Relationship of comorbidities and heart failure mortality in the city of São Paulo, Brazil

Koike, Marcia Kiyomi; Silva, Viviane; Romanek, Flavia Alves Ribeiro Monclùs; Shirassu, Mirian Matsura

doi:10.5935/MedicalExpress.2016.02.05

Brasil

Español English

ORIGINAL RESEARCH • MedicalExpress (São Paulo, online) 3 (2) • Mar-Apr 2016 • https://doi.org/10.5935/MedicalExpress.2016.02.05 copy

Relationship of comorbidities and heart failure mortality in the city of São Paulo, Brazil

RELAÇÃO DE CO-MORBIDADES E MORTALIDADE POR INSUFICIÊNCIA CARDÍACA NA CIDADE DE SÃO PAULO, BRASIL

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

The epidemiology of heart failure mortality in the city of São Paulo, Brazil has not been studied. The present study aims to characterize comorbities associated to cardiac heart failure deaths in São Paulo between 2000 and 2012.

METHOD:

The mortality information system (SIM/DataSUS) was evaluated and the following parameters were retrieved: age, sex, race, level of education and comorbidities (hypertension, diabetes, obesity, chronic obstructive pulmonary disease). Socioeconomic status was estimated by years of schooling, as: lower (0-3 years) and higher (> 3 years). We analyzed 14,814 death certificates.

RESULTS:

There was a prevalence of subjects in the subgroup: female, white, married or divorced, aged 78 years and lower socioeconomic status. Hypertension and diabetes were the most frequent comorbidities. There were associations of (a) diabetes with age, (b) age, gender and educational level with hypertension in individuals belonging to both the lower and higher socioeconomic levels.

CONCLUSION:

Individuals who died of congestive heart failure in São Paulo are mostly elderly, women, caucasian, with little education. Hypertension and diabetes are the two most common chronic diseases associated with death bycongestive heart failure.

KEYWORDS:
Mortality; Heart Failure; Epidemiology

	2000	2001	2002	2003	2004	2005	2006	2007	2008	2009	2010	2011	2012	Total (% , n)
Gender
Man (%, n)	39%, 503	40%, 474	40%, 418	38%, 392	40%, 407	39%, 468	39%, 410	40%, 439	39%, 449	40%, 473	39%, 476	41%, 508	42%, 467	40%, 5.884
Women (%, n)	61%, 775	60%, 700	60%, 628	62%, 641	60%, 611	61%, 737	61%, 633	60%, 671	61%, 698	60%, 724	61%, 732	59%, 732	58%, 648	60%, 8.930
Age Group (years old)
< 40	1.4%	1.8%	2.3%	1.7%	1.4%	1.7%	2.1%	1.1%	2%	1.1%	1.1%	1.3%	1.5%	1.6%, 232
40 a 49	2.5%	3.3%	3%	2.3%	3.3%	2.2%	2.7%	2.6%	2.7%	2.3%	3.1%	3.1%	3.9%	2.8%, 422
50 a 59	6.4%	5.8%	6%	5.6%	7.8%	4.8%	5.2%	7%	6.1%	6%	6.1%	7.6%	8.3%	6.4%, 944
60 a 69	14.2%	11.4%	14.3%	14.3%	12.9%	13.3%	12.7%	13.3%	13%	13.8%	13.1%	12.7%	11.8%	13.1%, 1.945
70 a 79	26.1%	29.8%	28%	26.8%	26.1%	23.7%	25.3%	24.4%	24.3%	22.9%	24.6%	20.6%	23.1%	25%, 3.704
80 a 89	32.2%	31.4%	30.6%	33.5%	31.7%	34.8%	36%	34.9%	35.1%	36.8%	35.7%	35.7%	33%	34%, 5.038
>90	17.1%	16.4%	15.8%	15.7%	16.8%	19.5%	16%	16.7%	16.8%	17%	16.3%	19%	18.3%	17.1%, 2.529
Race
White (%, n)	79%	80%	79.9%	80%	77.3%	79.9%	79.2%	75.1%	77.1%	76.6%	74.8%	73.2%	72.9%	77.3%, 11.022
Brown (%, n)	11.5%	11.7%	11.7%	11%	13.7%	11.5%	11.1%	15.1%	14.1%	14%	14.5%	16.7%	17.3%	13.4%, 1.910
Black (%, n)	5.6%	5.9%	6.1%	6.5%	6.2%	6.1%	7.8%	8%	6.8%	6.9%	7.9%	7.9%	7.6%	6.9%, 979
Yellow (%, n)	4%	2.4%	2.3%	2.4%	2.7%	2.6%	2%	1.8%	2%	2.5%	2.7%	2.2%	2.3%	2.4%, 351
Indian (n)		1		1		1								3
Marital Status
Singles (%, n)	14.3%	15.5%	13.2%	16.3%	18.8%	12.8%	15.5%	12.9%	14.5%	13.7%	14.8%	15%	17%	15%, 2.141
Married (%, n)	33.4%	34.6%	34.4%	32.3%	32.3%	32.6%	33.5%	34.6%	33.8%	32.8%	34%	33%	32%	33.3%, 4.789
Widowers (%, n)	2.1%	2%	2.5%	3.1%	3.9%	4.1%	4.2%	4.1%	3.5%	5%	5.2%	5%	4%	3.7%, 542
Divorced (%, n)	50.2%	47.9%	49.9%	48.4%	45%	50.5%	46.8%	48.4%	48.1%	48.5%	46%	47%	47%	48%, 6.897
Education
0 Years of study (%, n)	23%	20.2%	22.1%	18.5%	20%	20.5%	19.4%	18%	17.2%	14.9%	17.2%	22.9%	22.3%	19%, 2.481
1-3 Years of study (%, n)	37.6%	38.8%	36.1%	37.5%	33.5%	30.3%	30.8%	31.8%	29.7%	29.6%	32.5%	45.3%	42.5%	35.4%, 4.435
4-7 Years of study (%, n)	25.8%	25.1%	22.5%	24.6%	26.5%	28.4%	29.8%	29.6%	32%	29.7%	28.7%	14.4%	15.7%	25.3%, 3.176
> 8 Years of study (%, n)	13.6%	15.9%	19.3%	19.5%	20.1%	20.2%	20.1%	20.6%	21.1%	25.8%	21.6%	17.5%	19.6%	19.5%, 2.447
Socioeconomic Level
< SL (%, n)	60.7%	59%	58.2%	56%	53.4%	50.8%	50.1%	49.8%	46.9%	44.5%	49.7%	68.1%	64.8%	55.1%, 6916
> SL (%, n)	39%	41%	42%	44.0%	46.6%	49%	50%	50%	53%	55.5%	50.3%	31.9%	35.2%	44.8%, 5623
Total death by CHF	1.278	1.174	1.046	1.033	1.018	1.205	1.043	1.110	1.147	1.197	1.208	1.240	1.115	14.814

