Cardiovascular and cancer mortality in Brazil from 1990 to 2017

Abstract

The profile of mortality in Brazil has changed over the last three decades. Deaths due to infections, nutritional diseases and maternal causes accounted for 25% of all occurrences in 1990.In 2017, they represented approximately 10%. Injuries are now the cause in almost 20% of deaths among men and 5% among women. Hence, non-communicable diseases are proportionally increasing as the cause of death for both sexes (Figure 1). This nosological category encompasses cardiovascular, respiratory, digestive, neurological and renal diseases, along with cancer. The most frequent components are cardiovascular diseases and cancer, both worldwide and in Brazil. [1][2] Recently, an analysis conducted at the Center for Diseases Control and Prevention revealed that cancer may be about to surpass heart diseases as the leading killer in the United States. 3 I analyzed the trends of both cancer and cardiovascular diseases (including heart and cerebrovascular diseases) in Brazil using data from the Global Burden of Diseases study 2017, which are available online (http://ghdx.healthdata.org/gbd-results-tool). This description follows three steps: first, the total number of deaths and the proportional mortality; second, rates according to the population each year; and third, age-standardized rates.Figure 2 displays four moments over these decades . It shows that the number of deaths due to cardiovascular diseases was higher than the number due to cancer, but that a significant change took place over this period. In 1990, the number of deaths due to circulatory disorders was 140% higher than the number due to cancer; but in 2016, the number due to cardiovascular diseases was 60% greater than the number due to cancer. The proportional mortality due to circulatory disorders remained unchanged, but it increased significantly for death due to cancer. Among men, the proportional mortality increased from 10.6% (1990) to 17.4% (a relative increase of 65%). Among women, the proportional mortality increased from 12.7% (1990) to 19.2% (a relative increase of 50%). Figure 3 shows the trends in the numbers of deaths divided by the population of each year (crude rates). Visually, it is possible to speculate that cardiovascular rates are declining or flattening; in contrast, the rates due to cancer increased monotonically during this period. After adjustment for the difference in age strata over this period, as shown in Figure 4, it is easy to understand that the patterns for the risks of death due to circulatory disorders and cancer are different. The decline in age-standardized death rates due to cardiovascular diseases is steeper than that of the cancer rates. Table 1 presents the annual percentage change in the age-standardized death rates and shows that the decline in circulatory diseases over the period from 1990 to 2017 occurred at a faster pace. However, for both categories and both sexes, the rate of declining slowed down over the last five years of observation (2013)(2014)(2015)(2016)(2017).Concluding, in contrast to what has been described ...

Trends in cardiovascular diseases and heart disease death rates among adults aged 45-64: Brazil, 2000-2017

“…The conclusion was that "the risks of death due to cardiovascular diseases, independent of aging, are higher than the numbers and risks relating to cancer, for both sexes." 1 This result differed from what was observed recently in the United States. 2 One criticism of approaches in which all age strata are analyzed is that the older that people are when they die, the more frequent it is that comorbidities will be present, especially coexistence of heart disease and cancer.…”

“…In a previous editorial in this Journal this year, I addressed the question of whether the risk of death due to cancer in Brazil will surpass the risk of death due to cardiovascular diseases at some point over the next decades. The conclusion was that “the risks of death due to cardiovascular diseases, independent of aging, are higher than the numbers and risks relating to cancer, for both sexes.” 1 This result differed from what was observed recently in the United States. 2 …”

Regional Distribution of Causes of Death for Small Areas in Brazil, 1998–2017

“…In 1990, the highest level of mortality due to neoplasm was concentrated in the South region of the country, but a spread in mortality from this cause to all regions was observed by 2010. In 2010, almost all regions in the South and Southeast of the country had very high mortality rates from this particular cause, as did some areas of the Northeast (45). There is variation across regions in the level and the timing of mortality change from causes that directly influence the gender gap.…”

Atorvastatina Atenua o Remodelamento Vascular em Camundongos com Síndrome Metabólica

“…No Brasil, aproximadamente 350 mil indivíduos morrem por doenças cardiovasculares anualmente. 1,2 Dentre as diversas causas predisponentes para riscos cardiovasculares, destaca-se a síndrome metabólica (SM), caracterizada por um conjunto de comorbidades que envolvem aumento da circunferência abdominal (≥89 cm para mulheres e ≥102 cm para homens), aumento nos níveis de triglicerídeos (≥150 mg/dL), redução nos níveis de colesterol HDL (≤50 mg/dL para mulheres e ≤40 mg/dL para homens), aumento nos níveis pressóricos (≥130/85 mmHg) e aumento na glicemia de jejum (≥100 mg/dL). Dentre estas, a presença de pelo menos três comorbidades é elementar para o diagnóstico de SM.…”