Background: The Brazilian Information System on Mortality (SIM) is of vital importance in monitoring the trends of cardiovascular diseases (CVDs) and is aimed at supporting public policies. Objective: To compare historical series of CVD mortality based on data from the SIM, with and without correction, and from the Brazil Global Burden of Disease (GBD) Study 2017, in the 2000-2017 period. Methods: Analysis of CVD mortality in Brazil between 2000 and 2017. Three CVD mortality estimates were compared: Crude SIM, Corrected SIM, and GBD 2017. Absolute numbers and age-standardized rates were used to compare the estimates for Brazil, its states and the Federal District. Results: In the SIM, the total of deaths ranged from 261,000, in 2000, to 359,000, in 2017. In the GBD 2017, the total of deaths ranged from 292,000 to 388,000, for the same years, respectively. A high proportion of the causes of death from CVD corresponded to garbage codes, classified according to the GBD 2017, reaching 42% in 2017. The rates estimated by GBD ranged from 248.8 (1990) to 178.0 (2017) deaths per 100,000 inhabitants. The rates of the Crude SIM and Corrected SIM also showed a reduction for the whole series analyzed, the Crude SIM showing lower rates: 204.9 (1990) and 155.1 (2017) deaths per 100 thousand inhabitants. When analyzing by the states and Federal District, the Crude SIM trends reversed, with an increase in mortality rates in the Northern and Northeastern states. Conclusion: This study shows the decrease in CVD mortality rates in Brazil in the period analyzed. Conversely, when analyzing by the states and Federal District, the Crude SIM showed an increase in those rates for the Northern and Northeastern states. The use of crude data from the SIM can result in interpretation errors, indicating an increase in rates, due to the increase in death data capture and the improvement in the definition of the underlying causes of death in the past decade, especially in the Northern and Northeastern regions, justifying the use of corrected data in mortality analyses.

The world is facing a new challenge, the novel coronavirus disease 2019 , caused by a betacoronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), phylogenetically identical to the SARS-CoV (severe acute respiratory syndrome coronavirus) and the MERS-CoV (Middle East respiratory syndrome coronavirus) responsible for innumerable deaths in China in 2003 and in the Middle East in 2012, respectively. On March 11, 2020, the COVID-19 outbreak was characterized as a pandemic by the World Health Organization (WHO). 1 Twenty-three days after that announcement, the cases reported reached 1,056,777 in 182 countries, with 55,781 deaths, most of which occurring in Italy, Spain, France, China and Iran. So far, Brazil has registered 8,195 cases and 335 deaths, while Portugal, 9,886 cases and 246 deaths, figures that have increased steeply since the beginning of the pandemic. 2

Women need specific intervention and information about their particularities, especially regarding CV risk factors, as well as the biological, pathophysiological, and social differences between the sexes. The majority of large clinical trials that address current cardiovascular diseases (CVD) were not conducted with enough women to generate robust evidence. 1 CVD in women remains poorly studied, poorly recognized, underdiagnosed, and undertreated, generating worse outcomes. It is necessary to change this reality so that women are approached according to their singularities in order to reduce the burden of CVD by 2030. 2 Among the CV risk factors in Brazilian women, arterial hypertension, dietary risks, obesity, increased serum cholesterol, and fasting glucose stand out. 3 Sex-related CV risk factors, which affect CVD throughout life, play a crucial role in women. 4 Menopause, especially in women 40 years, promotes changes in body composition, with an increase in fat mass and a greater probability of metabolic syndrome. 5,6 Hypertensive diseases of pregnancy, such as pre-eclampsia, gestational diabetes, and premature birth, increase CVD in adulthood. 7 The use of contraceptive hormones associated with arterial hypertension increases the risk of myocardial infarction (MI) by 12 times. 8 Polycystic ovary syndrome and autoimmune diseases contribute to increased cardiovascular risk. 9

Background: Deaths from malformations of the circulatory system (MCS) have a major impact on mortality reduction. given that most cases are avoidable with correct diagnosis and treatment. Objectives: To describe the distribution of mortality from MCS by sex. age. and macroregion in Brazil. in individuals under the age of 20. between 2000 and 2015. Methods: A descriptive study of mortality rates and proportional mortality (PM) from MCS. other congenital malformations (OCM). circulatory system disease (CSD). ill-defined causes (IDC). and external causes (EC) in Brazil. Results: There were 1.367.355 deaths from all causes in individuals younger than 20. 55.0% under 1 year of age. A total of 144.057 deaths were caused by congenital malformations. 39% of them by MCS. In both sexes. the annual mortality from MCS was 5.3/100.000. PM from MCS was 4.2%. CSD 2.2%. IDC 6.2% and EC 24.9%. Unspecified MCS showed the highest PM rates in both sexes and age groups. especially in the north and northeast regions (60%). Deaths from malformations occurred 5.7 times more frequently during the first year of life than in other ages (MCS: 5.0; OCM: 6.4). Conclusions: MCS was the leading cause of death among all malformations. being twice as important as CSD. mainly under 1 year of age. The frequency of misdiagnosis of MCS as cause of death was high in all ages and both sexes. especially in the north and northeast regions. These findings highlight the need for the development of public health strategies focused on correct diagnosis and early treatment of congenital cardiopathies. leading to a reduction in mortality. (Arq Bras Cardiol. 2020; [online].ahead print.

