Original Article Short Editorial Original Article Short Editorial Original Article Short Editorial Original

111 Pages·2017·10.68 MB·English

Sociedade Brasileira de Cardiologia • ISSN-0066-782X • Volume 110, Nº 6, June 2018
Males, Age-standardized, 2016 Females, Age-standardized, 2016
Portugal
Air pollution
Other environmental
Occupational risks
Mozambique Tobacco
Alcohol & drug use
Atrial fibrillation
Dietary risks
Sao Tome Principe High fasting plasma glucose
High total cholesterol
High blood pressure
High body-mass index
Brazil Low bone mineral density
Impaired kidney function
Eq Guinea
Angola
Cape Verde
Timor-Leste
Guinea-Bissau
Figure 7 – Influence of the risk factors on the years of life lost (YLLs) because of cardiovascular
250% 200% 15P0e%rcent of total YL1L0s0% 50% 0% 250% 200% 150P%ercent of total Y1L0L0s% 50% 0% diseases, according to sex, in each Portuguese-speaking country in 2016.. Page 507
Original Article Endothelial Dysfunction and Inflammation Precedes Elevations in
Cardiovascular Disease Epidemiology in Portuguese-Speaking Blood Pressure Induced by a High-Fat Diet
Countries: data from the Global Burden of Disease, 1990 to 2016
Pressure Overload-induced Cardiac Hypertrophy Varies According to
Short Editorial
Different Ligation Needle Sizes and Body Weights in Mice
Cardiovascular Diseases in Portuguese: The Importance of Preventive
Review Article
Medicine
Pulmonary Ultrasound in Patients with Heart Failure - Systematic Review
Original Article
Metabolic Syndrome-Related Features in Controlled and Resistant Viewpoint
Hypertensive Subjects Update of the Impact of Consumption of Whole Chicken Eggs on the
Lipid Profile: to What Extent are They Impacting?
Short Editorial
Identifying the Impact of Metabolic Syndrome in Hypertensive Patients Anatomopathological Correlation
Original Article Case 3/2018 – A 60-year-old female with Chagasic heart disease,
Prevention of Sudden Cardiac Death in Hypertrophic Cardiomyopathy: admitted due to heart failure decompensation, cachexia and
What has Changed in The Guidelines? pulmonary infection
Short Editorial Case Report
Prevention of Sudden Death in Hypertrophic Cardiomyopathy Eosinophilic Myocarditis: Clinical Case and Literature Review
Original Articles
Image
Is There any Relationship Between Myocardial Repolarization
Challenging Diagnosis of Myocardial Infarction Due to Anomalous Left
Parameters and the Frequency of Ventricular Premature Contractions?
Circumflex Artery
Cardiovascular Risk in Xavante Indigenous Population
Letter to the Editor
Behavior of Blood Pressure Variables in Children and Adolescents with QTc and QTcd Measurements and Their Relationships with Left
Duchenne Muscular Dystrophy Ventricular Hypertrophy in Hemodialysis Patients
A JOURNAL OF SOCIEDADE BRASILEIRA DE CARDIOLOGIA - Published since 1948
Contents
Original Article
Epidemiology
Cardiovascular Disease Epidemiology in Portuguese-Speaking Countries: data from the Global
Burden of Disease, 1990 to 2016
Bruno Ramos Nascimento, Luisa Campos Caldeira Brant, Gláucia Maria Moraes de Oliveira, Marcus Vinícius
Bolívar Malachias, Gabriel Moreira Alves Reis, Renato Azeredo Teixeira, Deborah Carvalho Malta, Elisabeth
França, Maria de Fátima Marinho Souza, Gregory A. Roth, Antonio Luiz P. Ribeiro
.....................................................................................................................................................................page 500
Short Editorial
Cardiovascular Diseases in Portuguese: The Importance of Preventive Medicine
Fausto J. Pinto
.....................................................................................................................................................................page 512
Original Article
Hypertension
Metabolic Syndrome-Related Features in Controlled and Resistant Hypertensive Subjects
Arthur Santa Catharina, Rodrigo Modolo, Alessandra Mileni Versuti Ritter, Andréa Rodrigues Sabbatini,
Heno Ferreira Lopes, Heitor Moreno Junior, Ana Paula de Faria
.....................................................................................................................................................................page 514
Short Editorial
Identifying the Impact of Metabolic Syndrome in Hypertensive Patients
Luiz Aparecido Bortolotto
.....................................................................................................................................................................page 522
Original Article
Cardiomyopathy
Prevention of Sudden Cardiac Death in Hypertrophic Cardiomyopathy: What has Changed in
The Guidelines?
