Cause Of Death In Brazil Research Articles

Cardiovascular Risk Factors in Nurses Teachers

Background: Cardiovascular diseases are the main cause of death in Brazil and worldwide, being influenced by the presence of risk factors. In the current life context, these factors are increasingly present in individuals, also related to occupation, which require extensive workload, performance, reasoning, goal plan and maximum dedication from the individual, as is the case of undergraduate teachers in Brazil.
 Objective: To identify cardiovascular risk factors in teaching nurses of a private higher education institution (HEI) in Belém, PA, Brazil.
 Study Design: A cross-sectional, descriptive survey study with a quantitative approach. At a private HEI in Belém-PA, in March and April 2019.
 Methodology: Performed with 11 teachers nurses that the HEI had. A form was used on the teacher's profile and risk factors. Data were analyzed by simple descriptive statistics through the Bioestat 5.0 program.
 Results: They are young adults, married, with an extensive workload; 45.45% of them have already had alterations in the HDL and LDL levels, with a family history of Systemic Arterial Hypertension 72.73% and Diabetes Mellitus 81.82%. 45.45% use oral contraceptives. They have a low-fiber diet, rich in lipids and sodium, and practice physical activity. 72.73% consume alcoholic beverages, and none are smokers.
 Conclusion: The teaching profession, due to extensive workload and stressful activities, offers a risk for inadequate nutrition, sedentary lifestyle, and lack of time for leisure. These factors are associated with other existing factors, which may increase the chances of cardiovascular diseases in these professionals.

ACIDENTES DE TRÂNSITO

Os Acidentes de Trânsito (AT) matam no Brasil cerca de 47 mil pessoas em 2018, segundo a ONU, é a segunda maior causa de morte no Brasil, e atualmente o país ocupa o quinto lugar no ranking dos países com maiores índices de morte no trânsito, de acordo com a OMS, atrás apenas da Índia, China, EUA e Rússia. O gasto nacional com vítimas de AT custeada pelo SUS alcançou um montante de 56 bilhões de reais (ONSV,2014). No estado de Roraima, os AT tornaram-se um grave problema de saúde porque cerca de 90% das internações hospitalares nos leitos são ocupados por vítimas de AT. O objetivo da pesquisa foi apontar quais os tipos de impactos os AT causam nos setores de saúde e trânsito de Roraima. A metodologia quanto a abordagem foi do tipo quali-quatitativa com enfoque descritivo, isto é justificável porque aplicou-se como instrumento de coleta de dados a pesquisa documental e de campo (questionário e consulta em arquivos públicos). O estudo revelou que na saúde os AT provocam a superlotação dos leitos, excesso no consumo de medicamento, comprometimento e sobrecarregamento de profissionais de saúde, ocorrência de óbitos e uma legião de sequelados, tendo a maioria pessoas do sexo masculino e jovens na faixa etária de 20 a 39 anos. Quanto na área de trânsito constatou-se que o mau comportamento dos condutores (imperícia, imprudência e negligência), e o desrespeito às leis de trânsito foram as causas principais do AT.

Impact on mortality of being seropositive for hepatitis C virus antibodies among blood donors in Brazil: A twenty-year study

IntroductionHepatitis C virus (HCV) infection is a major health problem associated with considerable risk of mortality in different regions of the world. The purpose of this study was to investigate the contribution of HCV infection on all-cause and liver-related mortality, in a large cohort of blood donors in Brazil.MethodsThis is a retrospective cohort study of blood donors from 1994 to 2013, at Fundação Pró-Sangue—Hemocentro de São Paulo (FPS). This cohort included 2,892 and 5,784 HCV antibody seropositive and seronegative donors, respectively. Records from the FPS database and the Mortality Information System (SIM: a national database in Brazil) were linked through a probabilistic record linkage (RL). Mortality outcomes were defined based on ICD-10 (10th International Statistical Classification of Diseases and Related Health Problems) codes listed as the cause of death on the death certificate. Hazard ratios (HRs) were estimated for outcomes using Cox multiple regression models.ResultsWhen all causes of death were considered, RL identified 209 deaths (7.2%) among seropositive blood donors and 190 (3.3%) among seronegative blood donors. Donors seropositive for HCV infection had a 2.5 times higher risk of death due to all causes (95% CI: 1.76–2.62; p<0.001). When only liver-related causes of death were considered, RL identified 73 deaths among seropositive blood donors and only 6 among seronegative blood donors. Donors seropositive for HCV infection had a 23.4 times higher risk of death due to liver related causes (95% CI: 10.2–53.9; p<0.001). Donors seropositive for HCV had a 29.5 (95%CI: 3.9–221.7), 2.8 (95% CI: 1.4–5.5) and a 1.9 (95% CI: 1.2–3.0) times higher risk of death due to hepatocellular carcinoma, infection or trauma, respectively, compared to seronegative donors.ConclusionsAll-cause and liver-related mortality rate was increased among blood donors seropositive for HCV compared with the mortality rate among seronegative blood donors. Our data confirms HCV as a relevant cause of death in Brazil and also suggest that interventions directed at following patients even after access to specific drug treatment are urgent and necessary.

