Cardiovascular Diseases In Brazil Research Articles

Spatial Analysis of Mortality by Cardiovascular Disease in the Adult Population: A Study for Brazilian Micro-Regions Between 1996 and 2015

Cardiovascular disease (CVD) is one of the most serious health issues and the leading cause of death worldwide in both developed and developing countries, including Brazil. However, CVD mortality rates are not uniformly distributed across the country. Brazil is marked by important regional differences resulting from socioeconomic inequality and limited access to health services. Mortality varies in a number of dimensions including age, sex, race, socioeconomic status, educational level and geography/space. Geographic inequalities in mortality in Brazil appear to be greater than other countries in Latin America. Given the spatial distribution of causes and heterogeneity of deaths from cardiovascular disease in Brazil, both at macro and micro levels, the goal of this paper is to evaluate the spatial patterns of deaths from CVD in the adult population (over 30 years of age), by sex, in Brazilian micro-regions from 1996 to 2015. Our main contribution was to study an important cause of death in small areas (micro-regions), taking into consideration space, as a proxy of socioeconomic conditions, access to health care and social norms that might affect CVD, as an important variable to understand changes in the CVD mortality.

Decomposition of mortality rates from cardiovascular disease in the adult population: a study for Brazilian micro-regions between 1996 and 2015

Cardiovascular disease (CVD) is one of the most serious health issues and the leading cause of death worldwide, causing 30% of deaths in Brazil alone in recent years. However, CVD mortality rates are not uniformly distributed across the country. Brazil is marked by important regional differences resulting from socioeconomic inequality and limited access to health services. Given the spatial distribution of causes and heterogeneity of deaths from cardiovascular disease in Brazil, both at macro and micro levels, the goal of this paper is to investigate how age composition effects and age-specific mortality rates are related to the observed difference in deaths from cardiovascular disease in the adult population (over 30 years of age), by sex, in Brazilian micro-regions from 1996 to 2015. The results suggest there has been a decrease in mortality rates resulting from cardiovascular disease, and that both the effects of age structure and level may have influenced the variation of these deaths in Brazil over the period analyzed. These findings indicate that the Brazilian epidemiological transition is not uniform across and within regions of the country.

Analysis of the Economic Impact of Cardiovascular Diseases in the Last Five Years in Brazil.

BackgroundThere is growing concern about the economic impact of cardiovascular diseases (CVD) in Brazil and worldwide.ObjectiveTo estimate the economic impact of CVD in Brazil in the last five years.MethodsThe information to estimate CVD costs was taken from national databases, adding the direct costs with hospitalizations, outpatient visits and benefits granted by social security. Indirect costs were added to the calculation, such as loss of income caused by CVD morbidity or mortality.ResultsCVD mortality accounts for 28% of all deaths in Brazil in the last five years and for 38% of deaths in the productive age range (18 to 65 years). The estimated costs of CVD were R$ 37.1 billion in 2015, a 17% increase in the period from 2010 to 2015. The estimated costs of premature death due to CVD represent 61% of the total cost of CVD, Direct costs with hospitalizations and consultations were 22%, and costs related to the loss of productivity related to the disease were 15% of the total. Health expenditures in Brazil are estimated at 9.5% of GDP and the average cost of CVD was estimated at 0.7% of GDP.ConclusionCVD costs have increased significantly in the last five years. It is estimated that CVD costs increase as the Brazilian population ages and the prevalence of CVD increases.

