Serial temporal analysis of ischemic heart disease and stroke death risk in five regions of Brazil from 1981 to 2001.

OBJECTIVE The aim of this study was to evaluate the trends of ischemic and cerebrovascular death risk in the five regions--Midwest, Northeast, North, Southeast and South--of Brazil from 1981 to 2001. METHODS Data on mortality due to cerebrovascular and coronary heart diseases in the five regions of Brazil were obtained from the Brazilian Ministry of Health. The data source was the SIM--Sistema de Informações sobre Mortalidade (System of Information on Mortality), from the Department of Health Information Analysis. The population estimates were obtained from the IBGE (Brazilian Institute of Geography and Statistics) census of 1991 and 2000, and population estimates of 1996, all from DATASUS. The codes used in this study were International Classification of Diseases ICD-9 430-438 and ICD-10 I60-I69 for cerebrovascular diseases and ICD-9 410-414 and ICD-10 I21-I25 for ischemic disease. Statistical analysis was carried out by adjusted linear models. RESULTS There was a decline trend in death rates due to cerebrovascular disease at all age ranges and in both sexes in the South, Southwest, and Midwest regions. Additionally, death rates due to ischemic heart disease declined in the South and Southwest regions. There was a stabilization of the death risk in the Midwest and an increase in the Northeast region. CONCLUSION The risk of death due to cerebrovascular and ischemic heart diseases declined in the Southwest and South, which are the more developed regions of Brazil, whereas the risk increased in the less developed ones, mainly in the Northeast region.