Liliana Reis, Rogerio Teixeira, Andreia Fernandes, Inês Almeida, Marta Madeira, Joana Silva, Ana Botelho, João
Pais, José Nascimento, Lino Gonçalves
.....................................................................................................................................................................page 524
Short Editorial
Prevention of Sudden Death in Hypertrophic Cardiomyopathy
Edmundo Arteaga-Fernández and Murillo de Oliveira Antunes
.....................................................................................................................................................................page 532
Arquivos Brasileiros de Cardiologia - Volume 110, Nº 6, June 2018
Original Articles
Electrophysiology/Arrhythmias
Is There any Relationship Between Myocardial Repolarization Parameters and the Frequency of
Ventricular Premature Contractions?
Kayihan Karaman, Metin Karayakali, Arif Arisoy, Ilker Akar, Mustafa Ozturk, Ahmet Yanik, Samet Yilmaz, Atac Celik
.....................................................................................................................................................................page 534
Epidemiology
Cardiovascular Risk in Xavante Indigenous Population
Luana Padua Soares, Amaury Lelis Dal Fabbro, Anderson Soares Silva, Daniela Saes Sartorelli, Luciana Ferreira
Franco, Patrícia Chamadoira Kuhn, Regina Santiago Moises, João Paulo Botelho Vieira-Filho, Laércio Joel Franco
.....................................................................................................................................................................page 542
Hipertension
Behavior of Blood Pressure Variables in Children and Adolescents with Duchenne
Muscular Dystrophy
Fabiane R. R. H. Marui, Henrique Tria Bianco, Maria Teresa N. Bombig, Natascha G. F. Palmeira, José M.
Thalenberg, Fernando Focaccia Povoa, Maria Cristina de O. Izar, Francisco Antonio H. Fonseca, Acary S. B.
de Oliveira, Rui M. S. Povoa
.....................................................................................................................................................................page 551
Systemic Arterial Hypertension
Endothelial Dysfunction and Inflammation Precedes Elevations in Blood Pressure Induced by a
High-Fat Diet
Jorge Camargo Oishi, Cynthia Aparecida Castro, Karina Ana Silva, Victor Fabricio, Evelin Capelari Cárnio,
Shane A. Phillips, Ana Claudia Garcia de Oliveira Duarte, Gerson Jhonatan Rodrigues
.....................................................................................................................................................................page 558
Heart Failure
Pressure Overload-induced Cardiac Hypertrophy Varies According to Different Ligation Needle
Sizes and Body Weights in Mice
Zhen Jia, Zhijun Chen, Hongfei Xu, Malik Akuffu Armah, Peng Teng, Weidong Li, Dongdong Jian, Liang Ma, Yiming Ni
.....................................................................................................................................................................page 568
Review Article
Pulmonary Ultrasound in Patients with Heart Failure - Systematic Review
Rafael Tostes Muniz, Evandro Tinoco Mesquita, Celso Vale Souza Junior, Wolney de Andrade Martins
.....................................................................................................................................................................page 577
Viewpoint
Update of the Impact of Consumption of Whole Chicken Eggs on the Lipid Profile: to What
Extent are They Impacting?
