Non-communicable Diseases In Brazil Research Articles

The cost of obesity and related NCDs in Brazil: An analysis of hospital admissions, disability retirement benefits, and statutory sick pay

ObjectivesThis study analyses the prevalence of overweight/obesity in Brazil, and its costs regarding hospital admissions (HA), disability retirement benefits (DRB), and statutory sick pay (SSP) associated with obesity-related non-communicable diseases (NCDs). Study designTime-series study. MethodsThis study analyses data from the VIGITEL system (2010–2019) to calculate the body-mass index (BMI) of adult residents in Brazil's state capitals. Data on HA, DRB, and SSP were obtained from Brazil's SIH/SUS and AEPS Infologo systems. Pearson's correlation and linear regression models were applied. The study selected 23 diseases of the International Classification of Disease (ICDs) belonging to chapters C; E; I; and K. Cost values in BRL were deflated using IPCA. ResultsThe results showed a significant increase in overweight and obesity rates in Brazil, with BMI rising by 0.09 kg/m2 annually. Regression analysis revealed that each 1-point increase in the average BMI of the population is associated with an increase of 81,772 (BRL 237.51 million/year) new HA per year, 5541 (BRL 18.8 million/year) new DRB granted per year, and 42,360 (BRL 131 million/year) new SSP per year. Also, every 1 % increase in the share of the Brazilian population with obesity is associated with an increase of 16,973 (BRL 48.8 million/year) new HA per year, 1202 (BRL 3.97 million/year) new DRB granted per year, and 8686 (BRL 26.8 million/year) new SSP per year. Regressions for deflated values showed lower significance, suggesting a strong impact of inflation on health costs in Brazil. ConclusionsObesity prevalence in Brazil implies high direct and indirect costs for the Brazilian government, especially considering circulatory system diseases.

Noncommunicable disease burden in Brazil and its states from 1990 to 2021, with projections for 2030

ObjectivesThe aim of this study was to analyse the burden of disease due to noncommunicable diseases (NCDs) between 1990 and 2021 in Brazil. In addition, this study compared mortality from NCDs with mortality from all causes and COVID-19, analysed NCD mortality trends and projections for 2030, and analysed NCD mortality rates and risk factors attributed to these deaths among the 27 states of Brazil. Study designEcological studies. MethodsThis study used the Global Burden of Disease study (GBD) database from 1990 to 2021. Premature deaths from four NCDs (neoplasms, cardiovascular disease, chronic respiratory diseases and diabetes mellitus) were analysed. The following metrics were used to analyse the burden of NCDs in Brazil: absolute number of deaths, proportional mortality, mortality rate, years of life lost due to premature death (YLL), years lived with disabilities (YLD) and disability-adjusted years of life lost due to premature death (DALY). For comparison between the years studied and states, age-standardised rates were used. ResultsFinding from this study showed that there was increase in the proportion of premature deaths due to NCDs between 1990 and 2019 (29.4 % in 1990, 30.8 % in 2019), and a reduction in 2021 (24.7 %). The mortality rates, DALY and YLL from NCDs declined between 1990 and 2019 (−37.7 %, −34.5 % and −38.3 %, respectively); however, a stability in mortality rates, DALY, YLD, YLL was observed between 2019 and 2021 (−0.1 %, 0.7 %, −0.1 % and 0.8 %, respectively). Between 1990 and 2021, there was a decline in mortality rates, DALY and YLL for most states and an increase in YLD rates. However, results suggest that the Sustainable Development Goal (SDG) for the reduction in mortality from NCDs by one-third by 2030 will not be achieved. The main risk factors associated with premature death from NCDs in 2021 were high blood pressure, tobacco use, dietary risks, high body mass index (BMI) and high blood glucose levels. The correlation between sociodemographic index and percentage change in mortality rates was significant for the following total NCDs, cardiovascular disease, chronic respiratory disease, diabetes and neoplasms. ConclusionsThe current study highlights the importance of deaths from NCDs in Brazil and the worsening of mortality rates since 2016, as a result of austerity measures and the COVID-19 pandemic, which compromises the achievement of the SDG reduced mortality targets for NCDs. There was a reduction in risk factors for NCDs, mainly behavioural, although metabolic risk factors are of great concern and require new strategies to promote health, prevention and comprehensive care.

