Trends in mortality from heart failure in Brazil: 1998 to 2019

Ecological study with time series analysis of mortality from heart failure in Brazil, according to regions and Federation Units, in individuals aged 50 years or older in the period from 1998 to 2019. Deaths that had heart failure as the underlying cause (coded as I50 according to the International Classification of Diseases) that occurred during the study period were included in the study. Data were obtained from the Mortality Information System of the Brazilian Ministry of Health. Statistical analyses were performed using the Stata 11.1 program, by estimating the mortality rate due to heart failure per 100 thousand inhabitants. In the trend analysis, the Prais-Winsten regression was used.

Results:

Between 1998 and 2019, 567,789 deaths from heart failure were recorded in adults aged over 50 years, which corresponds to an average rate of 75.5 per 100 thousand inhabitants. There was a downward trend per sex, regions, and in 23 Federation Units. The highest mortality rates were observed for older ages in all regions of the country.

Conclusion:

The trend in mortality rates from heart failure among Federation Units and Brazilian regions was downward over 21 years. There was an upward trend in mortality from heart failure in the northern region and in the category “other health facilities.”

Keywords:
Heart failure; Aged; Time series studies; Mortality

	Federation Unit	Deaths		Average rate	APC*	95%CI^†	Interpretation
	Federation Unit	n	%	Average rate	APC*	95%CI^†	Interpretation
Midwest	Federal District	4,310	0.76	56.6	-6.63	-11.26–-1.75	Downward
	Goiás	19,260	3.39	93.2	-4.79	-5.48–-4.09	Downward
	Mato Grosso	6,802	1.20	76.3	-5.59	-6.51–-4.76	Downward
	Mato Grosso do Sul	5,496	0.97	68.9	-9.08	-11.59–-6.57	Downward
North	Acre	1,398	0.25	79.0	-2.86	-4.11–-1.59	Downward
	Amazonas	3,882	0.68	46.5	-2.48	-3.49–-1.45	Downward
	Amapá	725	0.13	54.1	-3.73	-6.05–-1.35	Downward
	Pará	12,251	2.16	59.5	-2.48	-3.14–-1.81	Downward
	Rondônia	3,651	0.64	42.3	-4.50	-5.45–-3.54	Downward
	Roraima	521	0.09	49.7	1.22	-2.44–5.02	Stationary
	Tocantins	3,319	0.58	81.0	-5.28	-6.57–-3.99	Downward
Northeast	Alagoas	8,588	1.51	84.9	-3.89	-5.16–-2.59	Downward
	Bahia	37,599	6.62	71.6	-3.11	-3.54–-2.68	Downward
	Ceará	20,182	3.55	63.8	-1.59	-2.56–-0.61	Downward
	Maranhão	12,758	2.25	62.8	-100	-0.96–0.97	Stationary
	Piauí	9,258	1.63	82.5	-2.02	-4.38–0.39	Stationary
	Pernambuco	21,043	3.71	64.1	-4.80	-5.52–-4.08	Downward
	Paraíba	13,598	2.39	87.2	-0.69	-2.80–1.47	Stationary
	Rio Grande do Norte	7,526	1.33	61.6	-1.63	-3.07–-0.17	Downward
	Sergipe	3,738	0.66	55.9	-4.30	-5.28–-3.30	Downward
South	Paraná	41,996	7.40	98.1	-5.38	-6.31–-4.45	Downward
	Rio Grande do Sul	43,113	7.59	81.3	-4.84	-5.33–-4.34	Downward
	Santa Catarina	19,859	3.50	79.5	-4.10	-4.73–-3.50	Downward
Southeast	Espírito Santo	6,941	1.22	56.1	-9.60	-12.49–-6.62	Downward
	Minas Gerais	74,418	13.11	89.1	-3.81	-4.54–-3.08	Downward
	Rio de Janeiro	54,306	9.56	71.1	-3.32	-4.52–-2.10	Downward
	São Paulo	131,251	23.12	73.8	-4.11	-5.07–-3.14	Downward

Place of occurrence	Deaths		Average proportional mortality			APC*	95%CI^†		Interpretation
Place of occurrence	n	%	Average proportional mortality			APC*	95%CI^†		Interpretation
Hospital	406,771	71.64	53.88			-3.61	-3.96–-3.25		Downward
Health facilities	22,296	3.92	2.70			7.60	3.92–11.42		Upward
Domicile	123,400	21.73	16.82			-5.50	-6.03–-4.97		Downward
Public highway	3,736	0.66	0.53			-7.68	-8.58–-6.77		Downward
Others	8,747	1.54	1.19			-5.03	-6.55–-3.49		Downward
	North		Northeast			South	Southeast		Midwest
	Deaths		Deaths			Deaths	Deaths		Deaths
	n	Rate	n	Rate	n	Rate	n	Rate	n	Rate
Ignored	2,839	0.50	0.51			-19.51	-23.44–-15.39		Downward
Hospital	18,786	42.7	89,054	44.5	72,540	55.7	200,564	53.7	25,827	50.8
Health facilities	446	1.0	2,683	1.3	1,842	1.4	16,463	4.4	862	1.7
Domicile	5,912	13.4	39,559	19.7	25,703	19.7	44,108	11.8	8,118	15.9
Public highway	220	0.5	1,113	0.5	812	0.6	1,209	0.3	382	0.7
Others	334	0.8	1,328	0.6	2,264	1.7	4,236	1.1	585	1.2
Ignored	49	0.1	553	0.3	1,807	1.4	336	0.1	94	0.8

Associação Brasileira de Saúde Coletiva Av. Dr. Arnaldo, 715 - 2º andar - sl. 3 - Cerqueira César, 01246-904 São Paulo SP Brasil , Tel./FAX: +55 11 3085-5411 - São Paulo - SP - Brazil
E-mail: revbrepi@usp.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Corresponding author: Vilmeyze Larissa de Arruda. Avenida Fernando Correa da Costa, Boa Esperança, CEP 78060-900, Cuiabá (MT), Brazil. E-mail: vilmeyze11@gmail.com