International journal of cardiology · 2026
Robust modeling of cardiovascular mortality patterns (2008-2024): Applying quasi-Poisson regression to assess demographic and regional disparities.
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Matos Endric Passos, Rabito Lucas Benedito Fogaça, Barreto Rejane Santos, de Souza Nathalie Campana, Dos Santos Oliveira João Arthur, Sanches Rafaely de Cassia Nogueira
Аннотация
BACKGROUND: This study examined spatiotemporal patterns and demographic determinants of mortality from diseases of the circulatory system (DCS) in Brazil, 2008-2024.
METHODS: We conducted a nationwide ecological time-series study using quasi-Poisson regression with a population offset to model death counts and estimate incidence rate ratios (IRRs). Univariable and multivariable models assessed associations of macroregion, sex, age group, and ICD-10 diagnostic category with DCS mortality, adjusting for long-term time trends.
RESULTS: Multivariable analysis showed a persistent annual increase of 0.62% in DCS mortality (IRR 1.0062, 95% CI 1.0047-1.0077). Marked regional disparities were observed, with the North region exhibiting substantially lower mortality rates (IRR 0.109, 95% CI 0.105-0.112) relative to the Southeast. Mortality rates were lower in females than in males (IRR 0.906, 95% CI 0.893-0.919). Age showed the strongest association with mortality: individuals aged ≥80 years had mortality rates 48 times higher (IRR 48.36, 95% CI 44.34-52.74) than those aged 20-29.
CONCLUSIONS: Cardiovascular mortality in Brazil increased between 2008 and 2024, reversing prior declines. The increase occurred across demographic groups and regions, suggesting a widespread epidemiological shift. These findings underscore the need for strengthened prevention strategies integrating clinical risk reduction with action on the social determinants of cardiovascular health.
METHODS: We conducted a nationwide ecological time-series study using quasi-Poisson regression with a population offset to model death counts and estimate incidence rate ratios (IRRs). Univariable and multivariable models assessed associations of macroregion, sex, age group, and ICD-10 diagnostic category with DCS mortality, adjusting for long-term time trends.
RESULTS: Multivariable analysis showed a persistent annual increase of 0.62% in DCS mortality (IRR 1.0062, 95% CI 1.0047-1.0077). Marked regional disparities were observed, with the North region exhibiting substantially lower mortality rates (IRR 0.109, 95% CI 0.105-0.112) relative to the Southeast. Mortality rates were lower in females than in males (IRR 0.906, 95% CI 0.893-0.919). Age showed the strongest association with mortality: individuals aged ≥80 years had mortality rates 48 times higher (IRR 48.36, 95% CI 44.34-52.74) than those aged 20-29.
CONCLUSIONS: Cardiovascular mortality in Brazil increased between 2008 and 2024, reversing prior declines. The increase occurred across demographic groups and regions, suggesting a widespread epidemiological shift. These findings underscore the need for strengthened prevention strategies integrating clinical risk reduction with action on the social determinants of cardiovascular health.