The relation between cardiovascular mortality and development: Study for small areas in Brazil, 2001–2015

Background: Cardiovascular disease (CVD) is one of the most serious health issues and the leading cause of death in Brazil, accounting for 30% of all deaths. Previous research shows that CVD mortality rates are not uniformly distributed across Brazil and have been changing over time. There is also previous evidence from other countries that economic development and improvements in the educational level have important effects in reducing CVD mortality. Objective: The goal of this paper is to contribute to this discussion by investigating the relation between CVD mortality and economic development over time and space, measured by gross domestic product (GDP) per capita, in Brazilian micro-regions from 2001 to 2015. Methods: We used data from the Mortality Information System (SIM-DATASUS) from 2001 to 2015. GDP data by micro-region were extracted from the Sistema IBGE de Recuperacao Automatica (SIDRA). Bivariate maps were used to establish the relationship between CVD mortality and GDP per capita. Results: The results show that GDP per capita increased in all micro-regions between 2001 and 2015. The results also suggest a rapid decline in CVD mortality in the South and Southeast micro-regions and a slower decline in the Central-West region. Meanwhile, the less developed North and Northeast regions showed an increase in CVD mortality over time. This spatial heterogeneity over the examined period appears to be associated with access to proper healthcare and strongly related to socioeconomic factors. In addition, males have higher mortality rates than females in approximately 72% of micro-regions. Contribution: This study provides useful clues for policymakers establishing public health planning and effective measures for the prevention of deaths from cardiovascular disease. The reduction of CVD mortality can positively impact GDP growth because it can increase life expectancy and consequently enable people to contribute to the Brazilian economy for a longer time.

Stroke protocol in a hospital of the inland of Brazil: Five years of experience

Stroke has a major impact on health, as it is the leading cause of disability and the second leading cause of death in Brazil. The implementation of a stroke protocol improves the results of a health institution. To present the experience of implantation of the stroke protocol in a hospital of the inland of Brazil. A retrospective study of the medical records of all patients treated with an initial stroke suspicion was carried out between January 2014 and December 2018. We will present data on the number of strokes, number of thrombolysis performed , quality indicators: time to perform skull CT, assessment of speech-language pathologist before diet and mortality During the five-year period, 1606 stroke patients were diagnosed, of which 1285 were ischemic stroke (80.0% of the total). A total of 61 thrombolysis were performed. The percentage of skull CT in 45 minutes in 2014 was 45.2%, and in the year 2017 it reached a percentage of 88.7%. The percentage of evaluation of speech-language pathologist before the diet increased from 45.3% in 2014 to 81.0% in 2018. The mortality rate in the year 2014 was 20.5%, reaching 24.3% in 2015, up to 18% in the year 2018. Despite all the difficulties such as poor human resources and the absence of a stroke unit, the use of the stroke care protocol allowed the improvement in the indicators and the clinical outcome of these patients.