Promoção da saúde de motoristas de caminhão de longa distância e suas famílias

ABSTRACT Objectives: to describe the development of a Health Information and Communication Technology for the health care of long-haul truck drivers and their families. Methods: this is a description of the development of an Information and Communication Technology, developed from March to September 2023, following the systematization of the experience in five steps: 1) starting point, 2) initial questions, 3) recovery of the lived process, 4) background reflection, and 5) arrival points. Results: the technology called “Work-Family Balance,” electronically available, presents resources for the health care of long-haul truck drivers. It is anchored in studies on the health of long-haul truck drivers, notes from the International Labor Organization, the Strategic Action Plan for Confronting Chronic Diseases and Non-Communicable Diseases in Brazil, 2021-2030, and the Declaration by the International Association of Family Nursing. Final Considerations: the theoretical improvement of nursing can potentially improve the health care of long-haul truck drivers, prevent Chronic Non-Communicable Diseases, and promote work-life balance to achieve the goals of Agenda 2030.

Association between food insecurity and chronic noncommunicable diseases in Brazil: a systematic review

RESUMO Objetivo: Analisar a associação da insegurança alimentar (IA) com as doenças crônicas não transmissíveis (DCNTs) no contexto brasileiro. Métodos: O protocolo da revisão foi registrado no International Prospective Register of Systematic Reviews (PROSPERO). As buscas foram realizadas na LILACS e na PubMed (setembro/2022). Foram incluídos estudos observacionais realizados com a população brasileira, publicados a partir de 2003, que: (1) analisam a associação da IA com DCNTs; e (2) utilizam a Escala Brasileira de Insegurança Alimentar (EBIA). Foram excluídos estudos com gestantes e que associam a IA com câncer, infecções sexualmente transmissíveis e doenças musculoesqueléticas e respiratórias. Os estudos foram submetidos à avaliação da qualidade metodológica. Resultados: Foram incluídos 27 estudos transversais, dentre os quais 9 utilizaram dados secundários de inquéritos nacionais e os demais utilizaram dados primários. Os estudos revelaram associação da IA com sobrepeso e obesidade em diferentes faixas etárias. Conclusão: Os artigos incluídos não produziram evidências sobre outras DCNTs de interesse para a saúde no Brasil, como a diabetes e a hipertensão arterial. No entanto, contribuem para corroborar a relação já conhecida entre obesidade e IA. Estudos sobre a temática, com desenho longitudinal, devem ser incentivados.

Temporal Trend in the Coexistence of Risk Behaviors for Noncommunicable Diseases in Brazil: 2009–2019

Individuals can accumulate multiple risk factors for noncommunicable diseases, increasing the chance of adverse health outcomes. We aimed to analyze the temporal trend in the coexistence of risk behaviors for noncommunicable diseases and their association with sociodemographic characteristics among adults in Brazil from 2009 through 2019. This cross-sectional study and time-series analysis was based on data collected by the Surveillance System for Risk Factors and Protection for Chronic Diseases by Telephone Survey (Vigitel) from 2009 through 2019 (N = 567,336). We used item response theory to identify the coexistence of risk behaviors (infrequent consumption of fruits and vegetables, regular consumption of sugar-sweetened beverages, smoking, abusive alcohol consumption, insufficient leisure-time physical activity). We used Poisson regression models to assess the temporal trend in the prevalence of the coexistence of noncommunicable disease-related risk behaviors and associated sociodemographic characteristics. Risk behaviors that most contributed to the occurrence of coexistence were smoking, consumption of sugar-sweetened beverages, and alcohol abuse. Coexistence was more frequent among men and was inversely associated with age and education level. During the study period, we found a significant decrease in coexistence (adjusted prevalence ratio decreased from 0.99 in 2012 to 0.94 in 2019; P = .001), especially before 2015 (adjusted prevalence ratio = 0.94; P = .001). We found a reduction in the frequency of the coexistence of noncommunicable disease-related risk behaviors and their association with sociodemographic characteristics. It is necessary to implement effective actions to reduce risk behaviors, especially behaviors that lead to a greater coexistence of those behaviors.

