de Sá P, Dias J A, Miguel J M
Instituto de Medicina Preventiva, Faculdade de Medicina de Lisboa.
Acta Med Port. 1994 Feb;7(2):71-81.
By late 70's, Portugal had one of the lowest IHD mortality rates amongst developed countries, with a declining trend. As for CVD, Portugal's figures were one of the highest, and showing a trend to increase. In what concerns to our country, by early 80's there were some data showing important regional variations concerning IHD and CVD mortality. So, the aims of this study were to analyse the evolution of IHD and CVD mortality rates in Portugal during the 80's and its possible relations with known risk factors evolution and distribution. The study also observed regional variations and regional mortality excesses, and international comparisons were established. During the studied decade, CVD and IHD were the leading causes of death in Portugal, with a ratio of 2.7/l respectively. There was a 24% decrease in CVD death rates, and 11% for IHD, equal for male and female. We found important differences amongst age groups: CVD predominates in extreme ages (the youngest and the oldest), whereas IHD predominates only in men 25-54 years old. We also found striking differences between provinces: in the northern coast CVD predominates, whereas in the South and Azores islands IHD leads. At the end of the decade, CVD mortality rates in Portugal where the highest in Europe; on the contrary, IHD mortality was the second lowest, just after France. This pattern is similar to the southern countries of Europe and Japan. Trends in the main cardiovascular risk factors in Portugal during the 80s are an incomplete explanation for this evolution pattern, although the authors value the suggested decrease in arterial hypertension prevalence as the main factor responsible for the observed reduction in IHD and CVD mortality in the country.
到70年代末，葡萄牙是发达国家中缺血性心脏病死亡率最低的国家之一，且呈下降趋势。至于心血管疾病，葡萄牙的数据是最高的之一，且呈上升趋势。就我国而言，到80年代初，有一些数据显示缺血性心脏病和心血管疾病死亡率存在重要的地区差异。因此，本研究的目的是分析80年代葡萄牙缺血性心脏病和心血管疾病死亡率的演变及其与已知风险因素演变和分布的可能关系。该研究还观察了地区差异和地区死亡率过高的情况，并进行了国际比较。在研究的十年中，心血管疾病和缺血性心脏病是葡萄牙的主要死因，比例分别为2.7/1。心血管疾病死亡率下降了24%，缺血性心脏病死亡率下降了11%，男性和女性相同。我们发现不同年龄组之间存在重要差异：心血管疾病在极端年龄（最年轻和最年长）中占主导地位，而缺血性心脏病仅在25 - 54岁的男性中占主导地位。我们还发现各省之间存在显著差异：在北部海岸心血管疾病占主导地位，而在南部和亚速尔群岛缺血性心脏病占主导。在这十年结束时，葡萄牙的心血管疾病死亡率在欧洲是最高的；相反，缺血性心脏病死亡率是第二低的，仅次于法国。这种模式与欧洲南部国家和日本相似。80年代葡萄牙主要心血管风险因素的趋势并不能完全解释这种演变模式，尽管作者认为动脉高血压患病率的下降是该国缺血性心脏病和心血管疾病死亡率下降的主要因素。
