Burden of Cardiovascular Disease in Brazil, 1996–2023: A Retrospective Descriptive Study of the Epidemiology and Impact on Public Healthcare with Emphasis on Acute Myocardial Infarction
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Background
Cardiovascular diseases (CVD) are the leading cause of death worldwide, and their epidemiology is correlated with genetic predisposition, exposure to risk factors, sex, age, access to medical care, and other sociodemographic characteristics. Brazil is a developing country with a vast territory, which leads to structural inequalities. Estimates of CVD in Brazil, in its regions, and in its population are poorly evaluated and analysed.
Methods
We obtained CVD-related data from the Brazilian Unified Health System (SUS) and analysed mortality and morbidity from 1996 to 2023 by sex, race/ethnicity, age, and region. We calculated the risk of death from the most prevalent diseases, the average length of hospital stay, and the costs associated with heart transplantation.
Findings
In Brazil, acute myocardial infarction was the pathology that led to the highest number of deaths across all variables analysed during the evaluated period. Other CVD were also related to causes of death and morbidity, such as hypertensive diseases and heart failure.
Interpretation
Brazil presents a serious challenge to the public health system due to the high number of deaths and the progressive mortality rate. This study represents a fundamental contribution to the basis for formulating public health policies aimed at reducing the growing impact associated with these diseases.
Funding
CNPq, CAPES, FAPEMIG, INCT
Research in context
Evidence before this study
Data published annually by the World Health Organization shows that cardiovascular diseases (CVD) are the leading cause of death worldwide, with acute myocardial infarction and stroke being the most prominent. Therefore, we began searching Google Scholar for epidemiological data on CVD over the last 5 years (2021-2025). We used search terms such as “myocardial infarction”, “hypertensive diseases”, and “hospital costs for cardiovascular diseases”. We noted that the studies were scattered in their information, in many cases failing to correlate important parameters for the manifestation of CVD or to measure the proportion of deaths over time. Although the population is aware that CVD are the leading cause of mortality, data available from health systems and records are not explicit and easily interpreted.
Added value of this study
This study aimed to evaluate different variables such as hospitalization costs, region, sex, age, and race/ethnicity in relation to the burden of CVD as a percentage of total deaths per 100,000 inhabitants in Brazil. We were able to identify the main causes of mortality from CVD, focusing our study on seven prominent diseases. We confirmed that acute myocardial infarction is still the CVD that causes the most deaths in the country. We analysed sociodemographic parameters with the manifestation of these diseases.
Implications of all available evidence
CVD continue to be the leading cause of death in Brazil and worldwide. This study serves as a basis for public health policy development, such as preventive measures. It highlights that the manifestation, incidence, and progression of these diseases are derived from a diverse set of factors, involving social, economic, and geographic spheres.
