[Cerebrovascular diseases in Portugal: some epidemiological aspects]

The Portuguese population is affected by the highest mortality rates in all the countries of the European Union. The highest mortality rates occur in some districts on the north coast where, in 1995, the rates standardised by age were above 200/100,000/annum, with the lowest figures in some districts in the interior and in Lisbon. These mortality rates have had a downward trend, but inferior to what is desired, or what occurs in other developed countries. The Autonomous Region of Madeira had a more significant percentage reduction (40%), followed by the Autonomous Region of the Azores (25%). Little is known of the effects of sporadic occurrences on the mortality associated to cerebrovascular disease. The consequences of two of these occurrences are described: the heat wave in June 1981 and the influenza epidemic in 1988-89. The number of deaths due to cerebrovascular diseases in the period corresponding to the heat wave was 2.2 times higher than expected, while during the influenza epidemic cerebrovascular diseases were the most common cause of death (25.8%) contributing to excess mortality. It is imperative that instruments be created to more accurately estimate the importance of this group of diseases in Portugal in what concerns incidence, resulting disability and health care requirements as well as social and financial costs for the individuals, the families and the community.