Cardiovascular diseases are responsible for 32% of total mortality in Brazil, mostly due to cerebrovascular and coronary artery disease. Epidemiologic and socio-economical factors play a pivotal role on the distribution, severity, and management of coronary artery disease and the burden is greater in the Southeast and South Regions of the country, with a higher mortality rate in low income populations. The Brazilian health care structure is divided into two complementary systems, a public and a private, however 75% of the population is covered exclusively by the public system. Some Brazilian institutions offer state-of-the-art care to patients with acute and chronic coronary artery disease, but regional inequalities in medical care are still significant. National policies will have to be implemented to fight risk factors, to ensure primary prevention strategies, including assistance on drugs with known protective effects, areas to be tackled by both the private and the public health sectors. Finally, large investments will have to be made to improve tertiary care, to reorganize systems of care for acute patients, and mainly unsure prompt access and continuity of cardiac care and secondary prevention strategies to the whole population.
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