Heart Map Brazil Healthcare Disparities

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

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Avery Sinclair in Health & Wellness May 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

Heart Map Brazil Healthcare Disparities

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.

Everything You Need To Know

1

What are angioplasty and coronary artery bypass surgery (CABG), and why are they important in the context of heart health?

Angioplasty is a medical procedure used to open blocked arteries, improving blood flow to the heart. Coronary artery bypass surgery (CABG) is a surgical procedure that creates new routes around blocked coronary arteries to restore blood flow. These interventions are crucial for individuals with severe coronary artery disease, helping to prevent life-threatening complications. The data between 2002 and 2010, indicates variations in the utilization of these procedures across different regions of Brazil, highlighting disparities in access to care.

2

What are the key regional differences in access to angioplasty and CABG that the study revealed?

The study analyzed data from 2002 to 2010, focusing on the standardized rates of angioplasty and CABG per 100,000 inhabitants aged 20 and over. The analysis revealed significant regional disparities, particularly along the North-South axis of Brazil. The South region consistently showed the highest rates of both procedures, while the North and Northeast regions had the lowest. This pattern underscores the critical need to address the imbalances in access to these vital cardiovascular interventions.

3

What are the implications of the regional disparities in access to angioplasty and CABG?

The regional inequalities in access to cardiovascular surgery, specifically angioplasty and CABG, have significant implications. These disparities mean that individuals in certain regions, particularly the North and Northeast of Brazil, may not receive timely or adequate care for severe coronary artery disease. This can lead to worse health outcomes, including a higher risk of heart attacks and other life-threatening complications. The study's findings highlight an inequitable distribution of healthcare resources and the importance of targeted interventions to ensure equitable access to life-saving cardiac care across all regions.

4

How does Brazil's utilization of angioplasty and CABG compare to that of OECD countries?

The findings indicate Brazil has lower rates of angioplasty and CABG compared to OECD countries. This suggests potential underutilization of these procedures in Brazil. While the specific reasons aren't detailed in this context, it points to broader systemic issues that may be affecting access to these essential cardiac interventions in Brazil. It is important to understand the complexities of the healthcare system to address these challenges and improve patient outcomes.

5

What steps can be taken to improve equitable access to cardiac care in Brazil?

Addressing regional inequalities in access to cardiovascular surgery requires a multifaceted approach. The study suggests strategies like establishing regional healthcare networks to improve access, optimizing the allocation of healthcare resources to ensure that all regions have adequate infrastructure and personnel, and implementing targeted interventions to address specific needs and challenges in underserved areas. These steps are crucial for ensuring equitable access to life-saving cardiac care across Brazil and improving the health of all citizens.

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