Heitor Oliveira Santos
.....................................................................................................................................................................page 585
Anatomopathological Correlation
Case 3/2018 – A 60-year-old female with Chagasic heart disease, admitted due to heart failure
decompensation, cachexia and pulmonary infection
Gustavo Alonso Arduine e Vera Demarchi Aiello
.....................................................................................................................................................................page 588
Arquivos Brasileiros de Cardiologia - Volume 110, Nº 6, June 2018
Case Report
Eosinophilic Myocarditis: Clinical Case and Literature Review
Paulo Dinis, Rogério Teixeira, Luís Puga, Carolina Lourenço, Maria Carmo Cachulo, Lino Gonçalves
.....................................................................................................................................................................page 597
Image
Challenging Diagnosis of Myocardial Infarction Due to Anomalous Left Circumflex Artery
Maksymilian P. Opolski, Kajetan Grodecki, Mateusz Spiewak, Mariusz Furmanek, Ilona Michalowska
.....................................................................................................................................................................page 600
Letter to the Editor
QTc and QTcd Measurements and Their Relationships with Left Ventricular Hypertrophy in
Hemodialysis Patients
Sora Yasri and Viroj Wiwanitkit
.....................................................................................................................................................................page 602
Arquivos Brasileiros de Cardiologia - Volume 110, Nº 6, June 2018
A JOURNAL OF SOCIEDADE BRASILEIRA DE CARDIOLOGIA - Published since 1948
Scientific Director Surgical Cardiology Non-Invasive Diagnostic Ergometrics, Exercise and
Dalton Bertolim Précoma Tirone David Methods Cardiac Rehabilitation
Chief Editor João Luiz Cavalcante Ricardo Stein
Interventionist Cardiology
Carlos Eduardo Rochitte Basic or Experimental First Editor (1948-1953)
Pedro A. Lemos
Internacional Coeditor Research † Jairo Ramos
João Lima Pediatric/Congenital Marina Politi Okoshi
Cardiology
Associated Editors Epidemiology/Statistics
Ieda Biscegli Jatene Marcio Sommer Bittencourt
Clinical Cardiology
Gláucia Maria Moraes Arrhythmias/Pacemaker Arterial Hypertension
de Oliveira Mauricio Scanavacca Paulo Cesar B. V. Jardim
Editorial Board
Brazil Carlos Eduardo Rochitte – Instituto do Coração do Hospital das Clínicas da
Aguinaldo Figueiredo de Freitas Junior – Universidade Federal de Goiás (UFG), Faculdade de Medicina (INCOR HCFMUSP), São Paulo, SP – Brazil
Goiânia GO – Brazil Carlos Eduardo Suaide Silva – Universidade de São Paulo (USP), São Paulo,
Alfredo José Mansur – Faculdade de Medicina da Universidade de São Paulo SP – Brazil
(FMUSP), São Paulo, SP – Brazil Carlos Vicente Serrano Júnior – Instituto do Coração (InCor HCFMUSP), São
Aloir Queiroz de Araújo Sobrinho – Instituto de Cardiologia do Espírito Santo, Paulo, SP – Brazil
Vitória, ES – Brazil Celso Amodeo – Instituto Dante Pazzanese de Cardiologia/Fundação Adib
Amanda Guerra de Moraes Rego Sousa – Instituto Dante Pazzanese de Jatene (IDPC/FAJ), São Paulo, SP – Brazil
Cardiologia/Fundação Adib Jatene (IDPC/FAJ), São Paulo, SP – Brazil Charles Mady – Universidade de São Paulo (USP), São Paulo, SP – Brazil
Ana Clara Tude Rodrigues – Hospital das Clinicas da Universidade de São Paulo Claudio Gil Soares de Araujo – Universidade Federal do Rio de Janeiro (UFRJ),
(HCFMUSP), São Paulo, SP – Brazil Rio de Janeiro, RJ – Brazil
André Labrunie – Hospital do Coração de Londrina (HCL), Londrina, PR – Brazil Cláudio Tinoco Mesquita – Universidade Federal Fluminense (UFF), Rio de
