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. 2018 Jun;110(6):500-511.
doi: 10.5935/abc.20180098.

Cardiovascular Disease Epidemiology in Portuguese-Speaking Countries: data from the Global Burden of Disease, 1990 to 2016

[Article in English, Portuguese]
Bruno Ramos Nascimento  1 , Luisa Campos Caldeira Brant  1 , Gláucia Maria Moraes de Oliveira  2 , Marcus Vinícius Bolívar Malachias  3 , Gabriel Moreira Alves Reis  1 , Renato Azeredo Teixeira  1 , Deborah Carvalho Malta  1 , Elisabeth França  1 , Maria de Fátima Marinho Souza  4 , Gregory A Roth  5 , Antonio Luiz P Ribeiro  1
Affiliations

Cardiovascular Disease Epidemiology in Portuguese-Speaking Countries: data from the Global Burden of Disease, 1990 to 2016

[Article in English, Portuguese]
Bruno Ramos Nascimento et al. Arq Bras Cardiol. 2018 Jun.

Abstract

Background: Portuguese-speaking countries (PSC) share the influence of the Portuguese culture but have socioeconomic development patterns that differ from that of Portugal.

Objective: To describe trends in cardiovascular disease (CVD) morbidity and mortality in the PSC between 1990 and 2016, stratified by sex, and their association with the respective sociodemographic indexes (SDI).

Methods: This study used the Global Burden of Disease (GBD) 2016 data and methodology. Data collection followed international standards for death certification, through information systems on vital statistics and mortality surveillance, surveys, and hospital registries. Techniques were used to standardize causes of death by the direct method, as were corrections for underreporting of deaths and garbage codes. To determine the number of deaths due to each cause, the CODEm (Cause of Death Ensemble Model) algorithm was applied. Disability-adjusted life years (DALYs) and SDI (income per capita, educational attainment and total fertility rate) were estimated for each country. A p-value <0.05 was considered significant.

Results: There are large differences, mainly related to socioeconomic conditions, in the relative impact of CVD burden in PSC. Among CVD, ischemic heart disease was the leading cause of death in all PSC in 2016, except for Mozambique and Sao Tome and Principe, where cerebrovascular diseases have supplanted it. The most relevant attributable risk factors for CVD among all PSC are hypertension and dietary factors.

Conclusion: Collaboration among PSC may allow successful experiences in combating CVD to be shared between those countries.

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Conflict of interest statement

Potential Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1
Global map showing the location of the Portuguese-speaking countries, 2017.
Figure 2
Figure 2
Most common causes of death, considering age-standardized mortality, in the Portuguese-speaking countries in 1990 and 2016. A: All causes; B: From cardiovascular diseases. LRI = lower respiratory tract infection; NTD = neglected tropical diseases.
Figure 3
Figure 3
Mortality attributed to cardiovascular diseases in the Portuguese-speaking countries from 1990 to 2016. A. Proportional mortality from cardiovascular diseases (%), B. Age-standardized mortality rate from cardiovascular diseases (deaths/100,000).
Figure 4
Figure 4
Age-standardized mortality rate in the Portuguese-speaking countries in 1990 and 2016.
Figure 5
Figure 5
Correlation between the change in mortality from cardiovascular diseases between 1990 and 2016 and the sociodemographic index (rs = 0.7; p = 0.04).
Figure 6
Figure 6
Disability-adjusted life years (DALYs) for each cardiovascular disease for each Portuguese-speaking country, 2016.
Figure 7
Figure 7
Influence of the risk factors on the years of life lost (YLLs) because of cardiovascular diseases, according to sex, in each Portuguese-speaking country in 2016.
Supplementary Figure 1
Supplementary Figure 1
Age-standardized Disability Adjusted Life Years (DALY) attributable to cardiovascular disease (CVD) in Portuguese-speaking countries, from 1990 to 2016.
Supplementary Figure 2
Supplementary Figure 2
Mortality attibutable to risk factors in Portuguese-speaking countries, in 1990 and 2016.
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