Tiótrefis G Fernandes1, Daniel H Bando2, Airlane P Alencar3, Isabela M Benseñor4, Paulo A Lotufo4. 1. Federal University Amazonas, Manaus, Amazonas, Brazil. 2. Federal University of Alfenas, Minas Gerais, Brazil. 3. Mathematics and Statistics Institute of University of São Paulo (USP), São Paulo, Brazil. 4. Hospital Universitario (USP), São Paulo, Brazil.
Abstract
BACKGROUND: It is not clear the relationship between stroke mortality trends and socioeconomic inequalities in low- and middle-income countries. AIMS: We compared differences of trends in stroke mortality by socioeconomic status in the city of Sao Paulo, Brazil. METHODS: We analyzed the intra-urban distribution of stroke death rates from 1996 to 2011 for persons aged 35-74 years old according to income using joinpoint regression. RESULTS: We confirmed 77 848 stroke deaths in the period, 51·4% of them among persons aged 35-74 years old. For all areas, there was parallelism between genders, and the average annual percent changes combined was -5·2 (-5·7 to -4·6) from 1996 to 2005 and -3·0 (-4·3 to -1·7) from 2005 to 2011. The full period average annual percent changes of age-adjusted rates between persons living in the high- and low-income area were, respectively, -5·4 and -4·2 (P = 0·002) for men and -5·9 vs. -4·9 (P = 0·017) for women. Differences in the risk of stroke between the high- and low-income areas increased more than twofold in the period in both genders. CONCLUSIONS: The risk of stroke death is decreasing in all regions, but the faster decline in mortality rates in the wealthiest area contributes to further greater inequalities.
BACKGROUND: It is not clear the relationship between stroke mortality trends and socioeconomic inequalities in low- and middle-income countries. AIMS: We compared differences of trends in stroke mortality by socioeconomic status in the city of Sao Paulo, Brazil. METHODS: We analyzed the intra-urban distribution of stroke death rates from 1996 to 2011 for persons aged 35-74 years old according to income using joinpoint regression. RESULTS: We confirmed 77 848 stroke deaths in the period, 51·4% of them among persons aged 35-74 years old. For all areas, there was parallelism between genders, and the average annual percent changes combined was -5·2 (-5·7 to -4·6) from 1996 to 2005 and -3·0 (-4·3 to -1·7) from 2005 to 2011. The full period average annual percent changes of age-adjusted rates between persons living in the high- and low-income area were, respectively, -5·4 and -4·2 (P = 0·002) for men and -5·9 vs. -4·9 (P = 0·017) for women. Differences in the risk of stroke between the high- and low-income areas increased more than twofold in the period in both genders. CONCLUSIONS: The risk of stroke death is decreasing in all regions, but the faster decline in mortality rates in the wealthiest area contributes to further greater inequalities.
Authors: Gláucia Maria Moraes de Oliveira; Luisa Campos Caldeira Brant; Carisi Anne Polanczyk; Deborah Carvalho Malta; Andreia Biolo; Bruno Ramos Nascimento; Maria de Fatima Marinho de Souza; Andrea Rocha De Lorenzo; Antonio Aurélio de Paiva Fagundes Júnior; Beatriz D Schaan; Fábio Morato de Castilho; Fernando Henpin Yue Cesena; Gabriel Porto Soares; Gesner Francisco Xavier Junior; Jose Augusto Soares Barreto Filho; Luiz Guilherme Passaglia; Marcelo Martins Pinto Filho; M Julia Machline-Carrion; Marcio Sommer Bittencourt; Octavio M Pontes Neto; Paolo Blanco Villela; Renato Azeredo Teixeira; Roney Orismar Sampaio; Thomaz A Gaziano; Pablo Perel; Gregory A Roth; Antonio Luiz Pinho Ribeiro Journal: Arq Bras Cardiol Date: 2022-01 Impact factor: 2.000
Authors: Gláucia Maria Moraes de Oliveira; Luisa Campos Caldeira Brant; Carisi Anne Polanczyk; Andreia Biolo; Bruno Ramos Nascimento; Deborah Carvalho Malta; Maria de Fatima Marinho de Souza; Gabriel Porto Soares; Gesner Francisco Xavier Junior; M Julia Machline-Carrion; Marcio Sommer Bittencourt; Octavio M Pontes Neto; Odilson Marcos Silvestre; Renato Azeredo Teixeira; Roney Orismar Sampaio; Thomaz A Gaziano; Gregory A Roth; Antonio Luiz Pinho Ribeiro Journal: Arq Bras Cardiol Date: 2020-09 Impact factor: 2.667
Authors: Luiz Vinicius de Alcantara Sousa; Laércio da Silva Paiva; Francisco Winter Dos Santos Figueiredo; Tabata Cristina do Carmo Almeida; Fernando Rocha Oliveira; Fernando Adami Journal: Open Cardiovasc Med J Date: 2017-11-16
Authors: Laércio da Silva Paiva; Fernando Rocha Oliveira; Luiz Vinicius de Alcantara Sousa; Francisco Winter Dos Santos Figueiredo; Thiago Hérick de Sá; Fernando Adami Journal: Sci Rep Date: 2019-02-27 Impact factor: 4.379