title: A reappraisal of stroke mortality trends in Brazil (1979-2009).
abstract: BACKGROUND
  Brazil has one of the highest cerebrovascular death rates in the Western Hemisphere. We investigated temporal trends according to gender and stroke subtypes.
  
  
  METHODS
  We analyzed mortality rates between 1979 and 2009 for different stroke subtypes. Data were stratified by gender and age (35-74 years). The annual percent change and significant changes in the trends were identified with Poisson regression.
  
  
  RESULTS
  After excluding deaths due to sequel from stroke for men, the annual percent changes (95% confidence intervals) were as follows: 1979-1984, 0.7 (-0.8 to 2.1); 1984-1994, -1.8 (-2.4 to -1.2); 1994-2007, -5.0 (-5.4 to -4.7); and 2007-2009, -0.8 (-7.0 to 5.8). For women, the annual percent changes were as follows: 1979-1994, -1.9 (-2.2 to -1.6); 1994-1997, -7.5 (-14.0 to -0.6); 1997-2007, -4.0 (-4.6 to -3.3); and 2007-2009, 1.6 (-5.5 to 9.2). For the 2006-2009 period, the average annual percent change (95% confidence interval) for all strokes was -3.1 (-3.3 to -2.9) for men and -2.9 (-3.1 to -2.8) for women. For the same period, the average annual percent change of death rates for stroke subtypes were, for men and women, respectively: intracerebral hemorrhage, -4.0 (-4.9 to -3.1) and -2.9 (-3.4 to -2.3); and ischemic stroke, -3.2 (-3.3 to -3.0) and -1.4 (-2.0 to -0.9).
  
  
  CONCLUSIONS
  Stroke mortality rates are declining in Brazil for all stroke subtypes.
authors.affiliation: Hospital Universitário, University of São Paulo, Sao Paulo, Brazil. palotufo@hu.usp.br
authors.forename: Paulo A
authors.initials: PA
authors.lastname: Lotufo
authors.forename: Alessandra C
authors.initials: AC
authors.lastname: Goulart
authors.forename: Tiotrefis G
authors.initials: TG
authors.lastname: Fernandes
authors.forename: Isabela M
authors.initials: IM
authors.lastname: Benseñor
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D002545:Brain Ischemia / Q000401:mortality; D001938:Brazil / Q000453:epidemiology; D002543:Cerebral Hemorrhage / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D012044:Regression Analysis; D017678:Sex Distribution; D020521:Stroke / Q000401:mortality*