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Sex Differences in Cardiovascular Disease Mortality in Brazil between 1996 and 2019
Antonio de Padua Mansur1, Desidério Favarato2, Célia Maria Cassaro Strunz3
1Serviço de Prevencao, Cardiopatia na Mulher e Reabilitação Cardiovascular, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, SP, Brazil.
Insights
Cardiovascular disease mortality rates declined in Brazil for both sexes, but reductions were greater in women. Men experienced a widening mortality gap compared to women for cardiovascular diseases, ischemic heart disease, and stroke.
Area of Science:
- Public Health
- Epidemiology
- Cardiovascular Medicine
Background:
- Cardiovascular diseases (CVD) represent a leading cause of mortality in Brazil for both genders.
- This study focuses on trends in age-adjusted death rates (DRaj) for all causes of death (ACD), CVD, ischemic heart disease (IHD), and stroke.
Purpose of the Study:
- To analyze trends in age-adjusted death rates (DRaj) for ACD, CVD, IHD, and stroke in Brazilian men and women aged 35-74 from 1996 to 2019.
- To compare mortality trends between genders and identify potential disparities.
Main Methods:
- Utilized data from the Ministry of Health mortality database for trend analysis.
- Employed Joinpoint Regression Program™ for trend analysis and rate adjustments.
- Calculated Average Annual Percentage Change (AAPC) to quantify the intensity of observed changes.
Main Results:
- In women, significant reductions were observed for ACD (AAPC = -1.6%), CVD (AAPC = -2.6%), IHD (AAPC = -1.9%), and stroke (AAPC = -4.6%).
- In men, while ACD showed reductions, the male-to-female ratio for CVD, IHD, and stroke increased over the study period, indicating a widening gap.
- Specifically, the male/female ratio for CVD increased from 1.58 to 1.83, IHD from 1.99 to 2.30, and stroke from 1.52 to 1.83.
Conclusions:
- Mortality from ACD, CVD, IHD, and stroke decreased more significantly in women compared to men.
- The increasing male-to-female mortality ratio for CVD, IHD, and stroke suggests a greater burden on men.
- Further research is necessary to elucidate the factors contributing to the better outcomes observed in women.
Background:
cardiovascular diseases (CVD) are Brazil's leading causes of death in women and men. This study analyzed age-adjusted death rate (DRaj) trends from all causes of death (ACD), CVD, ischemic heart disease (IHD), and stroke in women and men aged 35 to 74 years from 1996 to 2019.
Methods:
We analyzed DRaj trends for all causes of death (ACD), CVD, IHD, and stroke. Data were from the Ministry of Health mortality database. Joinpoint Regression Program™ performed trend analysis and adjustments in death rates. Average annual percentage change (AAPC) determined the intensity of changes.
Results:
In women, DRaj reduced for ACD (AAPC = -1.6%); CVD (AAPC = -2.6%); IHD (AAPC = -1.9%); and stroke (AAPC = -4.6%) (p < 0.001 for all). In men, ACD reduced from 1996 to 2004 (AAPC = -0.9%; p < 0.001), from 2012 to 2019 (AAPC = -1.9%; p < 0.001), and unchanged from 2004 to 2012; CVD (AAPC = -2.1%); IHD (AAPC = -1.5%); stroke (AAPC = -4.9%) (p < 0.001 for all) reduced from 1996 to 2019. From 1996 to 2019, the male/female ratio for ACD remained unchanged. CVD increased from 1.58 to 1.83, IHD from 1.99 to 2.30, and stroke from 1.52 to 1.83.
Conclusion:
ACD, CVD, IHD, and stroke were reduced more significantly in women, and the ratio of CVD, IHD, and CVD in men and women increased more in men. Future studies will be needed to determine the main factors responsible for a better outcome in women.
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