Trends in ischemic heart disease and stroke death ratios in brazilian women and men.
OBJECTIVE
Cardiovascular diseases are the main cause of death in women and men in Brazil, but the trends for the death ratios for ischemic heart disease and stroke in women and men remain unknown.


METHODS
In this study, the trends for the death ratios among women and men who were over 30 years of age were analyzed from 1980 to 2005. Data were collected for both the Brazilian population and the metropolitan area of São Paulo. Estimates of the population size and data for mortality were then obtained from the Brazilian Institute of Geography and Statistics and the Ministry of Health. The risk for death was adjusted using a direct method.


RESULTS
Death rates due to cardiovascular disease, ischemic heart disease, and stroke have declined in both Brazil and the metropolitan region of São Paulo. A linear regression analysis revealed a similar trend for ischemic heart disease and demonstrated a male/female ratio of 1.653 ± 0.001 (r=0.228; p=0.262) in Brazil and 1.763 ± 0.008 (r=0.863; p<0.001) in São Paulo. Comparisons between the slopes of the linear regressions showed an increased ischemic heart disease ratio in men/women in São Paulo in comparison to those in Brazil (p<0.0001). The linear regression showed an increasing trend for the male/female stroke ratio of 1.252 ± 0.004 (r=0.776; p<0.0001) in Brazil and 1.331 ± 0.006 (r=0.580; p=0.002) in São Paulo. Comparisons between the regressions for the stroke ratio were similar for men/women in São Paulo compared to Brazil (p=0.244).


CONCLUSIONS
We observed an increased trend in the ratio for ischemic heart disease death in men compared to women. Improvements in the control of risk factors and treatments for both men and women are mandatory to reduce the number of ischemic heart disease-related deaths in Brazil.
Heart Institute (InCor), Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Antonio de Padua
Ade P
Mansur
Desidério
D
Favarato
Solange Desirée
SD
Avakian
José Antonio F
JA
Ramires
D017677:Age Distribution; D001938:Brazil / Q000453:epidemiology; D002423:Cause of Death; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D009026:Mortality / Q000639:trends; D017202:Myocardial Ischemia / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D020521:Stroke / Q000401:mortality*; D013997:Time Factors
N Engl J Med. 2007 Jun 7;356(23):2388-98
17554120
Diabetes Care. 2004 May;27(5):1047-53
15111519
Circulation. 2008 Jan 29;117(4):e25-146
18086926
Arq Bras Cardiol. 2001 Feb;76(2):111-8
11270314
Neuroepidemiology. 2003 May-Jun;22(3):179-83
12711850
Circulation. 2010 Feb 23;121(7):e46-e215
20019324
Tohoku J Exp Med. 1960 Aug 25;72:91-103
13749685
Heart. 2006 Apr;92(4):453-60
16537758
Stroke. 2010 Mar;41(3):499-503
20075347
Stroke. 2009 Apr;40(4):1082-90
19211488
Arq Bras Cardiol. 2006 Dec;87(6):735-40
17262111
Arq Bras Cardiol. 2009 Jan;92(1):16-22
19219260
J Am Coll Cardiol. 2007 Nov 27;50(22):2128-32
18036449
Rev Assoc Med Bras (1992). 2002 Jul-Sep;48(3):231-6
12353107
Arq Bras Cardiol. 2009 Nov;93(5):506-10
20084313
Rev Panam Salud Publica. 2009 Jul;26(1):17-22
19814877
Curr Probl Cardiol. 2010 Feb;35(2):72-115
20109979