title: Diseases of the circulatory system before and after the family health program, Londrina, Paraná.
abstract: BACKGROUND
  The reduction in morbidity and mortality rates from diseases of the circulatory system (DCS) is one of the greatest challenges in primary care, and the implementation of the Family Health Program provides access to the multisectoral and integrated measures required for dealing with these diseases.
  
  
  OBJECTIVE
  To analyze DCS mortality and hospitalization rates before and after the implementation of the Family Health Program, in Londrina, Paraná.
  
  
  METHODS
  This was an ecological study, comparing DCS, cerebrovascular disease (CbVD) and ischemic heart disease (IHD) mortality rates and hospitalization rates by the SUS, in residents of Londrina, in two 4-year periods: 1997 to 2000, and 2002 to 2005. The data were obtained from the Mortality Information System and the Hospital Information System of the SUS. The ratios between the rates were calculated for both periods at 95% confidence interval.
  
  
  RESULTS
  The DCS was the first cause of death in the city, in both quadrennia. The CbVD and IHD accounted for more than 63% of DCS deaths. In comparing the two quadrennia, there was a reduction in CbVD mortality rates, which was significant only for subjects over 59 years, in both genders, and the hospitalization rates increased by 10%. For IHD, no significant change occurred in mortality rates, and there was a 40% increase in hospitalization rates.
  
  
  CONCLUSIONS
  The significant reduction only in CbVD mortality in the elderly suggests the need for expanding health assistance coverage to different population groups and the development of preventive and health promotion measures.
authors.affiliation: Departamento de Saúde Coletiva, Universidade Estadual de Londrina, PR, Brasil. brigidagimenez@gmail.com
authors.forename: Brígida Gimenez
authors.initials: BG
authors.lastname: Carvalho
authors.forename: Regina Kazue Tanno de
authors.initials: RK
authors.lastname: Souza
authors.forename: Darli Antonio
authors.initials: DA
authors.lastname: Soares
authors.forename: Mara Cristina Nishikawa
authors.initials: MC
authors.lastname: Yagi
mesh_terms: D000328:Adult; D017677:Age Distribution; D001938:Brazil / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000517:prevention & control; D002423:Cause of Death / Q000639:trends; D002561:Cerebrovascular Disorders / Q000401:mortality* / Q000517:prevention & control; D005192:Family Health; D005260:Female; D006078:Government Programs / Q000592:standards; D006760:Hospitalization / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D017678:Sex Distribution; D013997:Time Factors