Comparison of Trends in Mortality from Coronary Heart and Cerebrovascular Diseases in North and South America: 1980-2013

Abstract Until the past century, mortality trends from coronary heart disease (CHD) and cerebrovascular disease (CVD) were less favorable in Latin than in North America. We calculated age-standardized mortality rates using data from the World Health Organization database over the period 1980-2013. To identify significant changes in trends we performed joinpoint analysis. Since the early 2000’s, CHD mortality rates declined by about 35% in the USA and Canada in both sexes; similar declines were observed in some Latin American countries (i.e., Ecuador, Puerto Rico and Chile), while the declines were smaller in the other countries. In 2011-2013, the highest rates were in Venezuela (114.4/100 000 men) and Colombia (86.1/100 000 men), and the lowest ones (apart from Ecuador) in Panama, Chile and Argentina (between 41-46/100 000 men and between 18-19/100 000 women). For CVD mortality, a decline by about 30% was observed in Argentina, Panama and Uruguay plus Colombia for women, in addition to the USA and Canada. Smaller declines were observed in the other Latin American countries (from 23% in Colombian men to 5% in Venezuelan men). Throughout the period, rates in Latin America remained appreciably higher than those in North America. The highest CVD rates were observed in Brazil (51.6/100 000 men), and the lowest ones in Canada (12.9/100 000 women). In conclusion, trends in CHD and CVD mortality continue to be less favorable in Latin America than in Canada and the USA. The marked excess of CVD mortality is partly or largely attributable to inadequate control of dyslipidemia and hypertension.