Andrei Carvalho Sposito – Universidade Estadual de Campinas (UNICAMP), Janeiro, RJ – Brazil
Campinas, SP – Brazil Cleonice Carvalho C. Mota – Universidade Federal de Minas Gerais (UFMG),
Angelo Amato Vincenzo de Paola – Universidade Federal de São Paulo Belo Horizonte, MG – Brazil
(UNIFESP), São Paulo, SP – Brazil Clerio Francisco de Azevedo Filho – Universidade do Estado do Rio de Janeiro
Antonio Augusto Barbosa Lopes – Instituto do Coração Incor Hc Fmusp (UERJ), Rio de Janeiro, RJ – Brazil
(INCOR), São Paulo, SP – Brazil Dalton Bertolim Précoma – Pontifícia Universidade Católica do Paraná (PUC/
Antonio Carlos de Camargo Carvalho – Universidade Federal de São Paulo PR), Curitiba, PR – Brazil
(UNIFESP), São Paulo, SP – Brazil Dário C. Sobral Filho – Universidade de Pernambuco (UPE), Recife, PE – Brazil
Antônio Carlos Palandri Chagas – Universidade de São Paulo (USP), São Paulo, Décio Mion Junior – Hospital das Clínicas da Faculdade de Medicina da
SP – Brazil
Universidade de São Paulo (HCFMUSP), São Paulo, SP – Brazil
Antonio Carlos Pereira Barretto – Universidade de São Paulo (USP), São Paulo,
Denilson Campos de Albuquerque – Universidade do Estado do Rio de Janeiro
SP – Brazil
(UERJ), Rio de Janeiro, RJ – Brazil
Antonio Cláudio Lucas da Nóbrega – Universidade Federal Fluminense (UFF),
Djair Brindeiro Filho – Universidade Federal de Pernambuco (UFPE), Recife,
Rio de Janeiro, RJ – Brazil
PE – Brazil
Antonio de Padua Mansur – Faculdade de Medicina da Universidade de São
Domingo M. Braile – Universidade Estadual de Campinas (UNICAMP), São
Paulo (FMUSP), São Paulo, SP – Brazil
Paulo, SP – Brazil
Ari Timerman (SP) – Instituto Dante Pazzanese de Cardiologia (IDPC), São
Edmar Atik – Hospital Sírio Libanês (HSL), São Paulo, SP – Brazil
Paulo, SP – Brazil
Emilio Hideyuki Moriguchi – Universidade Federal do Rio Grande do Sul
Armênio Costa Guimarães – Liga Bahiana de Hipertensão e Aterosclerose,
(UFRGS) Porto Alegre, RS – Brazil
Salvador, BA – Brazil
Enio Buffolo – Universidade Federal de São Paulo (UNIFESP), São Paulo, SP – Brazil
Ayrton Pires Brandão – Universidade do Estado do Rio de Janeiro (UERJ), Rio
de Janeiro, RJ – Brazil Eulógio E. Martinez Filho – Instituto do Coração (InCor), São Paulo, SP – Brazil
Beatriz Matsubara – Universidade Estadual Paulista Júlio de Mesquita Filho Evandro Tinoco Mesquita – Universidade Federal Fluminense (UFF), Rio de
(UNESP), São Paulo, SP – Brazil Janeiro, RJ – Brazil
Brivaldo Markman Filho – Universidade Federal de Pernambuco (UFPE), Recife, Expedito E. Ribeiro da Silva – Universidade de São Paulo (USP), São Paulo,
PE – Brazil SP – Brazil
Bruno Caramelli – Universidade de São Paulo (USP), São Paulo, SP – Brazil Fábio Vilas Boas Pinto – Secretaria Estadual da Saúde da Bahia (SESAB),
Carisi A. Polanczyk – Universidade Federal do Rio Grande do Sul (UFRGS), Salvador, BA – Brazil
Porto Alegre, RS – Brazil Fernando Bacal – Universidade de São Paulo (USP), São Paulo, SP – Brazil
Flávio D. Fuchs – Universidade Federal do Rio Grande do Sul (UFRGS), Porto Paulo R. A. Caramori – Pontifícia Universidade Católica do Rio Grande do Sul
Alegre, RS – Brazil (PUCRS), Porto Alegre, RS – Brazil
Francisco Antonio Helfenstein Fonseca – Universidade Federal de São Paulo Paulo Roberto B. Évora – Universidade de São Paulo (USP), São Paulo, SP – Brazil
(UNIFESP), São Paulo, SP – Brazil Paulo Roberto S. Brofman – Instituto Carlos Chagas (FIOCRUZ/PR), Curitiba,
Gilson Soares Feitosa – Escola Bahiana de Medicina e Saúde Pública (EBMSP), PR – Brazil
Salvador, BA – Brazil
Pedro A. Lemos – Hospital das Clínicas da Faculdade de Medicina da USP
Glaucia Maria M. de Oliveira – Universidade Federal do Rio de Janeiro (UFRJ), (HCFMUSP), São Paulo, SP – Brazil
