Key result
Female sex is linked to faster CVD mortality declines, widening Brazil's sex gap to ~1.8-fold.
Why the study?
Cardiovascular diseases are the leading causes of death in Brazilian women and men, prompting analysis of sex-specific mortality trends over time.
How did age-adjusted mortality trends for all-cause death, cardiovascular disease, ischemic heart disease, and stroke differ between women and men aged 35 to 74 years in Brazil from 1996 to 2019?
Observational
How did age-adjusted mortality trends for all-cause death, cardiovascular disease, ischemic heart disease, and stroke differ between women and men aged 35 to 74 years in Brazil from 1996 to 2019?
Although cardiovascular, ischemic heart disease, and stroke mortality rates declined significantly across Brazil between 1996 and 2019, the declines were smaller in men than in women, widening the sex mortality gap and highlighting the need for targeted cardiovascular prevention.
Answers are grounded in this paper and cite their sources.
Highlights widening CVD mortality gap in Brazilian men; leaves open targeted prevention strategies and causal mechanisms.
Background: cardiovascular diseases (CVD) are Brazil’s leading causes of death in women and men. This study analyzed age-adjusted death rate (DRaj) trends from all causes of death (ACD), CVD, ischemic heart disease (IHD), and stroke in women and men aged 35 to 74 years from 1996 to 2019. Methods: We analyzed DRaj trends for all causes of death (ACD), CVD, IHD, and stroke. Data were from the Ministry of Health mortality database. Joinpoint Regression Program™ performed trend analysis and adjustments in death rates. Average annual percentage change (AAPC) determined the intensity of changes. Results: In women, DRaj reduced for ACD (AAPC = −1.6%); CVD (AAPC = −2.6%); IHD (AAPC = −1.9%); and stroke (AAPC = −4.6%) (p < 0.001 for all). In men, ACD reduced from 1996 to 2004 (AAPC = −0.9%; p < 0.001), from 2012 to 2019 (AAPC = −1.9%; p < 0.001), and unchanged from 2004 to 2012; CVD (AAPC = −2.1%); IHD (AAPC = −1.5%); stroke (AAPC = −4.9%) (p < 0.001 for all) reduced from 1996 to 2019. From 1996 to 2019, the male/female ratio for ACD remained unchanged. CVD increased from 1.58 to 1.83, IHD from 1.99 to 2.30, and stroke from 1.52 to 1.83. Conclusion: ACD, CVD, IHD, and stroke were reduced more significantly in women, and the ratio of CVD, IHD, and CVD in men and women increased more in men. Future studies will be needed to determine the main factors responsible for a better outcome in women.
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Mansur et al. (2022) conducted an observational in Cardiovascular disease, ischemic heart disease, and stroke mortality. Female sex vs. Male sex was evaluated on Average annual percentage change (AAPC) in age-adjusted death rate (DRaj) for cardiovascular diseases (CVD) (AAPC -2.6% in women vs -2.1% in men, p=<0.001). Female sex was associated with a greater decline in age-adjusted CVD death rates in Brazil from 1996 to 2019, increasing the male/female CVD mortality ratio to 1.83.
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