ABC | Volume 114, Nº2, February 2020

Original Article Fernandes et al. Heart failure trends in Less developed Brazil Arq Bras Cardiol. 2020; 114(2):222-231 2008‑2009, which is consistent with our findings of a 34% decrease in the absolute number of hospitalizations for HF in Brazil, and 62% in Paraiba. This observed reduction can be a sign of improvement in the overall management of the risk factors for HF, 4 a decrease in the incidence of ischemic heart disease, 15 and an improvement in HF management. 16 Hospitalizations for HF in Paraiba and Brazil were more common for individuals between the ages of 70 to 79 years old. Individuals older than 60 years old represented 71% and 73% of admissions for HF in Paraiba and Brazil, respectively; this is similar to the frequency (70%) reported in previous studies in LAC and U.S.. 2,4 In Paraiba and in Brazil, the Table 3 – Heart failure trends in Brazil, from 2008 to 2017 Variables 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 P values for trends* † Pearson (R) Number of deaths (population) 27,567 27,314 27,544 27,818 26,694 27,290 26,783 27,434 ------ ------ 0.276 -0.412 Women 13,990 14,136 14,236 14,525 13,824 14,014 13,846 14,435 ------ ------ 0.929 0.034 Men 13,428 13,047 13,159 13,130 12,756 13,166 12,825 12,900 ------ ------ 0.069 -0.689 Number of deaths (in-hospital) 22,513 23,043 23,667 24,451 23,071 22,858 22,031 22,756 23,519 19,209 0.131 -0.504 Women 11,021 11,356 11,740 12,099 11,426 11,305 10,963 11,450 11,738 10,509 0.401 -0.280 Men 11,198 11,395 11,676 12,092 11,408 11,301 10,823 11,097 11,577 10,213 0.119 -0.520 Mortality rate (population) 14.54 14.26 14.44 14.46 13.76 13.57 13.21 13.42 ------ ------ 0.017* -0.905 Mortality rate (in‑hospital) 8.3 8.5 8.9 9.4 9.5 9.7 9.8 10.5 11.0 10.8 0.003* 0.981 Women 8.5 8.7 9.2 9.6 9.8 10.0 10.2 11.0 11.5 11.2 0.003* 0.980 Men 8.2 8.4 8.7 9.2 9.3 9.4 9.6 10.1 10.6 10.4 0.003* 0.985 Number of admissions 270,988 269,891 265,038 260,995 242,919 236,550 223,825 217,050 214,432 178,445 0.004* -0.964 Deaths per age range (population) 15-19 years 56 55 47 49 51 41 40 35 ------ ------ 0.014* -0.926 20-29 years 206 204 180 176 165 174 159 145 ------ ------ 0.012* -0.947 30-39 years 468 415 379 387 396 373 358 355 ------ ------ 0.022* -0.863 40-49 years 1,039 1,002 1,034 957 913 920 836 815 ------ ------ 0.011* -0.957 50-59 years 2,389 2,303 2,293 2,269 2,259 2,214 2,072 2,157 ------ ------ 0.016* -0.910 60-69 years 4,296 4,249 4,196 4,268 4,057 4,230 4,123 4,255 ------ ------ 0.328 -0.370 70-79 years 7,178 7,027 7,062 7,013 6,727 6,969 6,707 6,845 ------ ------ 0.037* -0.788 Older than 80 years 11,788 11,928 12,206 12,539 12,012 12,259 12,383 12,733 ------ ------ 0.039* 0.782 Deaths per age range (in-hospital) 15-19 years 87 97 75 73 61 65 59 61 61 38 0.007* -0.898 20-29 years 284 271 264 241 220 230 188 176 175 152 0.003* -0.984 30-39 years 597 529 503 501 475 451 445 437 434 369 0.008* -0.887 40-49 years 1,278 1,216 1,227 1,216 1,104 1,102 981 1,004 1,052 853 0.005* -0.931 50-59 years 2,687 2,722 2,736 2,793 2,700 2,620 2,372 2,498 2,569 2,149 0.019* -0.783 60-69 years 4,358 4,578 4,739 4,769 4,599 4,452 4,439 4,601 4,783 4,149 0.533 -0.208 70-79 years 6,337 6,371 6,583 6,820 6,237 6,343 5,984 6,174 6,496 5,706 0.101 -0.546 Older than 80 years 6,591 6,967 7,289 7,778 7,438 7,343 7,318 7,596 7,745 7,306 0.064 0.617 Mean duration of hospitalization (days) 6.5 6.4 6.5 6.6 6.7 6.9 7.1 7.3 7.4 7.3 0.004* 0.960 *p < 0.05; † P value for trends according to the linear-by-linear association; Source of data: SUS Information System (DATASUS) and Brazilian Institute of Geography and Statistics (count of 2010) 226