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Published on: June 10, 2025
[Mortality due to heart failure: extended analysis and temporal trend in three states of Brazil]
Eduardo Nagib Gaui1, Carlos Henrique Klein, Gláucia Maria Moraes de Oliveira
1Cardiologia do Hospital Miguel Couto, Escola Nacional de Saúde Pública, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil. engaui@cardiol.br
Insights
Heart failure (HF) mortality decreased significantly in Brazil between 1999-2005. Analyzing multiple causes of death revealed HF
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Context:
- Heart failure (HF) is a significant cause of mortality globally and in Brazil.
- Previous studies in Brazil primarily used hospitalization data to assess HF mortality.
- Understanding HF mortality trends is crucial for public health interventions.
Purpose:
- To evaluate heart failure (HF) mortality rates by sex and age in Rio de Janeiro, São Paulo, and Rio Grande do Sul from 1999 to 2005.
- To compare HF mortality using different death certificate analysis methods (restricted, comprehensive, extended).
Summary:
- Mortality rates due to heart failure (HF) showed a decreasing trend from 1999 to 2005 across three Brazilian states.
- Rates increased with age, particularly for those 80 and older, and were higher in men up to age 80.
- Comprehensive and extended analyses of death certificates identified 3-fold and 20% more HF deaths, respectively, compared to restricted analysis.
Impact:
- The study highlights a substantial decrease in heart failure (HF) mortality in Brazil, contributing to national health data.
- Utilizing multiple causes of death provides a more accurate understanding of HF's impact.
- Challenges remain in selecting appropriate International Classification of Diseases (ICD) codes for comprehensive HF assessment.
Background:
Heart failure (HF) is a chronic disease with high prevalence and mortality rates. The mortality due to HF in Brazil has been studied more frequently using hospitalization data.
Objective:
To evaluate the mortality rates due to HF by sex and age range, in three states of Brazil, Rio de Janeiro, São Paulo and Rio Grande do Sul, from 1999 to 2005.
Methods:
The data were obtained from death certificates assessed in the three states. The mortality due to HF was assessed in the restricted (underlying cause of death), comprehensive (mentioned in any line of the death certificate) and extended (all codes with the presence of HF) forms.
Results:
The specific rates of mortality presented a clear decrease trend in the age groups, except in the group aged 80 years or older. The rates increased with age and were clearly higher among men up to 80 years of age. The rates of mortality due to HF were 3-fold higher in the comprehensive than in the restricted form of analysis. The extended form of analysis also added 20% of deaths in which HF was present.
Conclusion:
The results of this study demonstrated a decrease trend in the mortality rates due to HF when considering the three states - around 43% of Brazil - from 1999 to 2005. The methodology of multiple causes of death, in addition to the underlying ones, allows us to present a more comprehensive dimension of the importance of HF as cause of death. The adequate selection of the codes of the International Classification of Diseases (ICD), which comprehend the totality of the HF phenomenon, remains a challenge for further studies.
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