Mortality from Cardiovascular Diseases in the Elderly: Comparative Analysis of Two Five-year Periods

Abstract

Background: Cardiovascular diseases are the leading cause of death in Brazil. The better understanding of the spatial and temporal distribution of mortality from cardiovascular diseases in the Brazilian elderly population is essential to support more appropriate health actions for each region of the country.

Objective: To describe and to compare geospatially the rates of mortality from cardiovascular disease in elderly individuals living in Brazil by gender in two 5-year periods: 1996 to 2000 and 2006 to 2010.

Methods: This is an ecological study, for which rates of mortality were obtained from DATASUS and the population rates from the Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística). An average mortality rate for cardiovascular disease in elderly by gender was calculated for each period. The spatial autocorrelation was evaluated by TerraView 4.2.0 through global Moran index and the formation of clusters by the index of local Moran-LISA.

Results: There was an increase, in the second 5-year period, in the mortality rates in the Northeast and North regions, parallel to a decrease in the South, South-East and Midwest regions. Moreover, there was the formation of clusters with high mortality rates in the second period in Roraima among females, and in Ceará, Pernambuco and Roraima among males.

Conclusion: The increase in mortality rates in the North and Northeast regions is probably related to the changing profile of mortality and improvement in the quality of information, a result of the increase in surveillance and health care measures in these regions.

Graph 1

(A) Proportional mortality among female elderly in Brazil, divided by cause of death in five-year periods, from 1996 to 2000 and 2006 to 2010. (B) Proportional mortality among male elderly in Brazil, divided by cause of death in five-year periods, from 1996 to 2000 and 2006 2010. Chapter I: infectious and parasitic diseases; Chapter II: neoplasms; Chapter IV: endocrine, nutritional and metabolic diseases; Chapter IX: circulatory system diseases; Chapter X: respiratory diseases; Chapter XI: digestive diseases; Chapter XVIII: poorly-defined causes; Chapter XX: External causes. Source: Department of Informatics of the Unified Health System (DATASUS) / Ministry of Health.

Figure 1

Thematic maps of the mean mortality rate from cardiovascular diseases (MMRCD) per thousand inhabitants in each Brazilian state and gender in the periods from 1996 to 2000 and from 2006 to 2010. Natal (RN), Brazil, 2015. Source: Department of Informatics the Unified Health System (DATASUS)/ Ministry of Health, 2015.

Figure 2

Thematic maps of the mean rate of mortality from ill-defined causes (IDC) per thousand inhabitants for each Brazilian state and by gender in the periods from 1996 to 2000 and from 2006 to 2010. Natal (RN), Brazil, 2015. Source: Department of Informatics of the Unified Health System (DATASUS) / Ministry of Health, 2015.

Figure 3

Moran Map (significant) of spatial autocorrelation of the variable mean mortality rate from cardiovascular disease by gender, per thousand individuals for each state in Brazil, in the periods 1996-2000, and 2006 to 2010. Natal (RN), Brazil, 2015. CVD: cardiovascular disease; Source: Department of Informatics of the Unified Health System (DATASUS) / Ministry of Health, 2015.

Figure 4

Moran Map (significant) of spatial autocorrelation of the mean mortality rate from ill-defined causes (IDC) by gender, per thousand individuals for each state in Brazil, in the periods 1996-2000, and 2006 to 2010. Natal (RN), Brazil, 2015. Source: Department of Informatics of the Unified Health System (DATASUS) / Ministry of Health, 2015.