Cardiovascular disease mortality in the Americas: current trends and disparities
- Maria de Fatima Marinho de Souza1,
- Vilma Pinheiro Gawryszewski1,
- Pedro Orduñez2,
- Antonio Sanhueza1,
- Marcos A Espinal3
- 1Health Analysis and Information Project, Pan American Health Organization, Washington, DC, USA
- 2Chronic Diseases Project, Pan American Health Organization, Washington, DC, USA
- 3Health Surveillance, Diseases Prevention and Control, Pan American Health Organization, Washington, DC, USA
- Correspondence to Dr Vilma Pinheiro Gawryszewski, Health Analysis and Information Project, Pan American Health Organization, 525 23rd Street, Washington, DC 20037, USA; gawryszv{at}paho.org
-
Contributors MFMS was responsible for managing the mortality dataset, designing the statistical analysis plan and revising the paper; VPG was responsible for the conception and design of the project, data analysis and the draft and revision of the paper. PO participated in the study design, and drafting and revising the paper. AS designed the statistical analysis plan, undertook the statistical analysis and revised the paper. MAE participated in the study design, paper development and the critical revision of the paper.
- Received 16 February 2012
- Accepted 25 May 2012
Abstract
Objective To describe the current situation and trends in mortality due to cardiovascular disease (CVD) in the Americas and explore their association with economic indicators.
Design and Setting This time series study analysed mortality data from 21 countries in the region of the Americas from 2000 to the latest available year.
Main Outcomes Measures Age-adjusted death rates, annual variation in death rates. Regression analysis was used to estimate the annual variation and the association between age-adjusted rates and country income.
Results Currently, CVD comprised 33.7% of all deaths in the Americas. Rates were higher in Guyana (292/100 000), Trinidad and Tobago (289/100 000) and Venezuela (246/100 000), and lower in Canada (108/100 000), Puerto Rico (121/100 000) and Chile (125/100 000). Male rates were higher than female rates in all countries. The trend analysis showed that CVD death rates in the Americas declined −19% overall (−20% among women and −18% among men). Most countries had a significant annual decline, except Guatemala, Guyana, Suriname, Paraguay and Panama. The largest annual declines were observed in Canada (−4.8%), the USA (−3.9%) and Puerto Rico (−3.6%). Minor declines were in Mexico (−0.8%) and Cuba (−1.1%). Compared with high-income countries the difference between the median of death rates in lower middle-income countries was 56.7% higher and between upper middle-income countries was 20.6% higher.
Conclusions CVD death rates have been decreasing in most countries in the Americas. Considerable disparities still remain in the current rates and trends.
- Allied specialities
- cardiovascular disease
- circulatory system disease
- congenital heart disease
- coronary artery disease
- emergency medicine
- epidemiology
- hypertension
- inequity
- infection
- ischaemic heart disease
- neurology
- paediatric cardiology
- public health
- quality of care and outcomes
- stroke
- trend
Footnotes
-
Competing interests None.
-
Provenance and peer review Not commissioned; internally peer reviewed.
-
Data sharing statement Age-adjusted death rates per 100 000 population used in our trend analysis and some basic indicators for each country are available for researchers or public health professionals interested in doing any additional studies.
