Heart Online First, published on July 25, 2013 as 10.1136/heartjnl-2013-303617 Epidemiology
ORIGINAL ARTICLE
Ischaemic heart disease deaths in Brazil: current trends, regional disparities and future projections Cristina P Baena,1 Rajiv Chowdhury,2 Nicolle Amboni Schio,1 Ary Elias Sabbag Jr,3 Luiz Cesar Guarita-Souza,1 Marcia Olandoski,1 Oscar H Franco,4 José Rocha Faria-Neto1 ▸ Additional material is published online only. To view please visit the journal online (http://dx.doi.org/10.1136/ heartjnl-2013-303617). 1
Pontificia Universidade Catolica do Paraná, School of Medicine Curitiba, Curitiba, Paraná, Brazil 2 Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK 3 Department of Biostatistics, Federal University of Paraná, Curitiba, Brazil 4 Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands Correspondence to Cristina Pellegrino Baena, Pontificia Universidade Catolica do Paraná, School of Medicine Curitiba, Rua Dom Pedro I, 80, Curitiba, Paraná 80260 130, Brazil;
[email protected] CPB, RC, OHF and JRF contributed equally. Received 8 January 2013 Revised 1 July 2013 Accepted 2 July 2013
ABSTRACT Objective To quantify the trend of ischaemic heart disease (IHD) deaths in Brazil during the last decade (2000–2010) for various population characteristics and to forecast the upcoming mortality trends across regions in Brazil until the year 2015. Design Nationwide comparative observational study. Patients and methods The population studied encompassed all adult residents (≥20 years) living in five Brazilian regions between 2000 and 2010. Demographic, economic and mortality data were obtained from Brazilian National Mortality Data System and National Applied Economics Research Institute. Subnotified deaths were redistributed proportionally to IHD deaths. Age-standardised mortality rates (ASMRs) per 100 000 inhabitants, by sex and region, were calculated employing a standard Brazilian population and constructing multivariate regression models to quantify and to project temporal trends. Main outcome measures Absolute numbers of death due to IHD and region-specific death rates in Brazil by age and sex. Results During the study period, 627 786 men and 452 690 women died due to IHD in Brazil. ASMR trends across all regions for men and women converged, driven by a declining trend in the South and Southeast and an opposite incline in the North and Northeast ( p20 years population*
Monthly household per capita income†
100 100
*Proportion of the regional adult population relative to the country’s adult population. †Monthly mean per capita income in US dollars. Brazilian currency—1 Real equivalent to 0.5 in international dollars (9/9/2012). ‡Population frequencies divided by 100 000. § Data from 1999.
and women in the North and Northeast (overall ASMR changes of 2.00 vs 0.9 and 2.4 vs 1.8, respectively; p