Correlation between age and pulse wave velocity in adults, salvador, bahia, brazil in a populationbased study: Design, methods and preliminary results

Cardiovascular diseases are the leading cause of death in Brazil. The pulse wave velocity (PWV) is an independent cardiovascular risk factor detecting arterial stiffness, correlated to age, among other variables

Effects of Photobiomodulation on Apoptosis Process After Induced Myocardial Infarction in Rats: Analysis of Gene Expression

Cardiovascular Diseases (CVD) are the main cause of death in Brazil and in the rest of the world. Ischemic heart diseases represent 30% of deaths by CVD in occidental countries. It is well known that Myocardial Infarction (MI) harms contraction and is responsible of a hypertrophy process of the cardiomyocytes, besides the reduction of ventricle wall thickness, modifying extracellular matrix and promoting metabolic changes. Those metabolic processes stimulate a compensatory rearrangement by targeting three different morphologic regions: infarcted area, borderline area and the remote area to the MI. New treatments are aimed at the modulation of various cardiac processes, such as cardiac muscle contraction, metabolism, apoptosis, fibrosis formation and control of hypertrophy, with the objective of revert or prevent damage on those heart areas. Nowadays, Low‐Level Laser Therapy (LLLT) has become an alternative treatment by its capacity of modulation various biological processes and, depending on dose and wavelength parameters, anti‐inflammatory proprieties and faster cell proliferation. However, the action of the LLLT has not yet been elucidated and little is known about the remaining myocardium behaviour on this treatment, specially when related to apoptosis. Thus, the present study aims the evaluation of LLLT effects on genes related to apoptosis, by analysing TP53, MAP3K2, Bax, MAPK14 and Fas mRNA. The study, approved by the local ethics committee, was designed by the promotion of anterior descending coronary artery occlusion and posterior laser irradiation in the remote region to the myocardial infarction in rats, which were submitted to an echocardiography to evaluate myocardial function after therapeutics. Heart samples underwent an analysis by Real‐Time Polymerase Chain Reaction Array. Data showed that LLLT was capable of modulating apoptosis process, by downregulating TP53 gene, when compared to rats which underwent only anterior descending coronary artery occlusion. The study concludes that LLLT may stimulate cellular survival after MI, by the inhibition of apoptosis of remote region cells.Support or Funding InformationCNPq, CAPES, UNINOVEThis abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

The first central nervous system autopsy in Southern Brazil.

The history of Anatomical Pathology in the state of Paraná, in southern Brazil, is closely linked with the foundation of the Universidade Federal do Paraná (UFPR). This study identified the first central nervous system (CNS) clinical autopsy performed by the Department of Anatomical Pathology of the UFPR. This study reviewed the autopsy report archives of the Hospital de Clínicas-UFPR from 1951 onward. The clinical anatomy interpretations of the autopsy report and possible etiologic agents were discussed. The first adult clinical autopsy with CNS study was performed on April 23, 1952 on a 45-year-old man with lobar pneumonia with abscesses complicated by bacterial meningitis. This case was the first CNS clinical autopsy performed in the state of Paraná and, possibly, in southern Brazil. The death was due to an infectious disease, which was the main cause of death in Brazil in the 1950s.

Profile of deaths from unspecified stroke after investigation of garbage codes in 60 cities in Brazil, 2017.

Unspecified stroke (UnST) is of great importance in mortality statistics, as it is the fourth leading cause of death in Brazil. The objective of this study was to identify the profile of reclassified causes of death after investigation of deaths caused by UnST in Brazil. All deaths registered as UnST in 2017 in the Mortality Information System (SIM) were considered as garbage codes. The specific causes, detected after investigation in 60 selected cities, were analyzed by age and sex. Of the total deaths due to UnST identified in these 60 cities (n = 11,289), 25.8% were investigated. Of these, 56.3% were reclassified to ischemic stroke, 12.7% to hemorrhagic stroke, and 23.3% to other specific causes, such as diabetes and chronic kidney disease, in both sexes. The higher proportion of deaths due to ischemic stroke in comparison to hemorrhagic stroke was expected. However, the detection of other specific causes outside the stroke group indicates possible quality problems in the filling of death certificate (DC). The investigations allowed the identification of subgroups of deaths due to stroke. In addition to the research, however, it is important to conduct physician training in the adequate filling in of the DC, in order to improve estimates of specific stroke mortality, and to enable appropriate targeting of health actions and services.

Self-reported medical diagnosis of heart disease and associated risk factors: National Health Survey.

