Universidade Federal de Minas Gerais, Faculdade de Medicina e Hospital das Clínicas, Belo Horizonte, MG, Brasil.
Universidade Federal de Minas Gerais, Departamento de Estatística, Programa de Pós-Graduação em Estatística, Belo Horizonte, MG, Brasil.
Rev Soc Bras Med Trop. 2022 Jan 28;55(suppl 1):e0263. doi: 10.1590/0037-8682-0263-2021. eCollection 2022.
To better understand trends in the main cause of death in Brazil, we sought to analyze the burden of cardiovascular risk factors (RF) and cardiovascular diseases (CVD) attributable to specific RFs in Brazil from 1990 to 2019, using the estimates from the GBD 2019 study.
To estimate RF exposure, the Summary Exposure Value (SEV) was used, whereas for disease burden attributed to RF, mortality and disability-adjusted life-years (DALY) due to CVD were used. For comparisons over time and between states, we compared age-standardized rates. The sociodemographic index (SDI) was used as a marker of socioeconomic conditions.
In 2019, 83% of CVD mortality in Brazil was attributable to RF. For SEV, there was a reduction in smoking and environmental RF, but an increase in metabolic RF. High systolic blood pressure and dietary risks continue to be the main RF for CVD mortality and DALY. While there was a decline in age-standardized mortality rates attributable to the evaluated RF, there was also a stability or increase in crude mortality rates, with the exception of smoking. It is important to highlight the increase in the risk of death attributable to a high body mass index. Regarding the analysis per state, SEVs and mortality attributable to RF were higher in those states with lower SDIs.
Despite the reduction in CVD mortality and DALY rates attributable to RF, the stability or increase in crude rates attributable to metabolic RFs is worrisome, requiring investments and a renewal of health policies.
为了更好地了解巴西主要死亡原因的趋势,我们试图分析 1990 年至 2019 年巴西特定心血管风险因素(RF)和心血管疾病(CVD)的负担,使用 GBD 2019 研究的估计数。
为了估计 RF 暴露,使用了汇总暴露值(SEV),而对于归因于 RF 的疾病负担,使用了 CVD 导致的死亡率和伤残调整生命年(DALY)。为了进行时间和州之间的比较,我们比较了年龄标准化率。社会人口指数(SDI)被用作社会经济条件的标志。
2019 年,巴西 83%的 CVD 死亡率归因于 RF。就 SEV 而言,吸烟和环境 RF 有所减少,但代谢 RF 有所增加。高收缩压和饮食风险仍然是 CVD 死亡率和 DALY 的主要 RF。虽然归因于评估 RF 的年龄标准化死亡率有所下降,但粗死亡率也保持稳定或上升,除了吸烟。值得注意的是,高身体质量指数导致的死亡风险增加。关于各州的分析,SDI 较低的州的 SEV 和归因于 RF 的死亡率更高。
尽管归因于 RF 的 CVD 死亡率和 DALY 率有所下降,但代谢 RF 导致的粗率保持稳定或上升令人担忧,需要投资和更新卫生政策。