Universidade Federal de Alagoas - Campus Arapiraca, Arapiraca, AL - Brasil.
Faculdade São Francisco de Juazeiro, Juazeiro, BA - Brasil.
Arq Bras Cardiol. 2021 Jan;116(1):89-99. doi: 10.36660/abc.20190532.
Cerebrovascular diseases (CBVD) are the second major cause of death in the world.
To analyze the mortality trend of CBVD in Brazil (1996 to 2015) and its association with Human Development Index (HDI) and the Social Vulnerability Index (SVI).
This is an ecological study. We analyzed the mortality rate standardized by CBVD. Death data were obtained from the Mortality Information System (SIM) and populational data from the Brazilian Institute of Geography and Statistics (IBGE). The model of regression by inflection points (Joinpoint regression) was used to perform the temporal analysis, calculating the Annual Percent Change (APC) and Average Annual Percent Change (AAPC), with 95% of confidence interval and a significance of 5%. Trends were classified as increasing, decreasing or stationary. A multivariate regression model was used to analyze the association between mortality by CBVD, HDI and SVI.
During this period, 1,850,811 deaths by CBVD were recorded. We observed a reduction in the national mortality rate (APC -2.4; p = 0.001). Twenty federation units showed a significant trend, of which 13 showed reduction, including all states in the Midwest (n=4), Southeast (n=4) and South (n=3). The HDI was positively associated and the SVI was negatively associated with mortality (p = 0.046 and p = 0.026, respectively).
An unequal epidemiological course of mortality was observed between the regions, being higher in the Southeast and South states, with a significative tendency of reduction, and lower in the North and Northeast states, but with a significative tendency of increase. HDI and SVI showed an association with mortality. (Arq Bras Cardiol. 2021; 116(1):89-99).
脑血管疾病（CBVD）是世界上第二大致死原因。
分析巴西（1996 年至 2015 年）CBVD 的死亡率趋势及其与人类发展指数（HDI）和社会脆弱性指数（SVI）的关系。
这是一项生态学研究。我们分析了 CBVD 死亡率标准化。死亡数据来自死亡率信息系统（SIM），人口数据来自巴西地理与统计研究所（IBGE）。使用拐点回归模型（Joinpoint 回归）进行时间分析，计算年度百分比变化（APC）和平均年度百分比变化（AAPC），置信区间为 95%，显著性为 5%。趋势分为增加、减少或稳定。使用多元回归模型分析 CBVD 死亡率、HDI 和 SVI 之间的关系。
在此期间，记录了 1850811 例 CBVD 死亡。我们观察到全国死亡率下降（APC-2.4；p=0.001）。20 个联邦单位显示出显著趋势，其中 13 个单位显示下降，包括中西部（n=4）、东南部（n=4）和南部（n=3）的所有州。HDI 与死亡率呈正相关，SVI 与死亡率呈负相关（p=0.046 和 p=0.026）。
各地区的死亡率呈现出不平等的流行病学趋势，东南部和南部各州的死亡率较高，呈显著下降趋势，北部和东北部各州的死亡率较低，但呈显著上升趋势。HDI 和 SVI 与死亡率相关。（Arq Bras Cardiol. 2021; 116(1):89-99）。
