title: Cardiovascular disease mortality in the Americas: current trends and disparities.
abstract: OBJECTIVE
  To describe the current situation and trends in mortality due to cardiovascular disease (CVD) in the Americas and explore their association with economic indicators.
  
  
  METHODS
  This time series study analysed mortality data from 21 countries in the region of the Americas from 2000 to the latest available year.
  
  
  METHODS
  Age-adjusted death rates, annual variation in death rates. Regression analysis was used to estimate the annual variation and the association between age-adjusted rates and country income.
  
  
  RESULTS
  Currently, CVD comprised 33.7% of all deaths in the Americas. Rates were higher in Guyana (292/100 000), Trinidad and Tobago (289/100 000) and Venezuela (246/100 000), and lower in Canada (108/100 000), Puerto Rico (121/100 000) and Chile (125/100 000). Male rates were higher than female rates in all countries. The trend analysis showed that CVD death rates in the Americas declined -19% overall (-20% among women and -18% among men). Most countries had a significant annual decline, except Guatemala, Guyana, Suriname, Paraguay and Panama. The largest annual declines were observed in Canada (-4.8%), the USA (-3.9%) and Puerto Rico (-3.6%). Minor declines were in Mexico (-0.8%) and Cuba (-1.1%). Compared with high-income countries the difference between the median of death rates in lower middle-income countries was 56.7% higher and between upper middle-income countries was 20.6% higher.
  
  
  CONCLUSIONS
  CVD death rates have been decreasing in most countries in the Americas. Considerable disparities still remain in the current rates and trends.
authors: Health Analysis and Information Project, Pan American Health Organization, Washington, DC 20037, USA.
authors: Maria
authors: M
authors: de Fatima Marinho de Souza
authors: Vilma Pinheiro
authors: VP
authors: Gawryszewski
authors: Pedro
authors: P
authors: Orduñez
authors: Antonio
authors: A
authors: Sanhueza
authors: Marcos A
authors: MA
authors: Espinal
mesh_terms: D000367:Age Factors; D000569:Americas / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000191:economics / Q000401:mortality* / Q000517:prevention & control; D005260:Female; D017048:Health Care Costs / Q000639:trends; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000191:economics / Q000639:trends*; D006801:Humans; D007182:Income / Q000639:trends; D008297:Male; D009026:Mortality / Q000639:trends; D011314:Preventive Health Services / Q000639:trends; D012044:Regression Analysis; D012111:Residence Characteristics; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors