A reappraisal of stroke mortality trends in Brazil (1979-2009)

Abstract

Background Brazil has one of the highest cerebrovascular death rates in the Western Hemisphere. We investigated temporal trends according to gender and stroke subtypes. Methods We analyzed mortality rates between 1979 and 2009 for different stroke subtypes. Data were stratified by gender and age (3574years). The annual percent change and significant changes in the trends were identified with Poisson regression. Results After excluding deaths due to sequel from stroke for men, the annual percent changes (95% confidence intervals) were as follows: 19791984, 0 center dot 7 (0 center dot 8 to 2 center dot 1); 19841994, 1 center dot 8 (2 center dot 4 to 1 center dot 2); 19942007, 5 center dot 0 (5 center dot 4 to 4 center dot 7); and 20072009, 0 center dot 8 (7 center dot 0 to 5 center dot 8). For women, the annual percent changes were as follows: 19791994, 1 center dot 9 (2 center dot 2 to 1 center dot 6); 19941997, 7 center dot 5 (14 center dot 0 to 0 center dot 6); 19972007, 4 center dot 0 (4 center dot 6 to 3 center dot 3); and 20072009, 1 center dot 6 (5 center dot 5 to 9 center dot 2). For the 20062009 period, the average annual percent change (95% confidence interval) for all strokes was 3 center dot 1 (3 center dot 3 to 2 center dot 9) for men and 2 center dot 9 (3 center dot 1 to 2 center dot 8) for women. For the same period, the average annual percent change of death rates for stroke subtypes were, for men and women, respectively: intracerebral hemorrhage, 4 center dot 0 (4 center dot 9 to 3 center dot 1) and 2 center dot 9 (3 center dot 4 to 2 center dot 3); and ischemic stroke, 3 center dot 2 (3 center dot 3 to 3 center dot 0) and 1 center dot 4 (2 center dot 0 to 0 center dot 9). Conclusion Stroke mortality rates are declining in Brazil for all stroke subtypes.