Rio de Janeiro, RJ – Brazil
Protásio Lemos da Luz – Instituto do Coração do Hcfmusp (INCOR), São Paulo,
Hans Fernando R. Dohmann, AMIL – ASSIST. MEDICA INTERNACIONAL SP – Brazil
LTDA., Rio de Janeiro, RJ – Brazil
Reinaldo B. Bestetti – Universidade de Ribeirão Preto (UNAERP), Ribeirão
Humberto Villacorta Junior – Universidade Federal Fluminense (UFF), Rio de Preto, SP – Brazil
Janeiro, RJ – Brazil
Renato A. K. Kalil – Instituto de Cardiologia do Rio Grande do Sul (IC/FUC),
Ines Lessa – Universidade Federal da Bahia (UFBA), Salvador, BA – Brazil Porto Alegre, RS – Brazil
Iran Castro – Instituto de Cardiologia do Rio Grande do Sul (IC/FUC), Porto Ricardo Stein – Universidade Federal do Rio Grande do Sul (UFRS), Porto
Alegre, RS – Brazil Alegre, RS – Brazil
Jarbas Jakson Dinkhuysen – Instituto Dante Pazzanese de Cardiologia/Fundação Salvador Rassi – Faculdade de Medicina da Universidade Federal de Goiás (FM/
Adib Jatene (IDPC/FAJ), São Paulo, SP – Brazil GO), Goiânia, GO – Brazil
João Pimenta – Instituto de Assistência Médica ao Servidor Público Estadual Sandra da Silva Mattos – Real Hospital Português de Beneficência em
(IAMSPE), São Paulo, SP – Brazil Pernambuco, Recife, PE – Brazil
Jorge Ilha Guimarães – Fundação Universitária de Cardiologia (IC FUC), Porto Sandra Fuchs – Universidade Federal do Rio Grande do Sul (UFRGS), Porto
Alegre, RS – Brazil Alegre, RS – Brazil
José Antonio Franchini Ramires – Instituto do Coração Incor Hc Fmusp Sergio Timerman – Hospital das Clínicas da Faculdade de Medicina da USP
(INCOR), São Paulo, SP – Brazil (INCOR HC FMUSP), São Paulo, SP – Brazil
José Augusto Soares Barreto Filho – Universidade Federal de Sergipe, Aracaju, Silvio Henrique Barberato – Cardioeco Centro de Diagnóstico Cardiovascular
SE – Brazil (CARDIOECO), Curitiba, PR – Brazil
José Carlos Nicolau – Instituto do Coração (InCor), São Paulo, SP – Brazil Tales de Carvalho – Universidade do Estado de Santa Catarina (UDESC),
José Lázaro de Andrade – Hospital Sírio Libanês, São Paulo, SP – Brazil Florianópolis, SC – Brazil
José Péricles Esteves – Hospital Português, Salvador, BA – Brazil Vera D. Aiello – Instituto do Coração do Hospital das Clínicas da (FMUSP,
INCOR), São Paulo, SP – Brazil
Leonardo A. M. Zornoff – Faculdade de Medicina de Botucatu Universidade
Estadual Paulista Júlio de Mesquita Filho (UNESP), Botucatu, SP – Brazil Walter José Gomes – Universidade Federal de São Paulo (UNIFESP), São Paulo,
SP – Brazil
Leopoldo Soares Piegas – Instituto Dante Pazzanese de Cardiologia/Fundação
Adib Jatene (IDPC/FAJ) São Paulo, SP – Brazil Weimar K. S. B. de Souza – Faculdade de Medicina da Universidade Federal de
Goiás (FMUFG), Goiânia, GO – Brazil
Lucia Campos Pellanda – Fundação Universidade Federal de Ciências da Saúde
de Porto Alegre (UFCSPA), Porto Alegre, RS – Brazil William Azem Chalela – Instituto do Coração (INCOR HCFMUSP), São Paulo,
SP – Brazil
Luís Eduardo Paim Rohde – Universidade Federal do Rio Grande do Sul
(UFRGS), Porto Alegre, RS – Brazil Wilson Mathias Junior – Instituto do Coração (InCor) do Hospital das Clínicas
da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São
Luís Cláudio Lemos Correia – Escola Bahiana de Medicina e Saúde Pública
(EBMSP), Salvador, BA – Brazil Paulo, SP – Brazil
Luiz A. Machado César – Fundação Universidade Regional de Blumenau
Exterior
(FURB), Blumenau, SC – Brazil
Adelino F. Leite-Moreira – Universidade do Porto, Porto – Portugal
Luiz Alberto Piva e Mattos – Instituto Dante Pazzanese de Cardiologia (IDPC),
São Paulo, SP – Brazil Alan Maisel – Long Island University, Nova York – USA
Marcia Melo Barbosa – Hospital Socor, Belo Horizonte, MG – Brazil Aldo P. Maggioni – ANMCO Research Center, Florença – Italy
