Stroke mortality in São Paulo (1997-2003): a description using the Tenth Revision of the International Classification of Diseases

Abstract

Stroke mortality rates are higher in Brazil when compared to other countries. The city of São Paulo has a good system of mortality surveillance that allow us to describe the epidemiology of the stroke in the city. Our aim was to describe the stroke mortality pattern by gender and age characterizing the ischemic/ hemorrhagic ratio. We categorized mortality data by gender and a 10-year age-strata from 30-39 years-old to 70-79 years-old. To avoid random variations, we calculated the mean of all deaths occurred during the period of 1997 to 2003. Mortality rates were calculated using the population from the Brazilian National Census occurred in 2000. The proportion of deaths from all types of stroke related to all cardiovascular among women was higher when compared to men, mainly during middle-age. In other hand, the risk of stroke death is always higher among men during all ages. Ill-defined stroke certification is more common as underlying cause of death above the 60 years-old (40 per cent).Intracerebral hemorrhage was the most frequent cause of stroke death for both sexes from 30 to 59 years-old. Subarachnoideal hemorrhage was much more frequent as cause of death among women than in men. The ratio between ischemic/hemorrhagic (both subtypes) was 0.59 for men and 0.56 for women. Concluding, the magnitude of hemorrhagic stroke is still higher in São Paulo city, with an special burden to middle-aged people for both gender.