Cardiovascular disease in South America: current status and opportunities for prevention

Abstract

South America comprises widely different environments consisting of many complex and heterogeneous ethnicities, societies and cultures. During recent decades conspicuous advances in human and societal development have been made. South America now faces three major demographic shifts: population growth; urbanisation (almost 90% of the population live in urban areas) and ageing. Recently, an epidemiological transition has been seen. Urbanisation has brought unfavourable and prominent changes, such as increased smoking rates, stress, lack of physical activity and poor diets (more fat and calories). Consequently, owing to the interaction between environment and genetic susceptibility, the modifications induced by urbanisation have resulted in enhancement of the cardiovascular risk factors and cardiovascular disease (CVD). This situation is responsible for the burden of CVD in South America, requiring effective action towards better detection and control of cardiovascular risk factors aimed at reducing the burden of disease in the region, which tends to be higher and increasingly serious.

Desfechos clínicos aos 30 dias do registro brasileiro das síndromes coronárias agudas (ACCEPT)

“…However, the occurrence of severe outcomes was decreased, showing a percentage closer to those reported by controlled studies. This evidence only confirms that each registry has its own identity, directly related to the service profile of the participating institutions [5][6][7][8][9][10][11][12][13][14][15][16][17] .…”

“…One goal of registries is to identify inaccuracies or clinical practices that are in disagreement with the main recommendations of medical guidelines and then demand corrective measures, through the updating of medical knowledge and by improving care services to the target population. Therefore, the analysis of the results is related to the participating centers, the existing health policies and standardization of medical practice [11][12][13][14][15][16][17] . Several similar researches have been previously reported.…”

“…Previous registries have shown that the use of invasive and pharmacological interventions in the setting of acute coronary syndromes (ACS) are yet the meet ideal standards, with gaps and missed opportunities for treatment, based on the current guideline recommendations [11][12][13][14][15][16][17] .…”

Mortalidade por doenças cardiovasculares no Brasil e na região metropolitana de São Paulo: atualização 2011

“…It is known that urbanization is associated with an inadequate profile of risk factors for cardiovascular diseases 21 . The population's increased access to primary care and treatment of CVD should be a priority for the government, as CVD are the leading causes of death in individuals older than 60 years, especially among the less favored socioeconomic classes 22 .…”

Diretrizes

“…Apesar da significativa redução da mortalidade hospitalar do IAM nas últimas décadas 8,9 , houve pouco avanço no conhecimento sobre a epidemiologia e o tratamento na fase pré-hospitalar. É notória a necessidade de mudanças nesse cenário, embora poucas sejam as evidências geradas para este fim.…”