Araya Marlene Roselló, Padilla Sonia Guzmán
Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud (INCIENSA), San José, Costa Rica.
Rev Panam Salud Publica. 2004 Nov;16(5):295-301. doi: 10.1590/s1020-49892004001100001.
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.
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.
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.
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.
描述1970年至2001年间，按性别和地理区域划分，哥斯达黎加心血管疾病（CVD）、缺血性心脏病（IHD）和急性心肌梗死（AMI）的死亡率流行病学趋势。
我们对1970年至2001年间哥斯达黎加CVD、IHD和AMI的死亡率进行了描述性研究。信息来自中美洲人口中心的数据库。1970年至2001年间IHD和AMI的死亡率数据根据《国际疾病分类》（ICD）的最新修订版进行分析。哥斯达黎加领土分为以下区域：大都市区（8个县）、中央山谷半城区（18个县）、中央山谷农村地区（17个县）、低地半城区（12个县）和低地农村地区（26个县）。以每10万居民的粗死亡率形式，按年龄、性别和死亡年份，对每一种病因或病因组，考察了五年期（1970年至1999年）以及2000 - 2001两年期的死亡率趋势。所有比率均通过直接标准化方法，以1960年拉丁美洲人口作为标准人口，对性别、年龄、死亡年份和地理区域进行了调整。
CVD死亡率平均下降了33%（女性下降46.6%，男性下降20.2%），而IHD死亡率平均上升了18.4%（女性上升6.1%，男性上升28.4%）。在研究期间，男性AMI调整死亡率上升了12.8%，女性则略有下降，下降了4.4%。在整个研究期间，男性CVD、IHD和AMI的死亡率高于女性。IHD和AMI的死亡率在半城市和城市地区上升，尤其是在农村低地，相对于1995 - 1999年的比率，分别上升了123.9%和76.9%。
注意到CVD死亡率有所下降。最高比率出现在男性以及75岁及以上人群中。IHD和AMI死亡率上升幅度最大的是在半城市和农村地区、男性以及75岁及以上人群中。应特别关注CVD的危险因素，如吸烟、动脉高血压、超重和肥胖、久坐习惯以及不健康饮食。
