Decline on mortality for cardiovascular diseases in the city of São Paulo, Brazil

Background
In Brazil, cardiovascular diseases are the first cause of death. In the city of São Paulo, this pattern occurs since the 60´s. The aim of this study was to describe all-cause cardiovascular diseases mortality and the main cause subgroups: coronary heart diseases and stroke, in the city of São Paulo, for males and females aged 20 years and over, in two periods: 1996-1998 and 2003-2005.
Methods
We conducted an ecological study using mortality data by cardiovascular diseases, coronary heart diseases and stroke in each period. The populations were estimated from 2000 census. Mortality data were collected from the Program for Improving Local Mortality Data in the Municipality. The causes of deaths were coded according 10a Revision of the International Classification of Diseases. The death rates (per 100,000) were calculated for both periods, by causes, sex and age subgroups (20-29, 30-39, 40-49, 50-59, 60-69, 70 and over). The magnitude and mortality differentials were assessed using death rates and rate ratio.
Results
For both periods and each age group, death rates for cardiovascular disease group, coronary heart disease and stroke were highest among men. The death rates increased with age in both sexes for all-cause mortality. Mortality rates decreased for men and women in all age groups. There was an overall decline in mortality rates between 1996-1998 and 2003-2005. This pattern was greater among women. In the last period, for males and females aged 60-69, cardiovascular diseases mortality was 20% and 23% lower than in 1996-1998, respectively.
Conclusions
The cardiovascular diseases mortality decreases between the periods and increases with age. The mortality burden, especially for coronary heart diseases among men, is high. These results raises questions about potential years of life lost, prevention, control of risk factors, loss of economically active population and increased costs for the health care system