Clinical condition patterns of fully vaccinated brazilian patients of working age hospitalized due to severe Covid-19 according to ICU admission status

Objective: Discover patterns of clinical condition using data from patients of working age who were fully vaccinated against Covid-19, hospitalized due to the severe form of the disease, according to Intensive Care Unit (ICU) admission status in Brazil. Methods: This is a descriptive study with data extracted from the OpenDataSUS database using Association Rules Mining (ARM). Results: Information related to 3,470 individuals was described, of which 53% (n= 1,842) were male, 63% (n= 2,187) with comorbidities, 33% (n= 1,137) were admitted to the ICU and 23% (n= 796) died. ICU admission was associated with the use of invasive ventilatory support, male gender, presence of comorbidity, and death. For patients with no ICU admission, survival, absence of comorbidity, female gender, use of non-invasive ventilatory support and mild to moderate symptoms of the disease were found. Conclusion: These findings reinforce the need to administer booster doses of the Covid-19 vaccines, but also to strengthen policies to combat chronic noncommunicable diseases in Brazil.

Mortality from chronic respiratory disease in Brazil: time trend and forecasts.

ABSTRACTOBJECTIVE To analyze the time trend of monthly mortality rates from chronic respiratory diseases in Brazil from 1996 to 2017, with forecasts for 2022, besides analyzing the possibility of achieving the goal of the Plano de Ações Estratégicas para o Enfrentamento das Doenças Crônicas Não Transmissíveis no Brasil (Strategic Action Plan to Tackle Chronic Noncommunicable Diseases in Brazil) from 2011 to 2022.METHODS This is an ecological study that uses data from Sistema de Informações sobre Mortalidade (SIM – Mortality Information System), Sistema de Informações Demográficas e Socioeconômicas (Demographic and Socioeconomic Information System) and Pesquisa Nacional por Amostra de Domicílios Contínua (PNAD Contínua – Continuous National Household Sample Survey). We established the age range between 30 and 69 years old and the evolution of the rates over time was made by autoregressive integrated moving average models in R statistical tool.RESULTS Premature mortality rates from chronic respiratory diseases are decreasing in Brazil as a whole, mostly in state capitals. There is also a trend to reach the Ministry of Health’s goal in most of the country. For capitals that tend not to reach the goal, there is an association between mortality and social indicators, healthcare network and frequency of smoking.CONCLUSION This study intends to improve planning of the public health system for the control of chronic respiratory diseases.

Analysis of the impact of coronavirus disease 19 on hospitalization rates for chronic non-communicable diseases in Brazil.

The coronavirus disease (COVID-19) pandemic has impacted health services and healthcare systems worldwide. Studies have shown that hospital admissions for causes related to chronic non-communicable diseases (NCDs) have decreased significantly during peak pandemic periods. An analysis of the impact of the COVID-19 pandemic on hospital admissions for NCDs is essential to implement disability and mortality mitigation strategies for these groups. Therefore, this study aimed to analyze the impact of the COVID-19 pandemic on hospital admissions for NCDs in Brazil according to the type of NCD, sex, age group, and region of Brazil. This is an ecological study conducted in Brazil. Data on hospital admissions from January 1, 2017 to May 31, 2021 were extracted from the Unified Health System's Hospital Admissions Information System. The hospital admission rates per 100,000 thousand inhabitants were calculated monthly according to the type of NCD, sex, age group, and region of Brazil. Poisson regression models were used to analyze the impact of the COVID-19 pandemic on the number of hospital admissions. In this study, the pre-pandemic period was set from January 1, 2017 to February 29, 2020 and the during-pandemic from March 1, 2020 to May 31, 2021. There was a 27.0% (95.0%CI: -29.0; -25.0%) decrease in hospital admissions for NCDs after the onset of the pandemic compared to that during the pre-pandemic period. Decreases were found for all types of NCDs-cancer (-23.0%; 95.0%CI: -26.0; -21.0%), diabetes mellitus (-24.0%; 95.0%CI: -25.0%; -22.0%), cardiovascular diseases (-30.0%; 95.0%CI: -31.0%; -28.0%), and chronic respiratory diseases (-29.0%; 95.0%CI: -30.0%; -27.0%). In addition, there was a decrease in the number of admissions, regardless of the age group, sex, and region of Brazil. The Northern and Southern regions demonstrated the largest decrease in the percentage of hospital admissions during the pandemic period. There was a decrease in the hospitalization rate for NCDs in Brazil during the COVID-19 pandemic in a scenario of social distancing measures and overload of health services.

