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Peer-reviewedCC BYLancet regional health. Americas

Burden of cardiovascular disease in Brazil, 1996-2023: a retrospective descriptive study of the epidemiology and impact on public healthcare.

  1. 1Departamento de Fisiologia e Biofísica, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, 31270-901, Belo Horizonte, Minas Gerais, Brazil.
  2. 2United Nations, Resident Coordinator Office in Guatemala, Guatemala City, Guatemala.

Abstract

Background

Cardiovascular diseases (CVD) are the leading cause of death worldwide, and their epidemiology is correlated with genetic predisposition and exposure to risk. Brazil is a developing country with a vast territory, which leads to structural inequalities. We aimed to comprehensively characterise the epidemiology and burden of CVD in Brazil between 1996 and 2023, examining temporal trends, regional disparities, demographic patterns, healthcare costs, and heart transplantation.Methods

We conducted a nationwide retrospective descriptive ecological study using aggregated administrative data from the Brazilian Unified Health System (SUS), Brazil's publicly funded national health system. Mortality, hospitalization, and heart transplantation data from 1996 to 2023 were analysed according to sex, race/ethnicity, age, and geographic region. We estimated mortality rates for the major CVD, hospital length of stay, healthcare expenditures, and heart transplantation activity.Findings

Acute myocardial infarction remained the leading cause of cardiovascular mortality throughout the study period, while hypertensive diseases overtook heart failure after 2016 as the second leading cause of death. The overall CVD mortality rate-calculated as the number of CVD-related deaths divided by the total population and expressed as a percentage-increased from 7.3% in 1998 to 8.3% in 2023, peaking at 10.1% in 2021. Marked regional, age-, sex-, and race/ethnicity-related disparities were observed, including the complete absence of heart transplantation in the North region throughout the study period. Although hospitalization rates remained relatively stable, CVD-related healthcare expenditures and heart transplantation activity increased over time.Interpretation

CVD remains a major and growing public health challenge in Brazil, with substantial regional and demographic inequalities in disease burden and access to specialised care. These findings highlight the need for targeted public health strategies and more equitable allocation of healthcare resources to reduce cardiovascular morbidity and mortality.Funding

This study was funded by CNPq, CAPES, FAPEMIG, INCT.

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BibTeX
@article{basiliosoares2026burden,
  title = {{Burden of cardiovascular disease in Brazil, 1996-2023: a retrospective descriptive study of the epidemiology and impact on public healthcare.}},
  author = {Mellyely Carolina Basílio-Soares and João Sérgio Fonseca Guimarães and Ana Luíza Matos de Oliveira and André Gustavo Oliveira and Thiago Verano-Braga},
  journal = {Lancet regional health. Americas},
  year = {2026},
  month = oct,
  doi = {10.1016/j.lana.2026.101674},
  url = {https://europepmc.org/article/MED/42909254},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Burden of cardiovascular disease in Brazil, 1996-2023: a retrospective descriptive study of the epidemiology and impact on public healthcare.
AU  - Mellyely Carolina Basílio-Soares
AU  - João Sérgio Fonseca Guimarães
AU  - Ana Luíza Matos de Oliveira
AU  - André Gustavo Oliveira
AU  - Thiago Verano-Braga
PY  - 2026
DA  - 2026/10/14
JO  - Lancet regional health. Americas
DO  - 10.1016/j.lana.2026.101674
UR  - https://europepmc.org/article/MED/42909254
AB  - Background  Cardiovascular diseases (CVD) are the leading cause of death worldwide, and their epidemiology is correlated with genetic predisposition and exposure to risk. Brazil is a developing country with a vast territory, which leads to structural inequalities. We aimed to comprehensively characterise the epidemiology and burden of CVD in Brazil between 1996 and 2023, examining temporal trends, regional disparities, demographic patterns, healthcare costs, and heart transplantation.Methods  We conducted a nationwide retrospective descriptive ecological study using aggregated administrative data from the Brazilian Unified Health System (SUS), Brazil's publicly funded national health system. Mortality, hospitalization, and heart transplantation data from 1996 to 2023 were analysed according to sex, race/ethnicity, age, and geographic region. We estimated mortality rates for the major CVD, hospital length of stay, healthcare expenditures, and heart transplantation activity.Findings  Acute myocardial infarction remained the leading cause of cardiovascular mortality throughout the study period, while hypertensive diseases overtook heart failure after 2016 as the second leading cause of death. The overall CVD mortality rate-calculated as the number of CVD-related deaths divided by the total population and expressed as a percentage-increased from 7.3% in 1998 to 8.3% in 2023, peaking at 10.1% in 2021. Marked regional, age-, sex-, and race/ethnicity-related disparities were observed, including the complete absence of heart transplantation in the North region throughout the study period. Although hospitalization rates remained relatively stable, CVD-related healthcare expenditures and heart transplantation activity increased over time.Interpretation  CVD remains a major and growing public health challenge in Brazil, with substantial regional and demographic inequalities in disease burden and access to specialised care. These findings highlight the need for targeted public health strategies and more equitable allocation of healthcare resources to reduce cardiovascular morbidity and mortality.Funding  This study was funded by CNPq, CAPES, FAPEMIG, INCT.
SN  - 2667-193X
ER  -