Background
Heart failure (HF) is a highly prevalent disease with high mortality rates worldwide, representing the final stage of a large set of cardiovascular diseases.
Purpose
To evaluate the trend of mortality rates fromHF, by sex and Brazilian geoeconomic region, between 1980 and 2016.
Methods
Time series analysis of the underlying causes of death from HF between 1980 and 2016. Population and death-related data were obtained from the Information Technology Department of the Brazilian Unified Health System (DATASUS/MS). Annual crude mortality rates per 100,000 inhabitants were calculated. Standardized rates were estimated according to the age structure of the Brazilian population in the year 2000. Mortality rates were evaluated in all federal units (FedUs) that comprise the Braziliangeoeconomicregions (Northern, Northeastern, Southeastern, Southern and West-Central).
Results
In Brazil, of the 35,348,374 deaths recorded between 1980 and 2016, 3.2% had HF as the underlying cause. The crude mortality rates from HF in both sexes showed a similar reduction trend over the period. In men, those rates ranged from 13.77 in 1980 to 6.69 per 100,000 inhabitants in 2016, while in women, those rates ranged from 13.15 in 1980 to 7.27 per 100,000 inhabitants in 2016 (Figure 1). Despite the relative stability in the last decade, the standardized rates (Figure 1 - Std) showed a similar trend, but with lower values at the end of the study period. Of all FedUs, only Maranhão (Northeastern region) showed a mortality rate similar to that observed in 1980 (10.44 per 100,000 inhabitants in 1980 and 10.65 per 100,000 inhabitants in 2016). All the other FedUs showed a reduction over the period. The FedUs of the Southeastern, Southern and West-Central regions had the highest reductions, especially Espírito Santo (Southeastern region), Rio Grande do Sul (Southern region) and the Federal District, which decreased from 38.98, 53.34 and 28.56 in 1980 to 3.43, 8.49 and 4.33 per 100,000 inhabitants in 2016, respectively.
Figure 1
Conclusions
The crude and standardized mortality rates from HF decreased in the last 37 years, probably because of the better control of risk factors and the advances in HF treatment. The most important reductions occurred in the richest regions of the country, which may be related to the improvement of socioeconomic factors.