Introduction:To better understand trends in the main cause of death in Brazil, we sought to analyze the burden of cardiovascular risk factors (RF) and cardiovascular diseases (CVD) attributable to specifi c RFs in Brazil from 1990 to 2019, using the estimates from the GBD 2019 study. Methods: To estimate RF exposure, the Summary Exposure Value (SEV) was used, whereas for disease burden attributed to RF, mortality and disability-adjusted life-years (DALY) due to CVD were used. For comparisons over time and between states, we compared age-standardized rates. The sociodemographic index (SDI) was used as a marker of socioeconomic conditions. Results: In 2019, 83% of CVD mortality in Brazil was attributable to RF. For SEV, there was a reduction in smoking and environmental RF, but an increase in metabolic RF. High systolic blood pressure and dietary risks continue to be the main RF for CVD mortality and DALY. While there was a decline in age-standardized mortality rates attributable to the evaluated RF, there was also a stability or increase in crude mortality rates, with the exception of smoking. It is important to highlight the increase in the risk of death attributable to a high body mass index. Regarding the analysis per state, SEVs and mortality attributable to RF were higher in those states with lower SDIs. Conclusions: Despite the reduction in CVD mortality and DALY rates attributable to RF, the stability or increase in crude rates attributable to metabolic RFs is worrisome, requiring investments and a renewal of health policies.

A obesidade infantil continua aumentando em todas as regiões do mundo, sendo considerada um dos grandes desafios de saúde pública. A prevalência aumentou de menos de 1% em 1975 para 5,6% em meninas e 7,8% em meninos em 2016. 1 No Brasil, os dados também são preocupantes, uma vez que no último levantamento oficial realizado pelo Instituto Brasileiro de Geografia e Estatística (IBGE), constatouse que entre 2008 e 2009, 51,4% dos meninos e 43,8% das meninas com idade entre 5 a 9 anos apresentavam sobrepeso ou obesidade. 2 Crianças e adolescentes com obesidade têm cinco vezes mais chances de serem obesos quando adultos. 3 Além do mais, a obesidade na infância está associada com a elevação da pressão arterial, resistência à insulina, diabetes mellitus, dislipidemia e com o aumento da morbimortalidade cardiovascular na idade adulta. 4 Por isso, é importante identificar o excesso de gordura corporal nesta população e criar estratégias para prevenir o desenvolvimento de doenças crônicas no futuro.Com o objetivo de detectar crianças e adolescentes com risco cardiometabólico, sugeriu-se o uso de indicadores antropométricos como ferramentas de triagem epidemiológica, uma vez que são métodos não invasivos, de baixo custo e de fácil aplicação. 5,6 A circunferência da cintura (CC) por exemplo, é um indicador de adiposidade central relacionada a complicações metabólicas da obesidade na população pediátrica. 7,8 Porém, ainda não existem pontos de corte de CC padronizados para classificação de adiposidade abdominal em crianças e adolescentes, o que torna o seu uso limitado.Estudos descrevendo valores de percentis para CC têm apresentado resultados diferentes, uma vez que os valores de CC podem ser influenciados por idade, sexo e grupos étnicos, 9-11 dificultando o estabelecimento de valores de referência globais para essa medida antropométrica. Na edição atual dos Arquivos Brasileiros de Cardiologia, Santos et al., 12 publicaram estudo longitudinal, realizado com 22.000 crianças (11.199 meninos) com idades entre 6 e 10 anos de idades, matriculadas em escolas públicas e particulares de 13 cidades do estado de São Paulo. Os autores apresentaram curvas de referência da CC específicas para idade e sexo e pontos de corte para identificar crianças com risco de obesidade. Os autores descreveram que aproximadamente 30% das crianças apresentaram excesso de gordura, sendo classificados com sobrepeso ou obesidade, conforme o índice de massa corporal. As análises da curva ROC mostraram o percentil 75 como ponto de corte ideal para risco de sobrepeso e obesidade e que a obesidade é claramente diagnosticada nas crianças com a CC classificada a partir do percentil 85. 12

Fundamento: Estudos sobre mortalidade por Insuficiência Cardíaca (IC) no Brasil e Regiões Geográficas (RG) são escassos. Objetivo: Analisar a evolução temporal das taxas de mortalidade por IC por sexo e faixa etária no Brasil, RG e Unidades da Federação (UF), de 1980 a 2018, e associações com o Índice de Desenvolvimento Humano Municipal (IDHM). Métodos: Estudo de séries temporais dos óbitos por IC, por sexo e faixas etárias, no Brasil, RG e UF, de 1980 a 2018. Os óbitos e a população foram retirados do DATASUS para estimar taxas de mortalidade por 100.000 habitantes, brutas e padronizadas (método direto, população brasileira do ano 2000). Foram calculadas médias móveis de três anos das taxas padronizadas. Os IDHM das UF de 1991 e 2010 foram obtidos do Atlas Brasil. Empregou-se o coeficiente de correlação de Pearson, com 5% de significância. Resultados: A mortalidade por IC diminuiu no Brasil a partir de 2008, atingindo ao final de 2018 patamar semelhante nas RG e UF, sendo maior nos homens durante quase todos os períodos e faixas etárias, exceto naqueles acima de 60 anos, a partir de 1995, na região Sul. Observou-se relação inversa entre o IDHM e a redução das taxas de mortalidade (0,73). Conclusão: Houve redução das taxas de mortalidade por IC no Brasil progressivamente de 2008 até 2018, com patamares semelhantes em 2018 nas RG e UF, com maiores taxas no sexo masculino. Essas reduções parecem relacionadas com o IDHM em 2010, mais do que o aumento percentual ao longo do tempo.

The coronavirus disease 2019 (COVID-19) pandemic is a huge challenge to the health system because of the exponential increase in the number of individuals affected. The rational use of resources and correct and judicious indication for imaging exams and interventional procedures are necessary, prioritizing patient, healthcare personnel, and environmental safety. This review was aimed at guiding health professionals in safely and effectively performing imaging exams and interventional procedures. This review was aimed at: a) helping physicians to properly indicate and implement cardiovascular tests and interventional procedures in their clinical practice for patients with suspected