Marcus Vinícius Bolívar Malachias – Faculdade Ciências Médicas MG Ana Isabel Venâncio Oliveira Galrinho – Hospital Santa Marta, Lisboa – Portugal
(FCMMG), Belo Horizonte, MG – Brazil Ana Maria Ferreira Neves Abreu – Hospital Santa Marta, Lisboa – Portugal
Maria da Consolação V. Moreira – Universidade Federal de Minas Gerais Ana Teresa Timóteo – Hospital Santa Marta, Lisboa – Portugal
(UFMG), Belo Horizonte, MG – Brazil
Cândida Fonseca – Universidade Nova de Lisboa, Lisboa – Portugal
Mario S. S. de Azeredo Coutinho – Universidade Federal de Santa Catarina
Fausto Pinto – Universidade de Lisboa, Lisboa – Portugal
(UFSC), Florianópilis, SC – Brazil
Hugo Grancelli – Instituto de Cardiología del Hospital Español de Buenos
Maurício Ibrahim Scanavacca – Universidade de São Paulo (USP), São Paulo,
Aires – Argentina
SP – Brazil
James de Lemos – Parkland Memorial Hospital, Texas – USA
Max Grinberg – Instituto do Coração do Hcfmusp (INCOR), São Paulo, SP – Brazil
João A. Lima, Johns – Johns Hopkins Hospital, Baltimore – USA
Michel Batlouni – Instituto Dante Pazzanese de Cardiologia (IDPC), São Paulo,
SP – Brazil John G. F. Cleland – Imperial College London, Londres – England
Murilo Foppa – Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Jorge Ferreira – Hospital de Santa Cruz, Carnaxide – Portugal
RS – Brazil Manuel de Jesus Antunes – Centro Hospitalar de Coimbra, Coimbra – Portugal
Nadine O. Clausell – Universidade Federal do Rio Grande do Sul (UFRGS), Marco Alves da Costa – Centro Hospitalar de Coimbra, Coimbra – Portugal
Porto Alegre, RS – Brazil
Maria João Soares Vidigal Teixeira Ferreira – Universidade de Coimbra,
Orlando Campos Filho – Universidade Federal de São Paulo (UNIFESP), São Coimbra – Portugal
Paulo, SP – Brazil
Maria Pilar Tornos – Hospital Quirónsalud Barcelona, Barcelona – Spain
Otávio Rizzi Coelho – Universidade Estadual de Campinas (UNICAMP),
Nuno Bettencourt – Universidade do Porto, Porto – Portugal
Campinas, SP – Brazil
Pedro Brugada – Universiteit Brussel, Brussels – Belgium
Otoni Moreira Gomes – Universidade Federal de Minas Gerais (UFMG), Belo
Horizonte, MG – Brazil Peter A. McCullough – Baylor Heart and Vascular Institute, Texas – USA
Paulo Andrade Lotufo – Universidade de São Paulo (USP), São Paulo, SP – Brazil Peter Libby – Brigham and Women's Hospital, Boston – USA
Paulo Cesar B. V. Jardim – Universidade Federal de Goiás (UFG), Brasília, DF – Brazil Piero Anversa – University of Parma, Parma – Italy
Paulo J. F. Tucci – Universidade Federal de São Paulo (UNIFESP), São Paulo, SP – Brazil Roberto José Palma dos Reis – Hospital Polido Valente, Lisboa – Portugal
Sociedade Brasileira de Cardiologia
President State and Regional Relations Director SBC/MG – Carlos Eduardo de Souza Miranda
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Arquivos Brasileiros de Cardiologia
Volume 110, Nº 6, June 2018
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Original Article
Cardiovascular Disease Epidemiology in Portuguese-Speaking
Countries: data from the Global Burden of Disease, 1990 to 2016
Bruno Ramos Nascimento,1 Luisa Campos Caldeira Brant,1 Gláucia Maria Moraes de Oliveira,2 Marcus Vinícius Bolívar
Malachias,3 Gabriel Moreira Alves Reis,1 Renato Azeredo Teixeira,1 Deborah Carvalho Malta,1 Elisabeth França,1 Maria
de Fátima Marinho Souza,4 Gregory A. Roth,5 Antonio Luiz P. Ribeiro1
Universidade Federal de Minas Gerais (UFMG),1 Belo Horizonte, MG – Brazil
Universidade Federal do Rio de Janeiro,2 Rio de Janeiro, RJ - Brazil
Faculdade Ciências Médicas de Minas Gerais,3 Belo Horizonte, MG - Brazil
Ministério da Saúde, Brasília,4 DF - Brazil
University of Washington,5 Seattle, WA - USA
Abstract
Background: Portuguese-speaking countries (PSC) share the influence of the Portuguese culture but have socioeconomic
development patterns that differ from that of Portugal.