To analyze the risk factors associated with the self-reported medical diagnosis of heart disease in Brazil. This is a cross-sectional study, analyzing information from 60,202 adult participants of the Brazilian National Health Survey in 2013. Heart disease was defined by self-reported medical diagnosis of heart disease. We analyzed associations between the occurrence of disease and sociodemographic characteristics, health conditions and lifestyle. A hierarchical binary logistic regression model was used. The prevalence of self-reported diagnosis of heart disease in Brazil was 4.2% (confidence interval of 95% [95%CI] 4.0 ‒ 4.3) and was associated with females (odds ratio [OR] = 1.1; 95%CI 1.1 ‒ 1.1), people 65 years old or older (OR = 4.7; 95%CI 3.3 ‒ 5.6), poor or very poor health conditions (OR = 4.1; 95%CI 3.5 ‒ 4.6) and fair health conditions (OR = 2.4; 95%CI 2.2 ‒ 2.7), hypertensive individuals (OR = 2.4; 95%CI 2.2 ‒ 2.7), those with increased cholesterol (OR = 1.6; 95%CI 1.5 ‒ 1.8), overweight individuals (OR = 1.5; 95%CI 1.4 ‒ 1.8) and obese individuals (OR = 2.0; 95%CI 1.7 ‒ 2.2), sedentary behavior (OR = 1.5; 95%CI 1.02 ‒ 2.1), former smokers (OR = 1.4; 95%CI 1.3 ‒ 1.6) or current smokers (OR = 1.2; 95%CI 1.03 ‒ 1.3) and the consumption of fruits and vegetables 5 or more days each week (OR = 1.5; 95%CI 1.1 ‒ 1.5). The importance of knowledge on the prevalence of heart disease and associated risk factors in the present Brazilian epidemiological context must be emphasized because it guides actions to control and prevent cardiovascular diseases, the leading cause of death in Brazil and worldwide.

Characterisation of ocular involvement in an experimental model of neuroschistosomiasis mansoni.

The Global Burden of Disease Study 2010 listed schistosomiasis among the leading 100 causes of death in Brazil, responsible for 3.6% of the estimated total of deaths globally. Eye and adnexa are very rarely affected by schistosomiasis mansoni, with limited documentation of ocular pathology in this setting. This short communication reports ocular histolopathological findings in a murine model of neuroschistosomiasis mansoni. Lesions were found in the bulbar conjunctiva, lacrimal gland, choroid and corneoscleral limbus.

Efeito de três protocolos de treinamento na pressão arterial e frequência cardíaca em normotensos

Introdução: Doenças cardiovasculares representam a principal causa de morte no Brasil, sendo uma destas a hipertensão arterial. A prática regular de exercício físico permite um melhor controle da pressão arterial e indivíduos com maiores níveis de aptidão física apresentam um menor risco para desenvolver hipertensão. Além disso, pessoas com frequências cardíacas de repouso mais baixas apresentam uma menor probabilidade de desenvolverem cardiopatias. Objetivo: Comparar o efeito do treinamento aeróbico, de força e combinado nas pressões arteriais sistólica, diastólica e média e na frequência cardíaca de repouso em homens normotensos. Métodos: Ensaio clínico aleatorizado com três grupos experimentais e um grupo controle. Cada grupo experimental realizou uma destas três modalidades de treinamento, três vezes por semana, durante doze semanas. Participaram homens de 30 a 57 anos, sedentários e normotensos. A pressão arterial e a frequência cardíaca pré e pósintervenção foi aferida utilizando um aparelho automático validado e seguindo recomendações da Sociedade Brasileira de Cardiologia. Os dados foram comparados pelo teste t de Student e pela ANOVA one-way. Resultados: 39 voluntários completaram o estudo. Não houve variação significante da pressão arterial sistólica, diastólica e média e frequência cardíaca nos três grupos de treinamento entre pré e pós-intervenção. Apenas a frequência cardíaca nestes grupos apresentou diferenças significativas quando comparada ao grupo controle. Conclusão: Resultados sugerem que o treinamento físico, realizado três vezes por semana, durante doze semanas, não é suficiente para reduzir a pressão arterial de modo significativo em homens normotensos, seja este treinamento aeróbico, de força ou combinado.

