IJCS | Volume 31, Nº2, March / April 2018

DOI: 10.5935/2359-4802.20180003 123 International Journal of Cardiovascular Sciences. 2018;31(2)123-132 ORIGINAL ARTICLE Mailing Address: Gabriel Porto Soares • Rua Abdo José Ferreira, 32. Postal Code: 27700-000, Tambasco, Vassouras, RJ – Brazil. E-mail: gp.soares@yahoo.com.br , gpsoares@cardiol.br Evolution of Mortality from Diseases of the Circulatory System and of Gross Domestic Product per Capita in the Rio de Janeiro State Municipalities Gabriel Porto Soares, 1,2 Carlos Henrique Klein, 1,3 NelsonAlbuquerque de Souza e Silva, 1 GlauciaMariaMoraes deOliveira 1 Universidade Federal do Rio de Janeiro (UFRJ), 1 Universidade Severino Sombra, 2 Escola Nacional de Saúde Pública – Fiocruz, 3 Rio de Janeiro, RJ – Brazil Manuscript received March 05, 2017, revised manuscript July 10, 2017, accepted August 21, 2017 Abstract Background: Diseases of the circulatory system are the leading cause of death in Brazil and the world, falling progressively during the twentieth century, preceded by an increase in Gross Domestic Product. Objective: To correlate balanced and adjusted mortality rates from circulatory system diseases in the municipalities of Rio de Janeiro state between 1979 and 2010 with the gross domestic product per capita (GDPpc) beginning in 1950. Methods: Population and death data were obtained from the Department of Information and Computer Services at the National Health System/Brazilian Ministry of Health (Departamento de Informática do Sistema Único de Saúde - Ministério da Saúde - DATASUS-MS). Mortality rates were calculated for Ischemic Heart Disease (IHD), CerebrovascularDisease (CBVD), andCirculatorySystemDisease (CSD); adjustedby thedirectmethod; andbalanced for ill-defined causes. The GDPpc data were obtained from the Institute of Applied Economic Research (Instituto de Pesquisas Econômicas Aplicadas - IPEA). Mortality rates were correlated with socioeconomic indicators using Pearson's linear correlation coefficient to determine the annual optimized lag time. Regression slope coefficients between the dependent disease and independent socioeconomic indicator were estimated. Results: In recent decades, there has been a reduction inmortality fromCSD in all Rio de Janeiro state municipalities, mainly due to a decline in mortality from CBVD. The decline in mortality from CSD was preceded by an increase in the GDPpc, and a strong correlation was observed between this index and mortality rates. Conclusion: The evolution of the variation in GDPpc demonstrated a strong correlation with the reduction in CSD mortality. This relationship demonstrates the importance of improving the living conditions of the population to reduce cardiovascular mortality. (Int J Cardiovasc Sci. 2018;31(2)123-132) Keywords: Stroke / complications; Mortality; Risk Factors; Gross Domestic Product. Introduction The health conditions of the populations are influenced in a complex way by social determinants, such as income and wealth distribution and education, as if these indicators were interdependent risk factors for the occurrence of diseases. 1 During the 20th century, almost the entire world has experienced an improvement in socioeconomic indicators, in addition to a drop in the general mortality rates, with a consequent increase in the life expectancy of the populations. Furthermore, there was a change in the epidemiological profile, in which communicable diseases were no longer the major causes of death, being replaced by non-communicable diseases, mainly diseases of the circulatory system (DCS), which are the leading cause of mortality worldwide, corresponding to approximately one third of all deaths. Nevertheless, the deaths from DCS have shown a progressive reduction from the mid-20th century in developed countries, and, in Brazil, that reduction has been observed since the 1970s. 2-5