Cardiovascular disease mortality: time series and spatial analysis, Brazil, 2003-2023

Abstract

Abstract Objective: To describe the temporal and spatial distribution of cardiovascular disease mortality in Brazil from 2003 to 2023. Methods: A time series and spatial analysis study was conducted using secondary data from the Mortality Information System run by the Brazilian Unified Health System Department of Information Technology, including all deaths from circulatory system diseases. Sociodemographic characteristics were analyzed and standardized mortality rates per 100,000 inhabitants were calculated. The temporal trend was assessed using joinpoint regression, with estimated annual percentage change. The spatial analysis considered average municipal rates, both unadjusted and also smoothed by the local empirical Bayesian method, in addition to global and local spatial autocorrelation. Results: 7,088,623 cardiovascular disease deaths were recorded in Brazil between 2003 and 2023, with predominance in males and higher mortality rates among the elderly and people with low levels of education. The highest rates were observed in the Southeast (190.14/100,000) and Southern (187.59/100,000) regions, while the Northern (APC 2003-2008 4.38; APC 2008-2023 2.33) and Northeast (APC 2003-2007 8.15; APC 2007-2023 1.11) regions showed an increasing trend over the period (p-value<0.001). Global Moran’s I (0.02; p-value<0.05) indicated weak but statistically significant positive spatial autocorrelation. Local analysis revealed clusters of high mortality concentrated mainly in municipalities of Mato Grosso and Goiás states, while areas of low mortality predominated in the Northern region and on the Northeast coast. Conclusion: Cardiovascular disease mortality in Brazil showed heterogeneous distribution in time and space.