PP.32.01] MORTALITY FROM BLOOD-PRESSURE-RELATED DISEASES IN BRAZIL FROM 1980–2010

Objective: To estimate the mortality attributable to Hypertension in Brazil from 1980 to 2010 Design and method: Data about deaths from cardiovascular diseases in Brazil from 1980 to 2010 were obtained from the Ministry of Health/DATASUS. Besides the specific mortality from hypertensive diseases (ICD10 I10-I13 and corresponding ICD9 codes), cardiovascular mortality attributable to HTN was calculated using 2000 s Global Burden of Disease study estimation (Lancet 2008;371:1513–18). According to this study, mortality attributable to high blood pressure (> or = 115 mmHg systolic) was estimated by 54% of all deaths from CeVD (ICD10 I60–69 and corresponding ICD9), 47% of deaths from coronary artery disease (CAD) (ICD10 I20-I25 and corresponding ICD9), and 25% of deaths from other cardiovascular diseases (ICD10 I26–28, I34–37, I44–51, I70–99, and corresponding ICD9) can be attributed to HTN. Mortality rates (deaths/100,000 people) were adjusted by gender and age group using the direct method. For trend analysis data were adjusted by Poisson regression model. Results: Approximately 3,660,313 deaths could be attributed to HTN over the analyzed period. Those deaths accounted for 11.4% of all deaths recorded in 1980, increasing proportionally to 14.5% of all deaths in 2010. Cerebrovascular diseases were the main cause of those deaths (37.4%), followed by CAD (29.0%). There was an increase of mortality rates attributed to HTN in this period: adjusted mortality raised from 74.7 to 89.8/100,000 people (P-value < 0.01), which was more pronounced among women (66.8 to 81.8/100,000, R2 = 0.627). Conclusions: Between 1980 and 2010, there was an increase in mortality rates for causes directly attributable to high blood pressure in Brazil. Despite the limitations of risk estimate studies, there are evidences that the hypertension control is still not ideal in Brazil, with significant impact on related mortality.

Hospitalizations and hospital cost from cardiovascular diseases in Brazil

This study aimed to estimate the number and average cost of hospitalizations from cardiovascular diseases in Brazil. Descriptive, retrospective study with a quantitative approach, on the number and hospitalization cost from cardiovascular diseases (acute myocardial infarction, hypertension and heart failure) in Brazil. The research was conducted by using secondary data, available online at the Department of Health System Information, from 2008 to September 2015. Cardiovascular diseases were responsible for significant numbers of hospitalizations especially for heart failure representing higher admissions. As for costs, there was stability in the amount paid for the cases of hospitalizations by hypertension and increasing costs in Heart Failure and Acute Myocardial Infarction. Cardiovascular diseases continue to relate to the large increase in hospitalization rates from the analysis of the expenses of the Unified Health System with the Public Health.

Trends in Mortality Rate from Cardiovascular Disease in Brazil, 1980-2012.

BackgroundStudies have questioned the downward trend in mortality from cardiovascular diseases (CVD) in Brazil in recent years.Objectiveto analyze recent trends in mortality from ischemic heart disease (IHD) and stroke in the Brazilian population.MethodsMortality and population data were obtained from the Brazilian Institute of Geography and Statistics and the Ministry of Health. Risk of death was adjusted by the direct method, using as reference the world population of 2000. We analyzed trends in mortality from CVD, IHD and stroke in women and men in the periods of 1980-2006 and 2007-2012.Resultsthere was a decrease in CVD mortality and stroke in women and men for both periods (p < 0.001). Annual mortality variations for periods 1980-2006 and 2007-2012 were, respectively: CVD (total): -1.5% and -0.8%; CVD men: -1.4% and -0.6%; CVD women: -1.7% and -1.0%; DIC (men): -1.1% and 0.1%; stroke (men): -1.7% and -1.4%; DIC (women): -1.5% and 0.4%; stroke (women): -2.0% and -1.9%. From 1980 to 2006, there was a decrease in IHD mortality in men and women (p < 0.001), but from 2007 to 2012, changes in IHD mortality were not significant in men [y = 151 + 0.04 (R2 = 0.02; p = 0.779)] and women [y = 88-0.54 (R2 = 0.24; p = 0.320).ConclusionTrend in mortality from IHD stopped falling in Brazil from 2007 to 2012.