	2000	2001	2002	2003	2004	2005	2006	2007	2008	2009	2010	2011	2012	Total (%e/ou n)
Comorbidities
Hypertension (%, n)	48.4%	37.7%	45.2%	36.5%	53.2%	45.3%	46.6%	46.6%	52.5%	53.3%	52.8%	48.5%	51.2%	47.7%
< SL (%, n)	64	44	59	57	56	69	47	69	64	68	84	110	87	878
> SL (%, n)	29	34	35	38	43	33	50	54	70	84	67	34	45	616
Diabetes (%, n)	27.1%	36.7%	30.3%	27.3%	27.4%	34.7%	28.4%	29.2%	25.9%	21.8%	23.4%	24.9%	25.6%	27.5%
< SL (%, n)	33	52	30	37	25	37	27	39	31	32	35	50	41	469
> SL (%, n)	19	24	33	34	26	41	32	38	35	30	32	24	25	393
COPD (%)	14.6%	14.0%	16.3%	8.8%	9.1%	10.7%	9.6%	8.3%	8.4%	8%	8.7%	10.8%	8.1%	10.1%
< SL (%, n)	16	13	16	16	11	10	11	11	9	12	10	21	15	171
> SL (%, n)	12	16	18	7	6	14	9	11	10	10	15	11	6	145
Hypertension + Diabetes (%)	9.9%	11.6%	8.2%	27.3%	10.2%	9.3%	15.4%	19.9%	14.1%	17.2%	15.0%	15.8%	15.1%	14.7%
< SL (%, n)	15	12	11	37	9	11	15	22	11	18	23	33	25	242
> SL (%, n)	4	12	6	34	10	10	17	20	25	31	20	14	14	217
Obesity (n)	3	1	3	2	2	5	5	3	3	7	5	9	16	64
Hypertension + COPD (n)	4	4	6	5	2	3	1	2	3	5	3	7		45
Diabetes + COPD (n)	4	3	1	3	1						3		1	16

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