Epidemiology of Environmental, Behavioral and Metabolic Risk Factors for Stroke: Temporal Analysis in the Brazilian Population

Objective: To analyze the temporal trend of mortality and incidence attributed to environmental, behavioral, and metabolic risk factors for stroke in the Brazilian population between 1998 and 2017. Method: Ecological study using secondary data on the evolution of incidence and mortality related to risk factors identified in the ICD-10, both available on the GBD (Global Burden Disease) platform. Results: In the period analyzed, there was a 1.46% reduction in mortality from stroke associated with smoking per year (p=0.016), with a 2.18% decrease in women (p=0.006). Metabolic risk increased by 1.41% (p=0.029), being 3.33% among men (p=0.001). Pollution reduced by 1.53% for both sexes (p=0.013), with a 2.06% decrease in women (p=0.017). Stroke mortality also fell by 6.8% for men (p<0.001) and 6.0% for women (p<0.001). Analyzing the Brazilian states, in relation to smoking, there was a reduction (5.55%; p=0.022) in the Pará region. Regarding pollution, reductions were noted for the states of Piauí (6.76%; p=0.042) , Ceará (6.57%; p=0.001) and Paraná (4.86%; p=0.027). Conclusion: Between 1998 and 2017, Brazil showed a significant reduction in the incidence and mortality from stroke, with sharper drops in women. Mortality associated with smoking decreased, especially among women, while metabolic risk increased among men. Mortality from pollution reduced significantly, with the drops standing out in Pará, Piauí, Ceará and Paraná.