Analysis of cerebrovascular disease mortality trends in Andalusia (1980-2014).
BACKGROUND
In recent decades, mortality rates for cerebrovascular diseases (CVD) have decreased significantly in many countries. This study analyses recent tendencies in CVD mortality rates in Andalusia (1980-2014) to identify any changes in previously observed sex and age trends.


METHODS
CVD mortality and population data were obtained from Spain's National Statistics Institute database. We calculated age-specific and age-standardised mortality rates using the direct method (European standard population). Joinpoint regression analysis was used to estimate the annual percentage change in rates and identify significant changes in mortality trends. We also estimated rate ratios between Andalusia and Spain.


RESULTS
Standardised rates for both males and females showed 3 periods in joinpoint regression analysis: an initial period of significant decline (1980-1997), a period of rate stabilisation (1997-2003), and another period of significant decline (2003-2014).


CONCLUSIONS
Between 1997 and 2003, age-standardised rates stabilised in Andalusia but continued to decrease in Spain as a whole. This increased in the gap between CVD mortality rates in Andalusia and Spain for both sexes and most age groups.
Unidad de Gestión Clínica de Salud Pública, Prevención y Promoción de la Salud, Área de Gestión Sanitaria Sur de Sevilla, Sevilla, España. Electronic address: aurelio.cayuela.sspa@juntadeandalucia.es.
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Cayuela
Facultad de Medicina, Universidad de Sevilla, Sevilla, España.
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Cayuela
Unidad de Gestión Clínica Pino Montano A, Distrito Sanitario Sevilla, Sevilla, España.
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Rodríguez-Domínguez
Servicio de Neurorradiología Intervencionista, Hospital Universitario Virgen del Rocío, Sevilla, España.
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González
Unidad de Ictus, Servicio de Neurología, Hospital Universitario Virgen del Rocío, Sevilla, España.
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Moniche
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000453:epidemiology* / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013030:Spain / Q000453:epidemiology
Andalucía; Andalusia; Análisis de regresión; Cerebrovascular diseases; Enfermedad cerebrovascular; Epidemiology; Epidemiología; Mortalidad; Mortality; Regression analysis; Tendencia; Trends