heart disease between 1980 and 2012 among male and female older adults in all age groups, with the reduction more pronounced among individuals aged 80 years or older
Summary
Cardiovascular disease exerts considerable impact on morbidity and mortality rates throughout the world. In Brazil, cardiovascular disease has been the major cause of death for decades, with high prevalence rates of complications associated with ischemic heart disease (IHD) and cerebrovascular disease, which have a huge impact on the morbidity of the population[2,3]. According to the US Centers for Disease Control and Prevention, previous infection by influenza is a risk factor for death caused by acute myocardial infarction, vascular disease and diabetes. These deaths are not counted together with those due to pneumonia and influenza and the impact of the disease on the mortality rate may be underestimated[8]
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