A reappraisal of stroke mortality trends in Brazil (1979-2009)

Abstract

Background: Brazil has one of the highest cerebrovascular death rates in the Western Hemisphere. We investigated temporal trends according to gender and stroke subtypes.

Methods: We analyzed mortality rates between 1979 and 2009 for different stroke subtypes. Data were stratified by gender and age (35-74 years). The annual percent change and significant changes in the trends were identified with Poisson regression.

Results: After excluding deaths due to sequel from stroke for men, the annual percent changes (95% confidence intervals) were as follows: 1979-1984, 0.7 (-0.8 to 2.1); 1984-1994, -1.8 (-2.4 to -1.2); 1994-2007, -5.0 (-5.4 to -4.7); and 2007-2009, -0.8 (-7.0 to 5.8). For women, the annual percent changes were as follows: 1979-1994, -1.9 (-2.2 to -1.6); 1994-1997, -7.5 (-14.0 to -0.6); 1997-2007, -4.0 (-4.6 to -3.3); and 2007-2009, 1.6 (-5.5 to 9.2). For the 2006-2009 period, the average annual percent change (95% confidence interval) for all strokes was -3.1 (-3.3 to -2.9) for men and -2.9 (-3.1 to -2.8) for women. For the same period, the average annual percent change of death rates for stroke subtypes were, for men and women, respectively: intracerebral hemorrhage, -4.0 (-4.9 to -3.1) and -2.9 (-3.4 to -2.3); and ischemic stroke, -3.2 (-3.3 to -3.0) and -1.4 (-2.0 to -0.9).

Conclusion: Stroke mortality rates are declining in Brazil for all stroke subtypes.