Risk factors for the ill-defined causes of death in the Brazilian states: a multilevel analysis.

This study describes the spatial-temporal changes of the proportion of ill-defined causes of death in Brazil (1998-2012) and investigates which demographic and socioeconomic factors affect this proportion. We collected information of the proportion of ill-defined causes of death by age (15-59 years), sex, period, locality, and socioeconomic data. We used a multilevel Poisson model to investigate which factors affect the risk of ill-defined causes of death. Unlike states located in the South and Midwest, we detected clusters with high proportional levels of these deaths in states in the North and Northeast regions. A greater proportion occurred in 1998-2002 (0.09), in the North and Northeast (0.14 and 0.12, respectively), in older age groups (0.09), and in places with poor socioeconomic conditions. The adjusted analysis showed differences in proportion according to the region, age, period, schooling, social inequality, and income. The results indicate that the lower the age group and the better the socioeconomic situation, the lower the risk to register the cause of death as ill-defined. Although over the past years, the quality of Brazil's mortality data has gradually increased, investments towards improving mortality registries cannot be discontinued.

In the Heart of the Amazon: Noncommunicable Diseases and Apolipoprotein E4 Genotype in the Riverine Population.

The Amazon River basin is the largest tropical forest in the world. Most of the Amazon belongs to Brazil, a developing country that currently faces huge challenges related to the consolidation of its universal healthcare system. Noncommunicable diseases (NCDs) are the leading cause of death in Brazil, accounting for 74% of all deaths, and NCDs are probably underestimated in Amazonian population because of their geographical isolation and the precariousness of riverine communities. Important risk factors, such as genetic susceptibility, remain undetermined in the riverine population. This study performed fasting blood sugar (FBS) and blood pressure measurements and investigated the presence of the ε4 allele of apolipoprotein E (APOE4) to determine the prevalence of diabetes, hypertension and the genetic risk of NCDs. FBS and APOE4 were measured in blood samples from 763 participants using spectrometry and real-time PCR; 67.5% showed altered measurements, and 57.9% had never been diagnosed or treated. Altered FBS was found in 28.3% of the participants, hypertension in 57.6% and APOE4 in 32.0%. The health profile of the riverine population appears to differ from that of urban population in the Amazon. Additional risk factors for NCDs, such as environmental contamination and nutritional transition, may contribute more than increased genetic susceptibility to the prevalence of altered FBS and hypertension. Our results will help guide the development of preventive strategies and governmental actions for more effective management of NCDs in the Amazon area.

Cancer chemotherapy failure: a synthetic view

O Câncer é uma doença de alta prevalência e letalidade, sendo uma das principais causas de morte no Brasil e no mundo. Nas últimas décadas, grandes avanços foram alcançados na luta contra o câncer, com alguma tradução em curabilidade. Contudo, esses avanços ainda não são suficientes, de modo que o prognóstico do paciente com câncer ainda é, geralmente, desfavorável. De fato, há ainda diversas lacunas em nosso conhecimento a respeito dessa complexa e heterogênea doença. Diversos tratamentos contra o câncer já estão disponíveis à prática clínica - e outros ainda estão sendo desenvolvidos - uma delas a quimioterapia, tanto a tradicional quando a alvo dirigida, utilizada, sobretudo, como tratamento primário contra doença metastática ou secundário contra doença local ou localmente avançada. Diversos fatores podem atuar, através de vários mecanismos, de modo a determinar a falha do tratamento quimioterápico. Esses fatores estão distribuídos ao longo de diversas escalas biológicas, do nível molecular ao socioeconômico, tornando uma visão holística do tratamento um grande desafio, prejudicando a compreensão acerca do que pode dar errado. O objetivo deste trabalho é ser uma leitura compreensiva - mas não superficial - dos muitos fatores que influenciam o sucesso de quimioterapia. Deste modo, o resultado foi a presente discussão, na qual foram expostos avanços recentes, desafios a serem superados e novos caminhos a serem explorados na área.

Cerebrovascular and hypertensive diseases as multiple causes of death in Brazil from 2004 to 2013.

