Researchers at the University of São Paulo (USP) developed a study to help find more effective strategies to reduce the incidence of cardiovascular diseases, which are still the biggest causes of death in the country.
They analyzed the weight of different factors, such as those that increase the risk of a heart attack, such as high glucose (hyperglycemia), obesity, high cholesterol, hypertension and smoking. According to the Fundação de Amparo à Pesquisa do Estado de São Paulo (Fapesp), using statistical methods, the researchers determined the number of deaths attributed to each risk factor. The study measured the impact of each on cardiovascular disease death statistics, and hyperglycemia showed an association with this outcome five to ten times greater than other factors.
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Data from government sources, such as the Ministries of Social Development and Health and the Brazilian Institute of Geography and Statistics (IBGE), registered between 2005 and 2017, allowed the survey. The numbers were compared with information from other banks, such as the Global Health Data Exchange (GHDx) and the repository of the Institute for Health Metrics and Evaluation (IHME), at the University of Washington (United States).
An equation to calculate the number of deaths prevented or postponed due to changes in risk factors had already been established by previous studies, which made it possible to also analyze the rates of “premature” deaths, calculated in relation to the standard life expectancy.
In the authors’ conclusion, about 5,000 people would not have died from cardiovascular disease in the analyzed period if the rates of diabetes were lower in the population. The study also made it possible to conclude that at least 17,000 deaths were avoided only by reducing cigarette consumption during these 12 years.
In Brazil, between 2005 and 2017, there was a 21% decrease in mortality and an 8% decrease in the incidence of cardiovascular diseases. In addition to the reduction in smoking, greater access to basic health is listed as one of those responsible for the improvement in rates. This observation took into account the issue of hypertension, often associated with heart problems.
However, hypertension accounted for seven times fewer deaths from cardiovascular disease than hyperglycemia. One of the possibilities is that access to the universal health system, with an increase in primary care coverage, has made the rate of hypertension control high in the population.
The researchers inserted covariates into the analyzed models to account for data such as family income, Bolsa Família benefit, gross domestic product (GDP) per capita, number of doctors per inhabitant and primary care coverage.
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