Trends in ischemic heart disease and stroke death ratios in brazilian women and men

OBJECTIVE: Cardiovascular diseases are the main cause of death in women and men in Brazil, but the trends for the death ratios for ischemic heart disease and stroke in women and men remain unknown. METHOD: In this study, the trends for the death ratios among women and men who were over 30 years of age were analyzed from 1980 to 2005. Data were collected for both the Brazilian population and the metropolitan area of Sao Paulo. Estimates of the population size and data for mortality were then obtained from the Brazilian Institute of Geography and Statistics and the Ministry of Health. The risk for death was adjusted using a direct method. RESULTS: Death rates due to cardiovascular disease, ischemic heart disease, and stroke have declined in both Brazil and the metropolitan region of Sao Paulo. A linear regression analysis revealed a similar trend for ischemic heart disease and demonstrated a male/female ratio of 1.653 +/- 0.001 (r = 0.228; p = 0.262) in Brazil and 1.763 +/- 0.008 (r = 0.863; p < 0.001) in Sao Paulo. Comparisons between the slopes of the linear regressions showed an increased ischemic heart disease ratio in men/women in Sao Paulo in comparison to those in Brazil (p < 0.0001). The linear regression showed an increasing trend for the male/female stroke ratio of 1.252 +/- 0.004 (r = 0.776; p < 0.0001) in Brazil and 1.331 +/- 0.006 (r = 0.580; p = 0.002) in Sao Paulo. Comparisons between the regressions for the stroke ratio were similar for men/women in Sao Paulo compared to Brazil (p = 0.244). CONCLUSION: We observed an increased trend in the ratio for ischemic heart disease death in men compared to women. Improvements in the control of risk factors and treatments for both men and women are mandatory to reduce the number of ischemic heart disease-related deaths in Brazil.