Cardiovascular Health in Brazil

Abstract

O ur article reviews the current situation of cardiovascular diseases (CVD) in Brazil, focusing on the influence of socioeconomic status and regional variation in the epidemiology of CVD; and on current and novel strategies to confront CVD. After a brief description of the geographic, economic, and demographic aspects, the organizational aspects of the Brazilian healthcare system are explained. Next, risk factors and morbidity and mortality by CVD are described, followed by a discussion of strategies to confront CVD, regarding both prevention and treatment. Finally, the gaps in knowledge and suggested steps to overcome limitations are highlighted. Hence, this article aims to contribute to efforts to raise awareness concerning the CVD burden around the world, while highlighting initiatives that may promote the improvement of health and the reduction of disparities and current problems. Moreover, we hope it creates opportunities for interaction between researchers, clinicians, and health policy makers. Geographic, Economic, and Demographic DataBrazil is a country of continental dimensions exhibiting large differences in climate, genetic background, and lifestyle adopted in its distinct regions. It occupies 47% of South America, mainly in the tropical region, and has an estimated population of 202 768 562, with 51% women.1 The country is the fifth in land area, sixth in population, and currently the seventh economy in the world.2 Regarding income distribution, Brazil remains one of the world´s most unequal countries.2 Even though social disparities have decreased considerably over the past 14 years, 3 they are still unacceptable. The Gini coefficient for family income, a measure of inequality in income distribution ranging from 0 (complete equality) to 1 (complete inequality), declined from 0.59 in 2000 to 0.53 in 2012. The proportion of people living in poverty, defined as earning <US$ 2 a day, has fallen from 20.3% in 2001 to 6.8% in 2012. 2Brazil is divided into 5 regions: although the northeastern and northern regions (the latter generally sparsely populated in the midst of the Amazon Forest) have the worst socioeconomic indicators, the southeastern region has 42% of the population and is responsible for 56% of the gross domestic product ( Figure 1A).3 Inequalities in Brazil also have a Abstract-Brazil is a large country, with an evolving economy, but marked social inequalities. The population is formed by an admixture of native Brazilians, Europeans, and Africans; is predominantly urban; and faces rapid aging. Time trends related to health behaviors show a substantial reduction in smoking rates, but a rising prevalence of overweight and obesity, unhealthy eating habits, and insufficient physical activity. The high prevalence of hypertension and the increasing prevalence of diabetes mellitus are also causes for concern. Cardiovascular disease (CVD) has been the leading cause of mortality since the 1960s and has accounted for a substantial percentage of all hospitalizations. In 2011, CVD was responsible for 31% ...

Doença cerebrovascular no Brasil de 1990 a 2015: Global Burden of Disease 2015

“…Among chronic non-communicable diseases, those of the circulatory system are the main cause of mortality worldwide, including Brazil, which has one of the highest rates in South America [1][2][3] . Among cardiovascular diseases (CVD), cerebrovascular disease has specific characteristics within the Brazilian reality, being one of the most neglected diseases in the country.…”

Associations of Cigarette Smoking With Subclinical Inflammation and Atherosclerosis: ELSA‐Brasil (The Brazilian Longitudinal Study of Adult Health)

“…Annually, ≈6.2 million deaths worldwide and 200 000 deaths per year in Brazil have been attributed to smoking,2, 3 with almost one third of coronary heart disease deaths reported to be caused by smoking. Although the rates of smoking have declined since the 1990s, ≈12.5% to 15.5% of the Brazilian population were current smokers in 2012, comparable to the 15% to 16.5% smoking prevalence in the United States for the same year 4…”

Development and Evaluation of a Mobile Decision Support System for Hypertension Management in the Primary Care Setting in Brazil: Mixed-Methods Field Study on Usability, Feasibility, and Utility (Preprint)

“…Cardiovascular and cerebrovascular diseases are the leading causes of death in low and middleincome countries (LMIC) [1], including Brazil [8], and are responsible for the increasing use of health system resources, quite often from preventable complications.…”