Brain and cardiovascular diseases continue to be the main cause of death in Portugal, representing around 25% of total annual deaths. But their proportion has been decreasing steadily, approaching in 2023, for the first time, the proportion observed for malignant tumors. This leads the Directorate-General for Health to conclude that “brain and cardiovascular mortality indicators are equal to or lower than the European average.
This is revealed in a report from the National Program for Brain and Cardiovascular Diseases (PNDCCV) that portrays “10 Years of Brain and Cardiovascular Diseases in Portugal”, in the period between 2013–2023 and which is released this Wednesday, February 11th.
But if there are improvements, there are also warnings, as the report makes it clear that One of the biggest challenges for the next decade is the area of heart failurewhich despite having recorded a 37% reduction in hospitalizations, maintained high associated mortality, reflecting the burden of chronic disease and aging. More than 65% of hospitalizations for stroke and heart failure occur in people over 70 years of age.
According to the document, relevant improvements were detected immediately in the monitoring of patients in Primary Health Care (PHC) between 2015 and 2024, due to the increase in the control of patients with blood pressure and diabetes with controlled LDL cholesterol levels. This increase in the control of these patients also contributed to a greater number of consultations in the area of smoking cessation, which allowed better signaling of cardiovascular risk factors and their control.
This also led to, in the last decade, hospitalizations for diseases of the circulatory system decreased by 19%, reflecting gains in prevention, improved care response and therapeutic advances. The document also states that there was a consistent reduction in hospital mortality due to acute myocardial infarction (AMI) and cerebrovascular accident (CVA) during this period. However, it should be noted that, between 2017 and 2023, 198,927 hospitalizations were made for brain and cardiovascular diseases, of which more than 80% corresponded to acute stroke.
In the same period, a consistent improvement in in-hospital lethality in acute myocardial infarction and ischemic stroke was also observed, associated with a notable increase in access to advanced reperfusion therapies. However, the consolidation of the Stroke Green Ways and the Coronary Green Way had a direct impact on patient survival.
In the data presented now, challenges are identified, namely regional inequalities in access to differentiated care, the high lethality of hemorrhagic strokes, the growing number of adults with congenital heart disease and the need to reinforce cardiovascular rehabilitation and integration of care.
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