[Trends in mortality from ischemic heart disease and acute myocardial infarction in Costa Rica, 1970-2001].

OBJECTIVE

To describe epidemiologic trends in mortality from cardiovascular diseases (CVD), ischemic heart disease (IHD), and acute myocardial infarction (AMI) in Costa Rica, by sex and geographic region, between 1970 and 2001.

METHODS

We performed a descriptive study of mortality from CVD, IHD, and AMI in Costa Rica between 1970 and 2001. Information was obtained from the Central American Population Center's database. Mortality data for IHD and AMI between 1970 and 2001 were analyzed in accordance with the latest revision of the International Classification of Diseases (ICD). Costa Rica's territory was divided into the following regions: the metropolitan area (8 cantons), the semi-urban area of Valle Central (18 cantons), the rural area of Valle Central (17 cantons), the semi-urban lowlands (12 cantons), and the rural lowlands (26 cantons). Mortality trends by quinquennia (between 1970 and 1999) and for the 2000-2001 biennium were examined in the form of crude mortality rates per 100 000 inhabitants for each cause or group of causes, by age, sex, and year of death. All rates were adjusted for sex, age, year of death, and geographic region through the direct method of standardization, using the population of Latin America in 1960 as the standard population.

RESULTS

Mortality from CVD dropped by an average of 33% (46.6% among women and 20.2% among men), while mortality from IHD rose by an average of 18.4% (6.1% among women and 28.4% among men). The adjusted mortality rate for AMI among men rose by 12.8% over the study period and dropped slightly by 4.4% among women. Mortality from CVD, IHD, and AMI was greater in men than in women during the entire study period. Mortality rates for IHD and AMI rose in semi-urban and urban areas, especially in the rural lowlands, where they increased with respect to the 1995-1999 rates by 123.9% and 76.9%, respectively.

CONCLUSIONS

A reduction in mortality from CVD was noted. The largest rates were seen among men and in persons 75 years of age or older. The largest increases in mortality rates from IHD and AMI were seen in semi-urban and rural areas, among men, and in persons 75 years of age or older. Special attention should be paid to risk factors for CVD, such as smoking, arterial hypertension, overweight and obesity, sedentary habits, and an unhealthy diet.