RESUMO
BACKGROUND: Mortality rates due to coronary heart disease (CHD) have decreased in most countries, but increased in low and middle-income countries. Few studies have analyzed the trends of coronary heart disease mortality in Latin America, specifically the trends in young-adults and the effect of correcting these comparisons for nonspecific causes of death (garbage codes). The objective of this study was to describe and compare standardized, age-specific, and garbage-code corrected mortality trends for coronary heart disease from 1985 to 2015 in Argentina, Colombia, and Mexico. METHODS: Deaths from coronary heart disease were grouped by country, year of registration, sex, and 10-year age bands to calculate age-adjusted and age and sex-specific rates for adults aged ≥25. We corrected for garbage-codes using the methodology proposed by the Global Burden of Disease. Finally, we fitted Joinpoint regression models. RESULTS: In 1985, age-standardized mortality rates per 100,000 population were 136.6 in Argentina, 160.6 in Colombia, and 87.51 in Mexico; by 2015 rates decreased 51% in Argentina and 6.5% in Colombia, yet increased by 61% in Mexico, where an upward trend in mortality was observed in young adults. Garbage-code corrections produced increases in mortality rates, particularly in Argentina with approximately 80 additional deaths per 100,000, 14 in Colombia and 13 in Mexico. CONCLUSIONS: Latin American countries are at different stages of the cardiovascular disease epidemic. Garbage code correction produce large changes in the mortality rates in Argentina, yet smaller in Mexico and Colombia, suggesting garbage code corrections may be needed for specific countries. While coronary heart disease (CHD) mortality is falling in Argentina, modest falls in Colombia and substantial increases in Mexico highlight the need for the region to propose and implement population-wide prevention policies.
Assuntos
Doença das Coronárias/mortalidade , Adulto , Idoso , Argentina/epidemiologia , Colômbia/epidemiologia , Feminino , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Fatores de TempoRESUMO
Objetivo. Examinar y describir la mortalidad por cardiopatía coronaria y su patrón de cambio (tendencia) por sexo, edad y zona de residencia (urbana frente a rural) en Tianjín, China, en el contexto de la transición epidemiológica, y compararla con lastendencias actuales en las Américas y Europa. Métodos. Se analizaron 104 393 casos de muertes debidas a cardiopatía coronaria ocurridas en Tianjín entre 1999 y 2008. Se codificó la mortalidad debida a cardiopatíacoronaria según la Clasificación Internacional de Enfermedades (novena y décima revisiones). Se analizaron las tasas estandarizadas de mortalidad por cardiopatía coronaria y sus tendencias por edad, sexo y residencia urbana frente a rural. Resultados. Durante el período de estudio, de 10 años, la proporción de la mortalidad total debida a cardiopatía coronaria registrada en Tianjín aumentó significativamente(de 16% a 24%) y la mortalidad por cardiopatía coronaria estandarizadapor edad aumentó levemente (sin significación estadística), en contraposición con las tendencias de mortalidad por cardiopatía coronaria observadas en diversos países delas Américas y Europa, que están descendiendo. No se encontraron diferencias en la tendencia de la mortalidad por cardiopatía coronaria por sexo en Tianjín. La mortalidadgeneral por cardiopatía coronaria fue sistemáticamente más elevada en los grupos de mayor edad, los varones y los residentes de zonas urbanas. La proporción de muertes debidas a cardiopatía coronaria que ocurrieron fuera de los hospitales fue de 55,81%, con una tendencia decreciente en el período de estudio. Esta proporción fuemayor en las zonas rurales que en las urbanas, pero no se encontró diferencia entre los distintos grupos de edad.Conclusiones. Desde 1999 hasta el 2008, la mortalidad por cardiopatía coronaria en Tianjín varió según el sexo, la edad y la residencia urbana frente a la rural...
Objective. To examine and describe coronary heart disease (CHD) mortality and its pattern of change (trend) by sex, age, and area of residence (urban versus rural) in Tianjin, China, within the context of epidemiological transition, and compare it with current trends in the Americas and Europe.Methods. A total of 104 393 cases of CHD death in Tianjin occurring between 1999 and 2008 were monitored. Death due to CHD was coded using International Classification of Diseases (ICD) standards (ninth and tenth revisions). Standardized CHD mortality rates and their trends were analyzed by age, sex, and urban versus rural residence. Results. During the 10-year study period, the proportion of total deaths due to CHD in Tianjin increased significantly (from 16% to 24%) and age-standardized CHD mortalityincreased slightly (with no statistical differences), in contrast to CHD mortality trends in various countries in the Americas and Europe, which are declining. No difference was found inTianjins CHD mortality trend by sex. Overall CHD mortality was consistently higher among older age groups, males, and residents of urban areas. The proportion of CHD deaths occurringoutside hospitals was 55.81%, with a declining trend over the study period. Rural areas had a higher proportion of outside-hospital CHD mortality than urban areas, but no difference wasfound across age groups. Conclusions. From 1999 to 2008, CHD mortality in Tianjin varied by sex, age, and urbanversus rural area of residence. Future research to identify CHD risk factors and the populations most vulnerable to the disease is recommended to help strengthen CHD prevention. Strategiesfor CHD control similar to those used in various developed countries in the Americas and Europe should be developed to reduce the CHD burden in China.