Comparison of Trends in Mortality from Coronary Heart and Cerebrovascular Diseases in North and South America: 1980 to 2013.

Until the past century, mortality trends from coronary heart disease (CHD) and cerebrovascular disease (CVD) were less favorable in Latin than in North America. We calculated age-standardized mortality rates using data from the World Health Organization database over the period 1980 to 2013. To identify significant changes in trends, we performed joinpoint analysis. Since the early 2000's, CHD mortality rates decreased by about 35% in the USA and Canada in both genders; similar decreases were observed in some Latin American countries (i.e., Ecuador, Puerto Rico, and Chile), whereas the decreases were smaller in the other countries. In 2011 to 2013, the highest rates were in Venezuela (114.4/100,000 men) and Colombia (86.1/100,000 men) and the lowest ones (apart from Ecuador) in Panama, Chile, and Argentina (from 41 to 46/100,000 men and 18 to 19/100,000 women). For CVD mortality, a decrease by about 30% was observed in Argentina, Panama, and Uruguay plus Colombia for women, in addition to the USA and Canada. Smaller declines were observed in the other Latin American countries (from 23% in Colombian men to 5% in Venezuelan men). Throughout the period, rates in Latin America remained appreciably higher than those in North America. The highest CVD rates were observed in Brazil (51.6/100,000 men) and the lowest ones in Canada (12.9/100,000 women). In conclusion, trends in CHD and CVD mortality continue to be less favorable in Latin America than in Canada and the USA. The marked excess of CVD mortality is partly or largely attributable to inadequate control of dyslipidemia and hypertension.