The proportion of deaths attributed to hypertensive diseases (HYPDs) was only 50% of that registered for cerebrovascular diseases (CBVDs) in 2013 in Brazil. This article aims to evaluate mortality related to HYPDs and CBVDs as multiple causes of death, in Brazil from 2004 to 2013. Analysis of historical series of secondary data obtained from Brazilian official registries. Data about the deaths were obtained from the Mortality Information System of the Brazilian Ministry of Health, available on the DATASUS website. CBVDs and HYPDs were evaluated according to their mentions as the underlying cause of death or entry in any line of the death certificates (DCs), according to their International Statistical Classification of Diseases and Related Health Problems, 10th Revision codes. When CBVDs were the underlying causes of death, HYPDs were mentioned in 40.9% of the DCs. When HYPDs were the underlying causes of death, CBVDs were mentioned in only 5.0%. When CBVDs were mentioned without HYPDs, they were selected as the underlying cause of death 74.4% of the time. When HYPDs were mentioned in DCs without CBVDs, HYPDs were selected 30.0% of the time. In 2004, the frequency of any mention of HYPDs relative to the frequency of HYPDs cited as underlying causes increased fourfold and was followed by a plateau until 2013. In contrast, the frequency of any mention of CBVDs relative to the frequency of CBVDs as underlying causes decreased in the same period. Because this study was based on DC records, it was limited by the way these documents were completed, which may have included lack of record of the causes related to the sequence that culminated in death. When deaths related to HYPDs were evaluated as multiple causes of death, they were mentioned up to four times more often than when they were selected as underlying causes of death. This reinforces the need for better control of hypertension to prevent deaths.

Knowledge about Stroke in Belo Horizonte, Brazil: A Community-Based Study Using an Innovative Video Approach

Background and Purpose: Stroke is a leading cause of death in Brazil. Knowledge about the clinical manifestations of stroke as well as its risk factors and its management is still poor in the country. We intended to assess the stroke knowledge of an urban population in Belo Ho­rizonte, Brazil. Methods: Individuals assisted by a basic health unit were interviewed between February and August 2014. After demographic data collection, the participants were asked to watch a video that consisted of a person presenting stroke signals and they were asked to answer questions about the condition shown on the video. Afterwards, they answered a semi-structured questionnaire to evaluate their stroke knowledge. Results: A total of 703 people were interviewed (62.1% female, mean age 46.7 years). Recognition of a person having a stroke on the presented video was achieved by 56.1% of the subjects. Female sex (p = 0.029) and contact with someone who had had a stroke (family member [p < 0.01], neighbor [p < 0.05]) increased the odds of correctly identifying the condition showed on the video. The most commonly mentioned clinical manifestations of stroke were weakness (34.7%) and speech disturbance (31.6%). Stroke risk factors that were most named were “unbalanced diet” (42.3%) and hypertension (33.7%). Most participants (66.8%) said they would call the emergency medical services, while 17.8% would go directly to a hospital. Only 17 subjects knew thrombolytic therapy for acute stroke. Conclusion: Female sex and a family history of stroke increased the odds of recognizing the signs of stroke. Knowledge about the clinical manifestations, risk factors, and management of stroke was low in the studied population.

Estimated costs of hospitalization due to coronary artery disease attributable to familial hypercholesterolemia in the Brazilian public health system.

Cardiovascular diseases are the leading cause of death in Brazil, imposing substantial economic burden on the health care system. Familial hypercholesterolemia (FH) is known to greatly increase the risk of premature coronary artery disease (CAD). This study aimed to estimate the economic impact of hospitalizations due to CAD attributable to FH in the Brazilian Unified Health Care System (SUS). Retrospective, cross-sectional study of data obtained from the Hospital Information System of the SUS (SIHSUS). We selected all adults (≥ 20 years of age) hospitalized from 2012--2014 with primary diagnoses related to CAD (ICD-10 I20 to I25). Attributable risk methodology estimated the contribution of FH in the outcomes of interest, using international data for prevalence (0.4% and 0.73%) and relative risk for events (RR = 8.56). Assuming an international prevalence of FH of 0.4% and 0.73%, of the 245,981 CAD admissions/year in Brazil, approximately 7,249 and 12,915, respectively, would be attributable to an underlying diagnosis --of FH. The total cost due to CAD per year, considering both sexes and all adults, was R$ 985,919,064, of which R$ 29,053,500 and R$ 51,764,175, respectively, were estimated to be attributable to FH. The average cost per FH-related CAD event was R$ 4,008. Based on estimated costs of hospitalization for CAD, we estimated that 2.9-5.3% are directed to FH patients. FH can require early specific therapies to lower risk in families. It is mandatory to determine the prevalence of FH and institute appropriate treatment to minimize the clinical and economic impact of this disease in Brazil.

