Introduction We aim to describe time trends in death rates from cardiovascular diseases (CVD) and cancer in the Portuguese population in 1985–2005 and to quantify the contribution of variation in population's size and age structure, and risk to the change in number of deaths.
Methods The number of deaths from CVD (CID10: I00-I99) and all malignant tumours (CID10: C00-C99) and the population, by sex and age, were obtained from official statistics. We standardised mortality rates (direct method, European population) and used joinpoint analysis to identify changes in trends and to estimate the annual percent change (APC) of the standardised rate. We used the tool RiskDiff to quantify the contribution of risk, size and structure of the population during the periods with constant log-linear trend.
Results Mortality from CVD declined since 1985, most sharply since 1993 (men: APC=−4.0%, 95% CI −3.5 to −4.6; women: APC=−3.8%, 95% CI −3.1 to −4.4). The increasing population and its ageing explain a 30% increase in the number of deaths. The risk reduction explains a reduction by half, resulting in fewer deaths from CVD (men: −24%, women: −17%). Mortality from malignant tumours significantly increased until 1996 in men (APC=0.8%, 95% CI 0.5 to 1.1). Since 1996 in men and 1991 in women, despite the growing number of deaths (men: 13%, women: 16%), the risk is declining as illustrated by decreasing standardised mortality rates (men: APC=−0.4%, 95% CI −0.7 to −0.1; women: APC=−0.8%, 95% CI −0.9 to −0.6).
Conclusion In Portugal, the risk of death from CVD and cancer is decreasing, although this is reflected in fewer deaths only for CVD.
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