RISK OF HYPERKALEMIA ASSOCIATED WITH THE USE OF BLOCKERS OF THE RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM IN THE TREATMENT OF HEART FAILURE: A REVIEW

Heart failure (HF) is the leading cause of hospitalizations for cardiovascular diseases in Brazil. Hyperkalemia is an important adverse effect of therapy for HF. Several factors affect the incidence of hyperkalemia in patients treated for HF, as well as the presence of comorbidities and the use of associated medications. The aim of this study is to gather new evidence regarding the risk of hyperkalemia in patients treated for HF. The well-established therapy for HF involves drugs that may lead to hyperkalemia as inhibitors of angiotensin converting enzyme blockers, angiotensin II receptor blockers, aldosterone receptor blockers and direct renin inhibitors. The high incidence of HF in elderly patients with comorbidities such as diabetes mellitus and renal insufficiency increases the risk of hyperkalemia. Anti-inflammatory drugs, trimethoprim-sulfamethoxazole and heparin may aggravate the situation. Conclusion: Given the risk of hyperkalemia in patients undergoing treatment for HF, cautious monitoring of renal function and serum potassium should be performed.

Translation and cross-cultural adaptation of the Duke activity status index to Brazilian Portuguese

INTRODUCTION: The limited number of valid and reliable questionnaires for the evaluation of exercise tolerance has stimulated the development of simple international assessment tools for this purpose, one of the most widely used of which is the Duke Activity Status Index (DASI). However, this index has not yet been translated and adapted to the Portuguese language. OBJECTIVE: To develop a Brazilian version of the DASI and cross-culturally adapt it for the evaluation of cardiorespiratory fitness among patients with cardiovascular disease in Brazil. MATERIALS AND METHODS: The translation process involved four stages: initial translation, back-translation, multidisciplinary committee review and pre-test with 16 subjects (8 cardiac patients and 8 healthy individuals). Patients were screened from outpatient Cardiac Surgery, São Paulo Hospital. The Mann-Whitney and chi-square tests were employed to determine differences between controls and individuals with heart disease. RESULTS: The sample was characterized by individuals aged ≥ 50 years who were mainly from the southeastern region of Brazil (62.5%) and were non-smokers (56.2%). Less than half of the cohort was considered physically active (43.75%). The level of non-understanding was less than 10% of the sample. Doubts were prevalent among individuals with heart disease (75%) regarding the level of fatigue caused when performing a task. CONCLUSION: The present findings demonstrate that the DASI was successfully translated and adapted to Brazilian Portuguese.

Mortalidade por doenças cardiovasculares no Brasil e na região metropolitana de São Paulo: atualização 2011

Cardiovascular diseases (CVD) are the leading causes of death in our population. There was a progressive decrease in mortality due to CVD up to 2005. To update the trends in mortality from cardiovascular diseases in Brazil and in the metropolitan region of São Paulo (MRSP) from 1990 to 2009. Mortality and population data were obtained from the Brazilian Institute of Geography and Statistics and the Ministry of Health. The risk of death was adjusted by the direct method, having as reference the world population in 2000. There was a progressive decrease in the risk of death from ischemic heart disease (IHD) and stroke in Brazil and in the MRSP. From 1990 to 2009, there was a decrease in mortality from IHD and stroke in men and women in Brazil and in the MRSP. There was a greater reduction in mortality from IHD in men in the MRSP than in Brazil (36.24% vs. 23.35%, p <0.001) and in women in the MRSP (44.55% vs. 29.5%; p <0.001). The highest reduction in stroke mortality was observed in men in the MRSP, when compared to Brazil (42.43% vs. 34.9%, p = 0.036) and an equal reduction in women in the MRSP and in Brazil (42.98% vs. 36.15%, p = 0.082). The decrease in mortality was significant for all age groups. We observed a progressive decrease in mortality from CVD, IHD and stroke in Brazil and in the MRSP. In spite of this decrease, we still have high rates of mortality from these diseases.

Racionalidade e métodos do registro ACCEPT - Registro Brasileiro da Prática Clínica nas Síndromes Coronarianas Agudas da Sociedade Brasileira de Cardiologia

Assessing the Brazilian clinical practice in patients with acute coronary syndrome, in public and private hospitals to identify gaps in the incorporation of clinical interventions with proven benefit.To develop a registry of patients diagnosed with acute coronary syndrome to assess demographics, morbidity, mortality, and standard practice in the care of this condition. Besides, to assess the prescription of evidence-based interventions such as aspirin, statins, beta blockers and reperfusion, among others.Registry-type prospective observational study intended to document hospital clinical practices of acute coronary syndrome in public and private hospitals in Brazil. In addition, longitudinal follow-up will be held until discharge and measurement of mortality and occurrence of serious events at 30 days, 6 and 12 months.The findings will be presented one year after the start of collection (September 2011), and consolidated after a meeting with the population to discuss the objectives sought.The analysis of this multicenter registry will design a horizontal perspective for the treatment of patients suffering from cardiovascular disease in Brazil.

