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. 2022 Jun 10;118(6):1028-1048.
doi: 10.36660/abc.20210680. eCollection 2022.

Burden of Cardiovascular Diseases Attributable to Risk Factors in Portuguese-Speaking Countries: Data from the "Global Burden of Disease 2019" Study

[Article in English, Portuguese]
Bruno Ramos Nascimento  1 , Luisa Campos Caldeira Brant  1 , André Dias Nassar Naback  1 , Guilherme Augusto Veloso  2 , Carisi Anne Polanczyk  3   4   5 , Antonio Luiz Pinho Ribeiro  1 , Deborah Carvalho Malta  6 , Albano Vicente Lopes Ferreira  7 , Gláucia Maria Moraes de Oliveira  8
Affiliations

Burden of Cardiovascular Diseases Attributable to Risk Factors in Portuguese-Speaking Countries: Data from the "Global Burden of Disease 2019" Study

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

Abstract
in English, Portuguese

Background: The impact of risk factors (RF) on morbidity and mortality from cardiovascular disease (CVD) for most Portuguese-speaking countries (PSC) is little known.

Objectives: We aimed to analyze the morbidity and mortality from CVD attributable to RF and its variation, from 1990 to 2019, in PSC, based on estimates from the Global Burden of Disease (GBD) 2019 study.

Methods: We evaluated changes in cardiovascular RF, mortality rates and age-standardized disability-adjusted life years (DALYs) between 1990 and 2019. The correlation between percentage changes in mortality rates and the sociodemographic index (SDI) of each PSC was evaluated by the Spearman method. A p-value <0.05 was considered statistically significant.

Results: Elevated systolic blood pressure (SBP) was the main RF for mortality and DALYs for CVD for all PSC. Mortality from CVD showed a downward trend in 2019, more accentuated in Portugal (-66.6%, 95%CI -71.0 - -61.2) and in Brazil (-49.8%, 95%CI -52.5 - -47.1). There was a trend towards an inverse correlation between SDI and the percent change in mortality, which was significant for dietary risks (r=-0.70, p=0.036), high LDL cholesterol (r=-0.77, p=0.015) and high SBP (r=-0.74, p=0.023).

Conclusions: In addition to SBP, dietary and metabolic RF justified a greater variation in the burden of CVD correlated with SDI in the PSC, suggesting the need to adopt health policies adapted to the reality of each country, aiming to reduce their impact on population.

Fundamento: O impacto dos fatores de risco (FR) sobre a morbimortalidade por doença cardiovascular (DCV) na maioria dos países de língua portuguesa (PLP) é pouco conhecido.

Objetivo: Analisar a morbimortalidade por DCV atribuível aos FR e sua variação nos PLP de 1990 a 2019, a partir de estimativas do estudo Global Burden of Disease (GBD) 2019.

Métodos: Avaliamos as mudanças nos FR ocorridas no período, as taxas de mortalidade e os anos de vida perdidos por incapacidade (DALYs), padronizados por idade, entre 1990 e 2019. Realizou-se a correlação entre a variação percentual das taxas de mortalidade e o índice sociodemográfico (SDI) de cada PLP pelo método de Spearman. O valor p<0,05 foi considerado estatisticamente significativo.

Resultados: A pressão arterial sistólica (PAS) elevada foi o principal fator de risco para mortalidade e DALY por DCV para todos os PLP. A mortalidade por DCV mostrou uma tendência de redução em 2019, maior em Portugal (-66,6%, IC95% -71,0 - -61,2) e no Brasil (-49,8%, IC95% -52,5 - -47,1). Observou-se tendência à correlação inversa entre SDI e a variação percentual da mortalidade, que foi significativa para os riscos dietéticos (r=-0,70, p=0,036), colesterol LDL elevado (r=-0,77, p=0,015) e PAS elevada (r=-0,74, p=0,023).

Conclusões: Além da PAS, os FR dietéticos e metabólicos justificaram uma maior variação da carga de DCV, correlacionada com o SDI nos PLP, sugerindo a necessidade de adoção de políticas de saúde adaptadas à realidade de cada país, visando a redução de seu impacto sobre a população.

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Conflict of interest statement

Potencial conflito de interesse

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Figures

Figura 1
Figura 1. Ranking das taxas de mortalidade (/100 000 habitantes) por doenças cardiovasculares padronizadas por idade atribuíveis aos fatores de risco nos países de língua portuguesa em 1990 e 2019.
Figura 2
Figura 2. Percentual do total de mortes por doenças cardiovasculares atribuíveis a cada fator de risco cardiovascular, por país de língua portuguesa, em 1990 e 2019.
Figura 3
Figura 3. Taxas de mortalidade (por 100 000 habitantes) por doenças cardiovasculares ajustada por idade, atribuíveis a fatores de risco cardiovascular, por país de língua portuguesa, em 1990 e 2019.
Figura 4
Figura 4. Taxas de mortalidade e anos de vida perdidos por incapacidade (DALYs, Disability-Adjusted Life Years) por doenças cardiovasculares atribuíveis aos fatores de risco cardiovasculares agrupados, nos países de língua portuguesa entre 1990 e 2019.
Figura 5
Figura 5. Correlação entre o índice sociodemográfico (SDI, sociodemographic index) e a variação percentual nas taxas de mortalidade por doença cardiovascular atribuível aos fatores de risco, padronizadas por idade, em países de língua portuguesa de 1990 a 2019.
Figure 1
Figure 1. Ranking of cardiovascular disease age-standardized mortality rates (/100,000 inhabitants) attributable to risk factors in Portuguese-speaking countries in 1990 and 2019.
Figure 2
Figure 2. Percentage of total cardiovascular disease deaths attributable to each cardiovascular risk factor, by Portuguese-speaking country in 1990 and 2019.
Figure 3
Figure 3. Age-standardized cardiovascular disease mortality rate (/100,000 inhabitants) attributable to cardiovascular risk factors, by Portuguese-speaking country, in 1990 and 2019.
Figure 4
Figure 4. Cardiovascular disease mortality ate and disability-adjusted life years (DALYs) attributable to grouped cardiovascular risk factors in Portuguese-speaking countries, between 1990 and 2019.
Figure 5
Figure 5. Correlation between the sociodemographic index (SDI) and the percent change in age-standardized cardiovascular disease mortality rates attributable to selected risk factors in Portuguese-speaking countries from 1990 to 2019.
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