Health Analysis and Information Project, Pan American Health Organization, Washington, DC 20037, USA.
Heart. 2012 Aug;98(16):1207-12. doi: 10.1136/heartjnl-2012-301828.
To describe the current situation and trends in mortality due to cardiovascular disease (CVD) in the Americas and explore their association with economic indicators.
This time series study analysed mortality data from 21 countries in the region of the Americas from 2000 to the latest available year.
Age-adjusted death rates, annual variation in death rates. Regression analysis was used to estimate the annual variation and the association between age-adjusted rates and country income.
Currently, CVD comprised 33.7% of all deaths in the Americas. Rates were higher in Guyana (292/100 000), Trinidad and Tobago (289/100 000) and Venezuela (246/100 000), and lower in Canada (108/100 000), Puerto Rico (121/100 000) and Chile (125/100 000). Male rates were higher than female rates in all countries. The trend analysis showed that CVD death rates in the Americas declined -19% overall (-20% among women and -18% among men). Most countries had a significant annual decline, except Guatemala, Guyana, Suriname, Paraguay and Panama. The largest annual declines were observed in Canada (-4.8%), the USA (-3.9%) and Puerto Rico (-3.6%). Minor declines were in Mexico (-0.8%) and Cuba (-1.1%). Compared with high-income countries the difference between the median of death rates in lower middle-income countries was 56.7% higher and between upper middle-income countries was 20.6% higher.
CVD death rates have been decreasing in most countries in the Americas. Considerable disparities still remain in the current rates and trends.
描述心血管疾病（CVD）在美洲的死亡现状和趋势，并探讨其与经济指标的关系。
本时间序列研究分析了 2000 年至最新年份美洲地区 21 个国家的死亡率数据。
年龄调整死亡率、死亡率的年变化。采用回归分析估计年龄调整率的年变化和与国家收入的关系。
目前，心血管疾病占美洲所有死亡人数的 33.7%。死亡率较高的国家有圭亚那（292/100000）、特立尼达和多巴哥（289/100000）和委内瑞拉（246/100000），死亡率较低的国家有加拿大（108/100000）、波多黎各（121/100000）和智利（125/100000）。所有国家的男性死亡率均高于女性。趋势分析显示，美洲 CVD 死亡率总体下降了 19%（女性下降 20%，男性下降 18%）。除危地马拉、圭亚那、苏里南、巴拉圭和巴拿马外，大多数国家的死亡率都呈显著下降趋势。加拿大（-4.8%）、美国（-3.9%）和波多黎各（-3.6%）的年降幅最大。墨西哥（-0.8%）和古巴（-1.1%）的降幅较小。与高收入国家相比，中低收入国家死亡率中位数的差异高 56.7%，中上收入国家的差异高 20.6%。
大多数美洲国家的 CVD 死亡率呈下降趋势。目前的死亡率和趋势仍存在相当大的差异。
