Clinical Research and Epidemiology Unity, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil.
Int J Cardiol. 2013 Sep 10;167(6):2820-3. doi: 10.1016/j.ijcard.2012.07.006. Epub 2012 Aug 9.
Reductions in heart disease mortality rates are variable according to socioeconomic status.
We performed a time trend analysis of all heart diseases (all circulatory diseases, except rheumatic, cerebrovascular, and aortic diseases) comparing three different household income levels (high, middle, and low) in the city of Sao Paulo from 1996 to 2010.
A total of 197,770 deaths were attributed to heart diseases; 62% of them were due to coronary diseases. The rate of death due to heart diseases declined for the city as a whole. The annual percent change (APC) and 95% confidence intervals for men living in the high, middle and low income areas were -4.1 (-4.5 to -3.8), -3.0 (-3.5 to -2.6), and -2.5 (-2.8 to -2.1), respectively. The decline in death rate was greatest among men in the wealthiest area. The trend rates of women living in the high-income area had one joinpoint; APC was -4.4 (-4.8 to -3.9) from 1996-2005 and -2.6 (-3.8 to -1.4) from 2005-2010. Middle and low income areas had an APC of -3.6 (-4.1 to -3.1) and -3.0 (-3.2 to -2.7) from 1996-2010, respectively. During the last 5years of observation, there was a gradient of the decline of the risk of death, faster for people living in the wealthiest area and slower for people living in the more deprived neighborhoods.
Reduction in deaths due to heart diseases is greatest for men and women living in the wealthiest neighborhoods.
根据社会经济地位的不同，心脏病死亡率的降低情况也有所不同。
我们对 1996 年至 2010 年期间圣保罗市的所有心血管疾病（除风湿性、脑血管和主动脉疾病外的所有循环系统疾病）进行了时间趋势分析，比较了三个不同的家庭收入水平（高、中、低）。
共有 197770 人死于心脏病；其中 62%是由于冠心病。全市因心脏病导致的死亡率有所下降。高、中、低收入地区男性的年变化百分比（APC）和 95%置信区间分别为-4.1（-4.5 至-3.8）、-3.0（-3.5 至-2.6）和-2.5（-2.8 至-2.1）。最富裕地区的男性死亡率下降幅度最大。高收入地区女性的趋势率有一个联合点；APC 在 1996-2005 年为-4.4（-4.8 至-3.9），在 2005-2010 年为-2.6（-3.8 至-1.4）。中低收入地区的 APC 分别为 1996-2010 年的-3.6（-4.1 至-3.1）和-3.0（-3.2 至-2.7）。在观察的最后 5 年，死亡率下降的风险存在梯度，最富裕地区的人下降速度更快，而较贫困地区的人下降速度更慢。
最富裕社区的男性和女性死于心脏病的人数减少最多。