Trends in mortality rates where alcohol was a necessary cause of death in Brazil, 2000-2013.

ABSTRACTObjectiveTo analyze trends in mortality due to diseases and conditions fully attributable to alcohol in Brazil.MethodsThis was an ecological time-series study. Proportional, specific, and age-standardized mortality rates between 2000 and 2013 that were due to underlying or contributing causes fully attributable to alcohol use were analyzed by sex, ethnicity/skin color, age group, and region of residence in the country. Data on deaths were obtained from the Brazilian Mortality Information System (SIM). Prais-Winsten regression was used to analyze trends.ResultsDeaths with underlying causes and/or conditions contributing to death fully attributable to alcohol accounted for 2.5% of total deaths in the period. There were more deaths among men (3.8%) than among women (0.7%). In both sexes, there was a higher proportion of deaths in those 40–49 years old (27.9%) and those of black or pardo (mixed race) skin color (48.8%). Between 2000 and 2013, there was an upward trend in specific mortality rates attributable to alcohol in the country as a whole (average annual growth rate (AAGR) = 5.59%; 95% confidence interval (CI) = 3.55%-7.68%), especially in people aged less than 20 years old, in pardos (AAGR = 13.42%; 95% CI = 9.70%-17.25%), and in residents of the North region (AAGR = 17.01%; 95% CI = 14.94%-19.13%), the Northeast region (AAGR = 15.49%; 95% CI = 10.61%-20.58%), and the Midwest region (AAGR = 8.40%; 95% CI = 5.57%-11.32%).ConclusionAlcohol is an important and growing cause of premature death in Brazil, especially among men, black/pardo people, and the population living in the most disadvantaged regions. This overall increase in the harmful use of alcohol reflects ethnic and socioeconomic inequalities in Brazil, and it also points to the need for population-based policies to reduce the impact of morbidity and to prevent early mortality.

Evolution of Mortality from Diseases of the Circulatory System and of Gross Domestic Product per Capita in the Rio de Janeiro State Municipalities

Abstract Background: Diseases of the circulatory system are the leading cause of death in Brazil and the world, falling progressively during the twentieth century, preceded by an increase in Gross Domestic Product. Objective: To correlate balanced and adjusted mortality rates from circulatory system diseases in the municipalities of Rio de Janeiro state between 1979 and 2010 with the gross domestic product per capita (GDPpc) beginning in 1950. Methods: Population and death data were obtained from the Department of Information and Computer Services at the National Health System/Brazilian Ministry of Health (Departamento de Informatica do Sistema Unico de Saude - Ministerio da Saude - DATASUS-MS). Mortality rates were calculated for Ischemic Heart Disease (IHD), Cerebrovascular Disease (CBVD), and Circulatory System Disease (CSD); adjusted by the direct method; and balanced for ill-defined causes. The GDPpc data were obtained from the Institute of Applied Economic Research (Instituto de Pesquisas Economicas Aplicadas - IPEA). Mortality rates were correlated with socioeconomic indicators using Pearson's linear correlation coefficient to determine the annual optimized lag time. Regression slope coefficients between the dependent disease and independent socioeconomic indicator were estimated. Results: In recent decades, there has been a reduction in mortality from CSD in all Rio de Janeiro state municipalities, mainly due to a decline in mortality from CBVD. The decline in mortality from CSD was preceded by an increase in the GDPpc, and a strong correlation was observed between this index and mortality rates. Conclusion: The evolution of the variation in GDPpc demonstrated a strong correlation with the reduction in CSD mortality. This relationship demonstrates the importance of improving the living conditions of the population to reduce cardiovascular mortality.