Federal University Amazonas, Manaus, Amazonas, Brazil.
Federal University of Alfenas, Minas Gerais, Brazil.
Int J Stroke. 2015 Oct;10 Suppl A100:34-7. doi: 10.1111/ijs.12526. Epub 2015 Jun 4.
It is not clear the relationship between stroke mortality trends and socioeconomic inequalities in low- and middle-income countries.
We compared differences of trends in stroke mortality by socioeconomic status in the city of Sao Paulo, Brazil.
We analyzed the intra-urban distribution of stroke death rates from 1996 to 2011 for persons aged 35-74 years old according to income using joinpoint regression.
We confirmed 77 848 stroke deaths in the period, 51·4% of them among persons aged 35-74 years old. For all areas, there was parallelism between genders, and the average annual percent changes combined was -5·2 (-5·7 to -4·6) from 1996 to 2005 and -3·0 (-4·3 to -1·7) from 2005 to 2011. The full period average annual percent changes of age-adjusted rates between persons living in the high- and low-income area were, respectively, -5·4 and -4·2 (P = 0·002) for men and -5·9 vs. -4·9 (P = 0·017) for women. Differences in the risk of stroke between the high- and low-income areas increased more than twofold in the period in both genders.
The risk of stroke death is decreasing in all regions, but the faster decline in mortality rates in the wealthiest area contributes to further greater inequalities.
目前尚不清楚中低收入国家中风死亡率趋势与社会经济不平等之间的关系。
我们比较了巴西圣保罗市不同社会经济地位人群中风死亡率趋势的差异。
我们根据收入对 1996 年至 2011 年 35-74 岁人群的中风死亡率进行了城乡内分布分析，采用 Joinpoint 回归。
在此期间，我们确认了 77848 例中风死亡病例，其中 51.4%发生在 35-74 岁人群中。对于所有地区，男女之间存在平行关系，1996 年至 2005 年期间的平均年变化百分比为-5.2%（-5.7%至-4.6%），2005 年至 2011 年期间为-3.0%（-4.3%至-1.7%）。高收入和低收入地区的全期平均年龄调整发病率的年变化百分比分别为男性-5.4%和-4.2%（P=0.002），女性-5.9%和-4.9%（P=0.017）。在此期间，男女两性的高收入和低收入地区之间中风风险的差异增加了两倍多。
所有地区的中风死亡风险都在下降，但最富裕地区的死亡率下降速度更快，导致不平等现象进一步加剧。
