Heart Map Brazil Healthcare Disparities

Cardiac Care Divide: Understanding Regional Disparities in Heart Surgery Access in Brazil

Avery Sinclair in Health & Wellness November 2025 • 4 min read.

"A deep dive into the unequal access to angioplasty and coronary bypass surgery across Brazil, revealing critical insights for healthcare equity."

Cardiovascular diseases (CVDs) remain a leading cause of mortality worldwide, accounting for approximately 17.3 million deaths in 2008 alone, according to the World Health Organization (WHO). Of these deaths, a staggering 7.3 million were attributed to coronary heart disease. These statistics highlight the urgent need for effective and equitable cardiac care.

In Brazil, CVDs represent a significant public health challenge, accounting for 32.4% of all deaths between 1990 and 2009. Despite advancements in medical technology and treatment strategies, disparities in access to essential cardiovascular interventions, such as angioplasty and coronary artery bypass surgery (CABG), persist across different regions of the country.

These procedures serve as critical interventions for individuals with severe coronary artery disease, helping to improve blood flow to the heart and reduce the risk of life-threatening complications. The study aims to analyze the evolution of these rates and discuss the possible causes associated with regional inequalities. Standardized rates of angioplasty and coronary bypass surgery by age and sex per 100,000 inhabitants aged 20 and over, in the period from 2002 to 2010 were calculated.

Unequal Access: Mapping the Cardiac Care Divide

A 2012 study by Viacava, Porto, Laguardia, Moreira and Ugá, titled “Regional Differences in Access to Coronary Bypass Surgery in Brazil, 2002-2010,” sheds light on the stark regional disparities in access to cardiovascular surgeries within Brazil. The study highlights significant differences in hospitalization rates for angioplasty and CABG across various regions, raising concerns about equitable healthcare access.

The study compared the standardized rates of angioplasty and coronary artery bypass surgery (CABG) across different regions. International data comparison reveals that Brazil generally has lower rates of these procedures compared to OECD (Organisation for Economic Co-operation and Development) countries.

Angioplasty Trends: Standardized rates of hospitalization for angioplasty in individuals aged 20 and over showed an upward trend, increasing from 27.5 per 100,000 in 2002 to 39 per 100,000 in 2010.
Regional Variations: Significant differences were observed across Brazil's major regions, particularly along the North-South axis. However, a stable pattern of regional disparities persisted throughout the study period.
CABG Trends: The study also found differences in the rates of coronary artery bypass graft (CABG) surgery across regions.
OECD Comparison: When compared to OECD countries, Brazil generally shows lower rates of both Angioplasty and CABG, suggesting potential underutilization of these procedures.

The regions of Brazil—North, Northeast, Southeast, South, and Central-West—showed distinct patterns. The South region consistently had the highest rates of both angioplasty and CABG, while the North and Northeast regions had the lowest. Socioeconomic factors, healthcare infrastructure, and access to specialized services likely contribute to these differences. Also, a notable increase in the proportion of angioplasties performed relative to total revascularization procedures across all regions, with rates converging around 70% by 2010.

Moving Towards Equitable Cardiac Care

Addressing the regional inequalities in access to cardiovascular surgery requires a multifaceted approach. By prioritizing the establishment of regional healthcare networks, optimizing resource allocation, and implementing targeted interventions, Brazil can move closer to ensuring equitable access to life-saving cardiac care for all its citizens.

About this Article -

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This article is based on research published under:

DOI-LINK: 10.1590/s1413-81232012001100013, Alternate LINK

Title: Diferenças Regionais No Acesso A Cirurgia Cardiovascular No Brasil, 2002 -2010

Subject: Public Health, Environmental and Occupational Health

Journal: Ciência & Saúde Coletiva

Publisher: FapUNIFESP (SciELO)

Authors: Francisco Viacava, Silvia Porto, Josué Laguardia, Rodrigo Da Silva Moreira, Maria Alícia Dominguez Ugá

Published: 2012-11-01

Everything You Need To Know

What are the key differences in access to angioplasty and coronary artery bypass surgery (CABG) across different regions of Brazil?

The study by Viacava, Porto, Laguardia, Moreira and Ugá (2012) reveals significant disparities in hospitalization rates for both angioplasty and CABG across Brazil's regions. The South region consistently demonstrated the highest rates of both procedures, while the North and Northeast regions reported the lowest. This disparity highlights an inequitable distribution of healthcare resources and access to specialized cardiac interventions within the country. These differences persisted throughout the period from 2002 to 2010.

How do angioplasty and coronary artery bypass surgery (CABG) rates in Brazil compare to those in OECD countries?

Brazil generally exhibits lower rates of both angioplasty and coronary artery bypass surgery (CABG) when compared to OECD (Organisation for Economic Co-operation and Development) countries. This suggests a potential underutilization of these critical procedures in Brazil. The lower rates compared to OECD countries could indicate that there is a gap in access to care, availability of the procedures, or differences in treatment strategies.

What were the trends in angioplasty and CABG rates between 2002 and 2010 in Brazil?

Between 2002 and 2010, standardized rates of hospitalization for angioplasty in individuals aged 20 and over showed an upward trend, increasing from 27.5 per 100,000 in 2002 to 39 per 100,000 in 2010. The study also found differences in the rates of coronary artery bypass graft (CABG) surgery across regions. The specific changes in CABG rates are not detailed, but the study points out regional variations.

What are the implications of the observed regional disparities in access to angioplasty and coronary artery bypass surgery (CABG) in Brazil?

The regional disparities in access to angioplasty and CABG in Brazil have significant implications for public health and healthcare equity. Unequal access means that individuals in certain regions, particularly the North and Northeast, may face delayed or restricted access to life-saving interventions for severe coronary artery disease. This can lead to poorer health outcomes, increased mortality rates, and widening health inequalities. Addressing these disparities is critical to ensure that all Brazilians have equal opportunities to receive timely and effective cardiac care, regardless of their geographic location.

What strategies are suggested to address the cardiac care divide in Brazil and improve access to angioplasty and CABG?

Addressing the regional inequalities in access to cardiovascular surgery requires a multifaceted approach. This includes prioritizing the establishment of regional healthcare networks to improve coordination and resource sharing, optimizing resource allocation to ensure that areas with greater needs receive adequate support, and implementing targeted interventions aimed at increasing access in underserved regions. By focusing on these strategies, Brazil can move closer to ensuring equitable access to life-saving cardiac care for all its citizens, thus reducing the burden of cardiovascular diseases.