ABC | Volume 110, Nº6, June 2018

Original Article Nascimento et al Cardiovascular disease in Portuguese-speaking countries Arq Bras Cardiol. 2018; 110(6):500-511 Figure 6 – Disability-adjusted life years (DALYs) for each cardiovascular disease for each Portuguese-speaking country, 2016. Males,Age-standardized, 2016 Females,Age-standardized, 2016 Portugal Eq Guinea Brazil Cape Verde Sao Tome Principe Timor-Leste Angola Mozambique Guinea-Bissau 10k 10k 8k 8k 6k 6k 4k 4k 2k 2k 0k 0k DALYs per 100,000 DALYs per 100,000 Rheumatic heart disease Ischemic heart disease Hypertensive heart disease Cardiomyopathy Atrial fibrillation Aortic aneurysm Peripheral artery Endocarditis Other cardiovascular Cerebrovascular disease Figure 7 – Influence of the risk factors on the years of life lost (YLLs) because of cardiovascular diseases, according to sex, in each Portuguese-speaking country in 2016. Males,Age-standardized, 2016 Females,Age-standardized, 2016 Portugal Eq Guinea Brazil Cape Verde SaoTome Principe Timor-Leste Angola Mozambique Guinea-Bissau 250% 200% 150% 100% 50% 0% Percent of totalYLLs 250% 200% 150% 100% 50% 0% Percent of totalYLLs Air pollution Other environmental Tobacco Alcohol & drug use Atrial fibrillation Dietary risks High fasting plasma glucose High total cholesterol High blood pressure High body-mass index Low bone mineral density Impaired kidney function Occupational risks In Brazil and Portugal, that correlation was closer. The decline in age-standardized mortality rates in Brazil, associated with the increase in life expectancy, and the maintenance of a proportional mortality around 30%, from 1990 to 2016, point towards a greater relevance of the reduction in the premature mortality component. 20 The improvement in social inequality observed in Brazil and in some PSC might have contributed to that heterogeneous reduction in mortality as compared to the other Sub‑Saharan countries. 21 507