# Analysis of mortality by cardiovascular disease subgroups in Brazil before and during the COVID-19 pandemic (2000–2022) by sex and age group

## TL;DR

This study examines how the COVID-19 pandemic affected cardiovascular disease mortality in Brazil from 2000 to 2022, considering differences by sex and age group.

## Contribution

The study identifies pandemic-related inflection points in mortality trends for specific cardiovascular disease subgroups in Brazil.

## Key findings

- Mortality from ischemic heart disease and cerebrovascular disease decreased until 2020 but slowed or reversed during the pandemic.
- Other cardiovascular diseases increased significantly after 2020, with a 3.8% annual rise.
- Women and intermediate age groups (40-59 years) showed notable changes in mortality trends during the pandemic.

## Abstract

To analyze the effect of the COVID-19 pandemic on mortality by cardiovascular disease (CVD) subgroups in Brazil, considering sex and age group.

Ecological time-series study with secondary data from the Mortality Information System for the period 2000-2022. Age-adjusted mortality rates per 100,000 inhabitants were calculated and joinpoint regression models were used to estimate rate trends.

Mortality from CVD in Brazil between 2000 and 2022 showed a decrease in ischemic heart disease (IHD) and cerebrovascular disease (CBVD), while other CVD showed an unstable behavior, increasing after 2020. The reduction in IHD was more pronounced until 2020, decelerating thereafter. CBVD continued to decline but at a slower pace. Other CVD, after a downward trend, showed a significant increase (+3.8% per year), possibly because of the pandemic. Women had a greater reduction in mortality, especially due to IHD. Intermediate age groups (40-59 years) showed a decrease until 2020 but recorded increases after this period, reinforcing the impact of the pandemic. In 2021, all subgroups showed excess mortality: 8% for CBVD and IHD, and 15% for other CVD. In 2022, this pattern intensified, with values of 16% (CBVD), 18% (IHD) and 23% (other CVD).

The COVID-19 pandemic significantly impacted CVD mortality in Brazil, changing trends according to age group, sex and disease subgroup. The study points to an inflection in mortality rates during the pandemic, highlighting the need for further investigations to understand the mechanisms involved.

Analisar o efeito da pandemia de COVID-19 na mortalidade por subgrupos de doenças cardiovasculares (DCV) no Brasil, considerando sexo e grupo etário.

Estudo ecológico de séries temporais com dados secundários do Sistema de Informações sobre Mortalidade referentes ao período 2000–2022. Calcularam-se taxas de mortalidade ajustadas pela idade por 100 mil habitante, e utilizaram-se modelos de regressão por joinpoint para estimar as tendências das taxas.

A mortalidade por DCV no Brasil entre 2000 e 2022 mostrou queda nas doenças isquêmicas do coração (DIC) e cerebrovasculares (DCbV), enquanto outras DCV tiveram comportamento instável, com aumento após 2020. A redução das DIC foi mais acentuada até 2020, desacelerando posteriormente. As DCbV mantiveram queda, mas em ritmo menor. Já outras DCV, após tendência de redução, apresentaram alta significativa (+3,8% ao ano), possivelmente por causa da pandemia. As mulheres tiveram maior redução da mortalidade, especialmente por DIC. Faixas etárias intermediárias (40–59 anos) mostraram queda até 2020, mas registraram aumento após esse período, reforçando o impacto da pandemia. Em 2021, todos os subgrupos apresentaram excesso de mortalidade: 8% para DCbV e DIC e 15% para outras DCV. Em 2022, esse padrão intensificou-se, com valores de 16% (DCbV), 18% (DIC) e 23% (outras DCV).

A pandemia de COVID-19 impactou significativamente a mortalidade por DCV no Brasil, alterando tendências conforme faixa etária, sexo e subgrupo de doença. O estudo aponta para uma inflexão nas taxas de mortalidade durante a pandemia, destacando a necessidade de investigações adicionais para compreender os mecanismos envolvidos.