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1.
Rev Esp Cardiol ; 48(2): 106-14, 1995 Feb.
Artigo em Espanhol | MEDLINE | ID: mdl-7886261

RESUMO

INTRODUCTION: In order to obtain epidemiological information for health planification, age-adjusted time series and provincial distribution of ischaemic heart disease mortality have been constructed. MATERIAL AND METHODS: Analysis of time trends includes data from 1901 to 1989. Trends have been identified by linear regression analysis. For the period 1976-1986 age-adjusted and age and sex specific mortality rates have been calculated for each province. 1984 and 1989 levels have been compared to those of the European Union countries. RESULTS: After the sharp rise of the curve in the 50-70 decades, since 1976 mortality falls with an statistically significant negative slope. This change in trends cannot be explained by time variations in prevalence of the main risk factors. Although in many European countries mortality began to fall much earlier, Spain still remains between the lowest mortality rates in Europe. Provinces showing the highest rates are the islands, Andalucia, Badajoz, Murcia, Alicante and Asturias. This clear north-south pattern is maintained after stratifying by age and sex, thus indicating that geographical distribution is related more to environmental or socio-economic factors and to accessibility to qualified health care, than to the geographical distribution of age and sex related risk factors. CONCLUSIONS: Additional studies including other variables are needed to explain these time and spatial variations. Allocation of specialized health care resources can be an effective intervention, mostly in the above mentioned provinces.


Assuntos
Isquemia Miocárdica/mortalidade , Adulto , Distribuição por Idade , Idoso , Europa (Continente)/epidemiologia , União Europeia/estatística & dados numéricos , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Mortalidade/tendências , Distribuição por Sexo , Espanha/epidemiologia , Fatores de Tempo
2.
Neuroepidemiology ; 14(4): 165-73, 1995.
Artigo em Inglês | MEDLINE | ID: mdl-7643950

RESUMO

Cerebrovascular diseases (CVDs) constitute the most frequent cause of death in Spain. In order to identify the geographical pattern of CVD mortality, age- and sex-specific as well as age-adjusted mortality rates (ICD-8,9 rubrics 430-438) were calculated for the period 1975-1986 for each province in the country. Maps were constructed after categorization of mortality rates by quintile levels. In general, the geographical pattern was similar for the different age and sex strata. While most provinces in the northern half presented low or medium mortality, geographical areas located in the south, displayed rates in the uppermost quintiles. These results suggest that the spatial distribution of CVD mortality in Spain is not random and that the potential determinants underlying this geographical distribution, such as type of stroke, incidence, fatality, diagnostic or certification practices and competing causes of death, have an impact that is independent of age and sex and strongly associated with spatial location. Furthermore, these results can help in identifying high-risk populations.


Assuntos
Transtornos Cerebrovasculares/mortalidade , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Sexuais , Espanha/epidemiologia , Taxa de Sobrevida
3.
Neuroepidemiology ; 12(3): 148-57, 1993.
Artigo em Inglês | MEDLINE | ID: mdl-8272175

RESUMO

We studied the mortality from stroke as the underlying cause of death in Spain during the period 1901-1986. The age-adjusted mortality in 1986 was 114.4 per 100,000 among males and 100.6 per 100,000 for females. From 1901 to 1986, the SMR from stroke in Spain decreased by approximately 2/3, levelling off during the period 1950-1970, and again falling from 1973 on. A new plateau might have been initiated in the early 1980s. Since 1950, a marked continuous decrease is seen for hemorrhagic stroke and, since 1973, for ischemic stroke. In spite of difficulties in interpreting death record data, this study confirms that stroke mortality in Spain ranks on a medium level when compared with data from other European countries and that it conforms to the patterns reported for industrial countries. The drop in stroke mortality since 1973 preceded the widespread use of antihypertensive drugs.


Assuntos
Isquemia Encefálica/epidemiologia , Anti-Hipertensivos/uso terapêutico , Isquemia Encefálica/tratamento farmacológico , Isquemia Encefálica/prevenção & controle , Europa (Continente)/epidemiologia , Feminino , Promoção da Saúde , Humanos , Masculino , Mortalidade , Fatores Sexuais , Espanha/epidemiologia
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