Health impacts caused by excessive sodium consumption in Brazil: results of the GBD 2019 study

INTRODUCTION: Excessive sodium consumption is associated with increased blood pressure, which is an important risk factor for non-communicable diseases (NCDs). This study therefore aimed to describe the burden of NCDs attributable to excessive sodium consumption among Brazilians. METHODS: This observational study used mortality and Disability Adjusted Life Years (DALY) rates, and their respective uncertainty intervals (UI), from the Global Burden of Disease Study 2019 (GBD 2019). The burden was obtained by the population attributable fraction of each NCD, considering the minimum theoretical value of risk (intake of 0-3g of sodium/day); the excessive consumption proportion in the population, obtained through population inquiries; and the relative risks obtained through meta-analyses.RESULTS: Excessive sodium consumption was the third highest dietary risk contributing to deaths (30,814; 95% UI = 2,034 - 84,130) and DALYs (699,119; 95% UI= 43,130 - 1,914,066) in 2019. States from the Northeast region had the highest age-standardized rates of deaths and DALYs, and the male population was more affected by NCDs caused by excessive sodium consumption. Cardiovascular diseases were the main contributing factors in the burden attributable to excessive sodium consumption.CONCLUSIONS: Regardless of the progress in addressing NCDs related to this risk factor, the impact remains high, especially among men and in the Northeast region. More effective measures are needed to reduce sodium in industrialized products, such as health promotion actions to combat sodium consumption, in order to prevent and control NCDs in Brazil.

Prevalence of Multimorbidity of Chronic Noncommunicable Diseases in Brazil: Population-Based Study.

BackgroundMultimorbidity is the co-occurrence of two or more chronic diseases.ObjectiveThis study, based on self-reported medical diagnosis, aims to investigate the dynamic distribution of multimorbidity across sociodemographic levels and its impacts on health-related issues over 15 years in Brazil using national data.MethodsData were analyzed using descriptive statistics, hypothesis tests, and logistic regression. The study sample comprised 679,572 adults (18-59 years of age) and 115,699 elderly people (≥60 years of age) from the two latest cross-sectional, multiple-cohort, national-based studies: the National Sample Household Survey (PNAD) of 1998, 2003, and 2008, and the Brazilian National Health Survey (PNS) of 2013.ResultsOverall, the risk of multimorbidity in adults was 1.7 times higher in women (odds ratio [OR] 1.73, 95% CI 1.67-1.79) and 1.3 times higher among people without education (OR 1.34, 95% CI 1.28-1.41). Multiple chronic diseases considerably increased with age in Brazil, and people between 50 and 59 years old were about 12 times more likely to have multimorbidity than adults between 18 and 29 years of age (OR 11.89, 95% CI 11.27-12.55). Seniors with multimorbidity had more than twice the likelihood of receiving health assistance in community services or clinics (OR 2.16, 95% CI 2.02-2.31) and of being hospitalized (OR 2.37, 95% CI 2.21-2.56). The subjective well-being of adults with multimorbidity was often worse than people without multiple chronic diseases (OR=12.85, 95% CI: 12.07-13.68). These patterns were similar across all 4 cohorts analyzed and were relatively stable over 15 years.ConclusionsOur study shows little variation in the prevalence of the multimorbidity of chronic diseases in Brazil over time, but there are differences in the prevalence of multimorbidity across different social groups. It is hoped that the analysis of multimorbidity from the two latest Brazil national surveys will support policy making on epidemic prevention and management.

