Cardiovascular mortality and social inequalities in Sao Paulo City, Brazil, 1996-1998 and 2008-2010

Objective: to evaluate differences in mortality from ischemic heart disease (IHD) and cerebrovascular disease (CVD) in geographic areas with distinct socioeconomic characteristics in Sao Paulo city - Brazil, during two periods: 1996-1998 and 2008-2010. Methods: we studied deaths in the population aged over 20 years and social indicators aggregated into five territorial areas. We calculated standardized mortality ratios (SMR) using the indirect method and mortality risk ratio (MRR) between areas, estimated by Poisson regression, confidence intervals of 95% and trend testing. Results: among men, increased social exclusion was accompanied by increased MRR for IHD in 2008-2010, ranging from 1.19 in area 2 to 1.38 in area 5, compared to the wealthiest area the in range. Among women, this variation was 1.11 and 1.61, respectively. MRR for CVD showed association with social exclusion in both periods for both sexes (p<0,01). Conclusion: risk of mortality from IHD and CVD increased as social conditions declined in the geographic areas studied.