Objective: To describe trends in cardiovascular disease (CVD) morbidity and mortality in the PSC between 1990 and
2016, stratified by sex, and their association with the respective sociodemographic indexes (SDI).
Methods: This study used the Global Burden of Disease (GBD) 2016 data and methodology. Data collection followed
international standards for death certification, through information systems on vital statistics and mortality surveillance,
surveys, and hospital registries. Techniques were used to standardize causes of death by the direct method, as were corrections
for underreporting of deaths and garbage codes. To determine the number of deaths due to each cause, the CODEm (Cause of
Death Ensemble Model) algorithm was applied. Disability-adjusted life years (DALYs) and SDI (income per capita, educational
attainment and total fertility rate) were estimated for each country. A p-value < 0.05 was considered significant.
Results: There are large differences, mainly related to socioeconomic conditions, in the relative impact of CVD burden in
PSC. Among CVD, ischemic heart disease was the leading cause of death in all PSC in 2016, except for Mozambique and
Sao Tome and Principe, where cerebrovascular diseases have supplanted it. The most relevant attributable risk factors for
CVD among all PSC are hypertension and dietary factors.
Conclusion: Collaboration among PSC may allow successful experiences in combating CVD to be shared between those
countries. (Arq Bras Cardiol. 2018; 110(6):500-511)
Keywords: Cardiovascular Diseases; Epidemiology; Mortality; Global Burden of Disease / trends.
Introduction healthy lifestyle, access to primary and secondary prevention
of CVD and treatment of acute cardiovascular events, is, thus,
Cardiovascular diseases (CVD) are a major cause of death
essential for CVD control in all countries.1
worldwide. Although CVD are not the first cause of death
in many low- and middle-income countries, they account Portuguese-speaking countries (PSC) were culturally
influenced by Portugal at different levels.2 The study of the
for 80% of the deaths and 88% of the premature deaths in
trends in morbidity and mortality from CVD in those countries
those countries.1 The control of infectious, maternal and child
can provide us useful data regarding the similarities and
diseases, the increase in life expectancy and the growing
differences between them. Those data can provide an exchange
urbanization have contributed to the trend towards increasing
of information between countries regarding well-succeeded
the importance of CVD in low- and middle-income countries.
actions for fighting CVD, in addition to allowing reflections on
The implementation of health policies, such as promotion of a
the influence of culture on the burden of CVD.
