Trends in relative mortality from cerebrovascular diseases in Brazilian state capitals, 1950-1988

This article seeks to describe trends in relative mortality from cerebrovascular diseases (CVDs) in Brazilian state capitals from 1950 through 1988. Absolute numbers of deaths from all causes; from CVDs; and from ill-defined signs, symptoms, and afflictions were obtained from official Brazilian mortality statistics. In calculating relative CVD mortality, deaths from ill-defined signs, symptoms, and afflictions were excluded. The collected data permitted calculation of relative CVD mortality in most state capitals for 1950, 1955, 1960, 1961-1965, 1966-1970, 1971-1975, 1977-1980, 1981-1985, and 1986-1988. During the study period CVD mortality was found to play an increasing role in overall mortality in all the state capitals. Regional grouping of data showed greater relative CVD mortality in the South and Southwest Regions toward the start of the study period. However, over the course of this period the part that CVD mortality played in overall mortality grew most rapidly in the less-developed North, Northeast, and Center-West Regions. In general, relative CVD mortality data in nearly all the state capitals demonstrate the attention that needs to be devoted to CVDs within the context of adult public health. In particular, there is a clear need to greatly strengthen and improve the marginal existing programs for detection and control of hypertension and diabetes in Brazil. This should be done by assessing international experience with programs of this type and adapting that experience to Brazilian conditions. Beyond that, it will be important to support health promotion and protection efforts that can deal with risk factors and secure prevention through lifestyle modification--something that can provide benefits in dealing not only with CVDs but also with diabetes, obesity, and certain neoplasias.