Inequalities in the use of health services by adults and elderly people with and without noncommunicable diseases in Brazil, 2019 National Health Survey.

The objective of this study was to investigate the use of health services and limitations in performing usual activities by adults and elderly people with and without noncommunicable chronic diseases (NCDs), according to sociodemographic strata. This is a cross-sectional study in which data from the 2019 National Health Survey were analyzed. The final sample corresponded to 88,531 households with interviews carried out, referring to individuals aged 18 years and above. The prevalence of use of services by the population with NCDs was compared with that of the population without NCDs and stratified by socioeconomic and demographic variables. Prevalence ratios (PRs) and 95% confidence intervals (95%CI) were calculated. In 2019, 47.6% (95%CI 47.0-48.3) of the population reported having one or more NCDs. Population with NCDs had more medical consultations in the last 12 months (adjusted PR [APR]=1.21; 95%CI 1.20-1.23), used more health services in the last 2 weeks (APR=2.01; 95%CI 1.91-2.11), were referred to more hospitalization (APR=2.11; 95%CI 1.89-2.36), and had more limitations in performing usual activities (APR=2.52; 95%CI 2.30-2.76), compared with the population without NCDs. A positive dose-response gradient was observed between the number of comorbidities and the use of services. In all socioeconomic and demographic strata, the prevalence of indicators was higher in people with NCDs. The presence of NCDs was associated with a higher frequency of use of health services (i.e., consultation, use of services, and hospitalization) and the restriction of usual activities in all socioeconomic and demographic strata.

Metabolic health in Brazil: trends and challenges

Metabolic health in Brazil: trends and challenges

Dietary changes in the NutriNet Brasil cohort during the covid-19 pandemic.

ABSTRACTOBJECTIVETo describe the dietary characteristics of participants in the NutriNet Brasil cohort immediately before and during the covid-19 pandemic.METHODSOur data stem from an adult cohort created to prospectively investigate the relationship between diet and morbidity and mortality from chronic non-communicable diseases in Brazil. For this study, we selected the first participants (n = 10,116) who answered twice to a simplified questionnaire on their diet the day before, the first time when entering the study, between January 26 and February 15, 2020, and the second between May 10 and 19, 2020. The questionnaire inquiries about the consumption of healthy (vegetables, fruits and legumes) and unhealthy (ultra-processed foods) eating markers. Comparisons of indicators based on the consumption of these markers before and during the pandemic are presented for the study population and according to gender, age group, macro-region of residence and schooling. Chi-square tests and t-tests were used to compare proportions and means, respectively, adopting p < 0.05 to identify significant differences.RESULTSFor all participants, we found a modest but statistically significant increase in the consumption of healthy eating markers and stability in the consumption of unhealthy food markers. This favorable pattern of dietary changes during the pandemic occurred in most sociodemographic strata. We observed a less favorable changing pattern, with a tendency to increasing consumption of healthy and unhealthy food markers, in the Northeast and North macro-regions and among people with less schooling, suggesting social inequalities in the response to the pandemic.CONCLUSIONSIf confirmed, the trend of increased consumption of ultra-processed foods in underdeveloped regions and by people with less schooling is concerning, as eating these foods increases the risk of obesity, hypertension and diabetes, whose presence increases the severity and lethality of covid-19.

