Time Trends in Mortality from Cardiovascular Diseases: An Ecological Study of Brazil's Regions and States, 2010-2023

Death from cardiovascular diseases (CVD) represents an essential marker for evaluating the progress and limitations of public policies, especially in territories with greater vulnerability. To analyze mortality from CVD, hypertensive diseases (HD), ischemic heart disease (IHD), and cerebrovascular diseases (CEVD) by sex, in Brazil, its regions, and Federative Units, between 2010 and 2023. Time series study with mortality data obtained from DATASUS. Rates were standardized by age, and the temporal trend was assessed using the Joinpoint regression model, with the calculation of annual percent change (APC) and the Average Annual Percentage Change (AAPC) for the entire period. A 95% confidence interval and a significance level of 5% were considered. Between 2010 and 2023, there were 4,991,937 deaths from CVD in Brazil (52.50% in men). Mortality from CVD decreased in men (Federal District: -3.58%, p<0.001; South: -2.23%, p<0.001), but increased in Amazonas (1.04%, p<0.01) and Amapá (1.54%, p<0.01). IHD increased in men in Amapá (5.21%, p<0.001) and Roraima (2.61%, p=0.03). HD increased in Bahia (men: 1.38%, p=0.03; women: 1.50%, p=0.04) and Rio Grande do Sul (men: 1.93%, p<0.001; women: 1.86%, p<0.01). CEVD mortality shows a downward trend in most states. Premature mortality from HD increased among men in the South (+1.61%, p<0.001). In Brazil, despite advances in the prevention and treatment of CVD, improvements have not been equitable: strong regional and socioeconomic inequalities persist, with higher mortality rates among vulnerable populations.