The “Global Burden of Disease Study” (GBD Study) is
an important epidemiological observational study that uses
Mailing Address: Gláucia Maria Moraes de Oliveira • metrics of morbidity and mortality related to major diseases,
Universidade Federal do Rio de Janeiro – R. Prof. Rodolpho P. Rocco, 255 injuries and risk factors at global, at national and regional
– Prédio do HU 8º andar – sala 6, UFRJ. Postal Code 21941-913, Cidade
levels. One of the GBD Study objectives is to understand, by
Universitária, RJ – Brazil
E-mail: [email protected], [email protected] assessing the trends, the changes in the profile of the diseases
Manuscript received December 08, 2017, revised manuscript March 21, that affect the 21st century populations.3
2018, accepted March 21, 2018
This study was aimed at describing the trends of CVD
DOI: 10.5935/abc.20180098
morbidity and mortality in the PSC between 1990 and
500
Nascimento et al
Cardiovascular disease in Portuguese-speaking countries
Original Article
2016, based on the estimates of the GBD 2016 Study, and Definitions of CVD
to assess the association between those trends and the The nine most common global causes of death and
sociodemographic index (SDI) of those countries. morbidity related to CVD and an additional category for
‘other CVD’ were considered, in addition to the estimates
Methods of global morbidity and mortality grouped by CVD.7
The underlying cause of death was defined as CVD according
to the International Classification of Diseases (ICD) codes,
Portuguese-speaking countries
from the death certificate (DC), the basic document that
The PSC are the official members of the Community of informs the causes of death in countries with systems of
Portuguese-Speaking Countries (CPLP), an international vital statistics, such as Brazil. The following causes were
organization created in July 17, 1996, aimed at "deepening analyzed, with their corresponding ICD-10 codes according
the mutual friendship and cooperation between its members".2 to the GBD Study’s classification list of causes: 1- rheumatic
The initial list of countries included Angola, Brazil, Cape fever with cardiac involvement (codes I01-I01.9, I02.0,
Verde, Guinea-Bissau, Mozambique, Portugal and Sao Tome I05-I09.9); 2-ischemic heart disease (codes I20-I25.9);
and Principe. In 2002, after its independence, Timor-Leste 3- cerebrovascular disease (CbVD) (G45-G46.8, I60-I69.9);
was accepted as a member. In 2014, Equatorial Guinea was 4- hypertensive heart disease (I11); 5- cardiomyopathy and
accepted as a member, after Portuguese was adopted as the myocarditis (A39.52, B33.2-B33.24, D86.85, I40-I43.9,
official language of the country. Table 1 and Figure 1 show I51.4-I51.5); 6- atrial fibrillation and flutter (I48); 7- aortic
the location and the demographic, social and economic aneurysm (I71); 8- peripheral artery disease (I70.2-I70.7,
characteristics of the PSC. I73-I73.9); 9-endocarditis (A39.51, I33-I33.9, I38-I39.9).
Garbage codes, such as heart failure (I50) and pulmonary
The GBD Study embolism (I26), which do not define the pathology that
caused the death, were redistributed to those specific causes
The GBD Study is a multinational collaborative research
based on the GBD methodology, according to algorithms
project with the goal of producing consistent estimates of
defined in that study.
health loss due to over 333 diseases and injuries. A wide range
of data sources (data of national surveillance, verbal autopsy Regarding mortality, those causes were grouped
and vital registration, published and unpublished registries of based on the specific sequelae of disease (for example,
diseases, and published scientific literature) and methods are ischemic heart disease due to acute coronary syndrome,
applyed to produce specific results with uncertainty intervals chronic stable angina, chronic ischemic heart disease and
for age, sex and country for the years 1990-2016, and such ischemic cardiomyopathy). Adjustments were performed
results are annually updated for the entire temporal series. for data that did not comply with the specific definition
The present study is based on data from the GBD 2016 Study of case (for example, electronic confirmation for the
and its previously detailed methodology.4-6 clinical diagnosis).4,8,9
Table 1 – Demographic, social and economic characteristics of the Portuguese-speaking countries, 2013
Sao
Equatorial Guinea-
Angola Brazil Cape Verde Mozambique Portugal Tome and Timor-Leste
Guinea Bissau
Principe
Population (millions) 19 201 1 1 2 24 10 0.2 1
Population density
15 24 127 39 44 31 113 190 79
(inhab/km²)
Area (1,000 km²) 1247 8516 4 28 36 786 92 1.0 15
GDP (USD, billions) 125 2473 2 22 1 16 226 0.3 1
GDP per capita (USD) 4805 12217 3589 20247 611 606 21619 1620 1108
Major religion Catholicism Catholicism Catholicism Catholicism Islam Catholicism Catholicism Catholicism Catholicism
Public expenditure with
2.6 4.0 2.5 2.6 1.1 2.1 9.1 2.0 10.4
health (%GDP)
Public expenditure with
4.9 6.2 5.5 2.2 2.2 5.7 4.2 5.6 16.2
education (%GDP)
Illiteracy rate
28.4 8.5 12.8 6.0 40.1 41.2 5.2 9.6 35.9
(% population)
Sociodemographic
0.42 0.66 0.55 0.61 0.29 0.28 0.75 0.45 0.45
index *
*Data from 2015. GDP: gross domestic product. USD: United States dollars.
501 Arq Bras Cardiol. 2018; 110(6):500-511