Trends in mortality due to noncommunicable diseases in Brazil and the sustainable development targets

Abstract Background Monitoring premature mortality due to noncommunicable diseases (NCDs) is a global priority, as part of the Agenda 2030. Objective The current study aims to describe the mortality trends and disability-adjusted life years (DALYs) lost due to NCDs between 1990 and 2017 for Brazil and states, projections for 2030. Methods We analyzed the following NCDs: cardiovascular diseases, chronic respiratory diseases, neoplasms, diabetes mellitus, comparing deaths and mortality rates between 1990 and 2017, for Brazil and states. The study used the concept of premature mortality used by the World Health Organization (30 to 69 years). The absolute number of deaths, mortality rates, DALYs, years of life lost (YLL), were used, comparing 1990 and 2017. We also analyzed the premature death fraction (YLL) for NCDs attributable to risk factors. Results There was a reduction of 35,3% from 509.1 deaths/100,000 inhabitants (1990) to 329.6 deaths/100,000 inhabitants due to NCD in 2017. DALYs rate decreased by 33.6% and the YLL rate by 36.0% in the same period. There was a reduction in the NCD rates in all 27 states. The main risk factors related to premature deaths by NCDs in 2017 among women were - high body mass index, diet risks, high systolic blood pressure, tobacco, and among men, diet risks, high systolic blood pressure, tobacco, high body mass index. Trends in mortality rates due to NCDs were declining in the period, however, after 2015, the curve reversed and fluctuation and tendency to increase rates were observed. Conclusions Trends of mortality rates by NCD were declining in the period, however, after 2015, the curve was inverted and the fluctuation and trend of increasing rates was observed, which can compromise the SDG goals in 2030. Key messages The austerity policies adopted and the economic crisis in Brazil after 2015, resulted in increased poverty and worsening NCD mortality indicators. With the NCD indicators worsening in 2015, SDG targets may not be achieved.

A Telephone Surveillance System for Noncommunicable Diseases in Brazil.

A Telephone Surveillance System for Noncommunicable Diseases in Brazil.

Socio-economic and demographic characteristics associated with risk behaviour patterns for chronic non-communicable diseases in Brazil: data from the National Health Survey, 2013.

To identify risk behaviour patterns for chronic non-communicable diseases (NCD) in the Brazilian population and to investigate associated socio-economic and demographic factors. Factor analysis was used to identify patterns considering the following risk behaviours: consumption of soft drinks/artificial juice, sweet foods, red meat with apparent fat, chicken skin; inadequate consumption of fruits and vegetables; alcohol abuse; smoking; absence of physical activity during leisure time; and time spent watching television. The χ 2 test was used to compare ratios. All analyses accounted for weighting factors and the study's complex sampling design effect. The socio-economic and demographic variables evaluated were gender, age, schooling level and macro region of residence. National Health Survey, a household survey with national representation, conducted in 2013 in Brazil.ParticipantsIndividuals (n 60202) aged 18 years or over. Four risk behaviour patterns were identified: 'Physical inactivity in leisure time and Inadequate consumption of fruits and vegetables', 'Saturated fat', 'Alcohol and Smoking' and 'Sedentary behaviour and Sugar', explaining 52·01 % of the total variance. Overall, greater adherence to 'Saturated fat' and 'Alcohol and Smoking' patterns was observed among men and those with lower education level. The 'Sedentary behaviour and Sugar' and 'Physical inactivity in leisure time and Inadequate consumption of fruits and vegetables' patterns had greater adherence among younger individuals, and the first was associated with higher education whereas the second with less education among individuals residing in the North and Northeast regions. Risk behaviour patterns for NCD were heterogeneous, reflecting the socio-economic and demographic differences in Brazil.

Probability of premature death for chronic non-communicable diseases, Brazil and Regions, projections to 2025.

Objective: To analyze the mortality trends for Chronic Noncommunicable Diseases (NCDs) in the period 2000-2013 and its probability of death until 2025. time series analysis of mortality from cardiovascular diseases, cancer, diabetes and chronic respiratory disease, with correction for ill-defined causes and underreporting of deaths and calculation of probability of death. There was an average decline of 2.5% per year in all four major NCDs in Brazil. There was a decline in all regions and federal units. The reduced likelihood of death by 30% in 2000 to 26.1% in 2013 and expected decline to 20.5% in 2025. From the trend of reduction is expected to reach Brazil reducing overall goal 25% by 2025.