Desigualdade social e mortalidade precoce por doenças cardiovasculares no Brasil

To investigate the relationship between some indicators of socioeconomic status and adult mortality due to cardiovascular diseases in Brazil. Adult deaths (aged between 35 and 64 years) due to cardiovascular diseases and subgroups of ischemic heart disease and cerebrovascular-hypertensive diseases were assessed during the period from 1999 to 2001. Data was obtained from the National Mortality Information System. Ninety-eight Brazilian municipalities with the best quality of information were included in the study. Simple and multiple linear regression methods were used to assess the association between socioeconomic indicators and mortality due to cardiovascular diseases. Univariate analysis revealed a negative association between mortality due to cardiovascular and cerebrovascular-hypertensive diseases and income and education and a direct association with poverty rates and poor housing conditions. In regard to ischemic heart disease, there was an inverse association with poverty rates and education indicators and a direct association with poor housing conditions. After adjusting to other variables, education still remained associated to mortality due to cardiovascular disease and its subgroups. For each percent point increase in adults with high level of education, there was a decrease of 3.25 per 100,000 inhabitants in the mortality rate due to cardiovascular diseases. The analysis of mortality in those municipalities has shown there is an inverse association between cardiovascular diseases and social and economic factors, especially education. Is it likely that better education can improve life conditions and thus have a positive impact on premature mortality.

Stress influence on genesis, onset and maintenance of cardiovascular diseases: literature review.

Recent mortality profiles in Brazil show that circulatory diseases are the leading cause of death in Brazil. These disorders contribute to 34% of deaths, with 50% of those deaths occurring in people under 50 years of age, that is, in people who are still active in the workforce. We assume that the growing incidence of cardiovascular diseases has occurred as the globalization of Brazil continues and brings with it the associated health risk factors of modern lifestyles, including stress. This paper reports the evidence on the influence of stress in the development, onset and progress of cardiovascular diseases. We aim to define the concept of stress and to point systematically to the interrelationships between its emotional and bodily manifestations through a discussion of the history and study of stress. We then suggest that factors leading to the experience of stress in Brazil are no different than in any other modern nation. We further offer a perspective on nursing interventions currently undertaken in Brazil in both hospital and community settings, with their more recent emphasis on health promotion and prevention. An extensive literature review was undertaken. The data presented here were selected from reviews and clinical studies described in MEDLINE, LILACS, SciELO databases, as well as in the classical literature. We also refer to the current Brazilian literature on the prevalence of cardiovascular diseases and their associated risk factors. The incidence of cardiovascular diseases in Brazil is rising. Because of the globalization of Brazilian society, with its consequent competitiveness and accelerated modern lifestyles, Brazilians are no less immune to the usual health risk factors associated with cardiovascular diseases. Stresses associated with a modern lifestyle, however, are emerging as a new and major risk for developing cardiovascular diseases in Brazil.

Current status of myocarditis and endomyocardial biopsy in Brazil.

The results presented here show the inadequate attention that has been paid to myocarditis as a clinical entity and to employing endomyocardial biopsy examination as a valuable tool for diagnostic and research purposes. The results must be interpreted with caution, as otherwise false conclusions may be drawn as far as the epidemiological profile of cardiovascular diseases in Brazil is concerned. The data are likely to be influenced by the striking regional differences in development which are reflected in the scientific output. The high incidence of positive serology in patients in endemic areas of Trypanosoma cruzi infection is a further complication. It is possible that Chagas' disease may be overestimated clinically, decreasing therefore the interest in clarifying diseases with comparable clinical features. Myocarditis (excluding a protozoal etiology) and dilated (congestive) cardiomyopathy may serve as examples. Considering these various points, together with the complex and multi-disciplinary requirements of obtaining and interpreting catheter biopsies of the heart explains the limited clinical application of this technique in Brazil.