Variations and particularities in cardiovascular disease mortality in Brazil and Brazilian states in 1990 and 2015: estimates from the Global Burden of Disease.

OBJECTIVE: : To analyze variations and particularities in mortality due to cardiovascular disease (CVD) in Brazil and in Brazilian states, in 1990 and 2015.
METHODS: : We used data compiled from the Global Burden of Disease (GBD) 2015, obtained from the database of the Mortality Information System (SIM) of the Brazilian Ministry of Health. Correction of the sub-registry of deaths and reclassification of the garbage codes were performed using specific algorithms. The cardiovascular causes were subdivided into 10 specific causes. Age-standardized CVD mortality rates - in 1990 and 2015 - were analyzed according to sex and Brazilian state.
RESULTS: : Age-standardized CVD mortality rate decreased from 429.5 (1990) to 256.0 (2015) per 100,000 inhabitants (40.4%). The proportional decrease was similar in both sexes, but death rates in males were substantially higher. The reduction of age-standardized mortality rate was more significant for rheumatic heart disease (44.5%), ischemic cardiopathy (43.9%), and cerebrovascular disease (46.0%). The decline in mortality was markedly different across states, being more pronounced in those of the southeastern and southern regions and the Federal District, and more modest in most states in the north and northeast regions.
CONCLUSION: : Age-standardized CVD mortality has declined in Brazil in recent decades, but in a heterogeneous way across states and for different specific causes. Considering the burden magnitude and the Brazilian population aging, policies to prevent and manage CVD should continue to be prioritized.