Physical activity and preventable premature deaths from non-communicable diseases in Brazil.

ABSTRACTBackgroundStudies on the impact of counterfactual scenarios of physical activity on premature deaths from non-communicable diseases (NCDs) are sparse in the literature. We estimated preventable premature deaths from NCDs (diabetes, ischemic heart disease, stroke, and breast and colon cancers) in Brazil by increasing population-wide physical activity (i) to theoretical minimum risk exposure levels; (ii) reaching the physical activity recommendation; (iii) reducing insufficient physical activity by 10%; and (iv) eliminating the gender differences in physical activity.MethodsPreventable fractions were estimated using data from a nationally representative survey, relative risks from a meta-analysis and number of premature deaths (30–69 years) from the Brazilian Mortality Information System.ResultsPhysical activity could potentially avoid up to 16 700 premature deaths from NCDs in Brazil, corresponding to 5.75 and 3.23% of premature deaths from major NCDs and of all-causes, respectively. Other scenarios suggested the following impact on premature deaths: reaching physical activity recommendation (5000 or 1.74% of major NCDs); 10% reduction in insufficient physical activity (500 or 0.17% of major NCDs); eliminating gender differences in physical activity (1000 or 0.33% of major NCDs).ConclusionsPhysical activity may play an important role to reduce premature deaths from NCD in Brazil.

Níveis pressóricos de pacientes em acompanhamento pelo Programa Hiperdia

Introdução: O Programa Hiperdia é uma ação importante para a prevenção das doenças crônicas não-transmissíveis no Brasil, particularmente no controle da hipertensão arterial e diabetes. Objetivo: Comparar os níveis pressóricos de pacientes hipertensos em acompanhamento pelo Programa Hiperdia da Estratégia de Saúde da Família do munícipio de Recife-PE, em relação a uma amostra da população local sem acompanhamento. Métodos: Estudo transversal, analítico, de abordagem quantitativa, realizado com um grupo de 135 pacientes hipertensos do Programa Hiperdia e 196 pacientes sem vínculo com uma unidade de saúde ou sem diagnóstico prévio de hipertensão arterial como grupo controle. Resultados: Os pacientes do programa Hiperdia apresentaram-se como controlados (73,3%) e com médias de pressão arterial diastólica e sistólica menor que o grupo controle (p&lt;0,001 e p=0,011, respectivamente). Conclusão: Os resultados ressaltam a importância do programa e a necessidade de estratégias para melhorar o diagnóstico na população em geral.

Mortality due to noncommunicable diseases in Brazil, 1990 to 2015, according to estimates from the Global Burden of Disease study.

Noncommunicable diseases (NCDs) are the leading health problem globally and generate high numbers of premature deaths and loss of quality of life. The aim here was to describe the major groups of causes of death due to NCDs and the ranking of the leading causes of premature death between 1990 and 2015, according to the Global Burden of Disease (GBD) 2015 study estimates for Brazil. Cross-sectional study covering Brazil and its 27 federal states. This was a descriptive study on rates of mortality due to NCDs, with corrections for garbage codes and underreporting of deaths. This study shows the epidemiological transition in Brazil between 1990 and 2015, with increasing proportional mortality due to NCDs, followed by violence, and decreasing mortality due to communicable, maternal and neonatal causes within the global burden of diseases. NCDs had the highest mortality rates over the whole period, but with reductions in cardiovascular diseases, chronic respiratory diseases and cancer. Diabetes increased over this period. NCDs were the leading causes of premature death (30 to 69 years): ischemic heart diseases and cerebrovascular diseases, followed by interpersonal violence, traffic injuries and HIV/AIDS. The decline in mortality due to NCDs confirms that improvements in disease control have been achieved in Brazil. Nonetheless, the high mortality due to violence is a warning sign. Through maintaining the current decline in NCDs, Brazil should meet the target of 25% reduction proposed by the World Health Organization by 2025.