<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1405-9940</journal-id>
<journal-title><![CDATA[Archivos de cardiología de México]]></journal-title>
<abbrev-journal-title><![CDATA[Arch. Cardiol. Méx.]]></abbrev-journal-title>
<issn>1405-9940</issn>
<publisher>
<publisher-name><![CDATA[Instituto Nacional de Cardiología Ignacio Chávez]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1405-99402016000400358</article-id>
<article-id pub-id-type="doi">10.1016/j.acmx.2016.05.009</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Análisis de la mortalidad por enfermedades cerebrovasculares en Costa Rica entre los años 1920-2009]]></article-title>
<article-title xml:lang="en"><![CDATA[Analysis of cerebrovascular disease mortality in Costa Rica between the years 1920-2009]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Evans-Meza]]></surname>
<given-names><![CDATA[Ronald]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pérez-Fallas]]></surname>
<given-names><![CDATA[José]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bonilla-Carrión]]></surname>
<given-names><![CDATA[Roger]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="A01">
<institution><![CDATA[,Universidad Hispanoamericana de San José Unidad de Investigación e Innovación en Ciencias de la Salud ]]></institution>
<addr-line><![CDATA[San José ]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="A02">
<institution><![CDATA[,Universidad Hispanoamericana de San José Departamento de Estadística de la Unidad de Investigación e Innovación en Ciencias de la Salud ]]></institution>
<addr-line><![CDATA[San José ]]></addr-line>
<country>Costa Rica</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2016</year>
</pub-date>
<volume>86</volume>
<numero>4</numero>
<fpage>358</fpage>
<lpage>366</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S1405-99402016000400358&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S1405-99402016000400358&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S1405-99402016000400358&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Objetivo Analizar la tendencia de la mortalidad por enfermedades cerebrovasculares en Costa Rica y su impacto sobre la mortalidad general entre los años 1920-2009.  Métodos Se obtuvieron las tasas brutas por trienios y quinquenios del lapso estudiado, así como las tasas estandarizadas del grupo etario entre 35-74 años durante el lapso 1970-2009. Igualmente, la proporción de muertes por accidente cerebrovascular (ACV) en relación a la mortalidad general.  Resultados La tendencia durante el periodo 1920-1969 fue hacia el ascenso (r = 0.82, r2 = 0.67, betha: 0.30; p = &#8804; 0,00) en tanto que para el lapso 1970 ocurrió lo contrario (r = 0.42, r2 = 0.18, betha: &#8722;0.064; p = 0.01). Las tasas ajustadas para el grupo 35-74 años entre 1970-2009 descendieron en un 58.03%, siendo la tendencia estadísticamente significante para ambos sexos; varones: r2 = 0.94, betha: &#8722;0.73; mujeres: r2 = 0.97, betha: 0.95. El máximo porcentaje de la mortalidad por ACV en relación a la mortalidad general fue de 7,22 alcanzado en el quinquenio 1985-1989, descendiendo a 5.92% en el periodo 2005-2009.  Conclusiones En el contexto latinoamericano, las tasas de mortalidad por ACV en Costa Rica son bajas, pero todavía constituyen un grave problema de salud pública por la gran mortalidad, morbilidad y discapacidad que ocasionan, pese a una tendencia hacia el descenso.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Objective To analyze the trend in mortality from cerebrovascular diseases in Costa Rica and its impact on overall mortality from 1920 to 2009.  Methods Crude rates by triennium and quinquennium were obtained. We also obtanied age standardized rates in the age group 35-74 years during the period 1970-2009. Finally we got the death percentage from stroke in relation to overall mortality.  Results The trend for the period 1920-1969 was to the upside (r=0.82, r2 =0.67, betha 0.30; P&#8804;0.00) whereas for the period 1970 occurred otherwise (r=0.42, r2 =0.18, betha &#8722;0064; P=0.01). Adjusted for the group 35-74 years between 1970-2009 rates decreased by 58.03% was statistically significant trend for both sexes; men r2=0.94, betha: &#8212;0.73; women: r2=0.97, betha: 0.95. The maximum percentage of mortality from stroke in relation to the overall mortality was 7.22 in the period 1985-1989 reached down to 5.92% in 2005-2009.  Conclusions In the Latin American context, stroke mortality rates in Costa Rica are low but still represent a serious public health problem by the high mortality, morbidity and disability that they cause, despite a downward trend.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Mortality]]></kwd>
<kwd lng="en"><![CDATA[Cerebrovascular disease (stroke)]]></kwd>
<kwd lng="en"><![CDATA[Descriptive studies]]></kwd>
<kwd lng="en"><![CDATA[Descriptive epidemiology]]></kwd>
<kwd lng="en"><![CDATA[Costa Rica]]></kwd>
<kwd lng="es"><![CDATA[Mortalidad]]></kwd>
<kwd lng="es"><![CDATA[Enfermedades cerebrovasculares]]></kwd>
<kwd lng="es"><![CDATA[Estudios descriptivos]]></kwd>
<kwd lng="es"><![CDATA[Epidemiología descriptiva]]></kwd>
<kwd lng="es"><![CDATA[Costa Rica]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Demographic and epidemiologic drivers of global cardiovascular mortality]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Roth]]></surname>
<given-names><![CDATA[GA]]></given-names>
</name>
<name>
<surname><![CDATA[Forounzafar]]></surname>
<given-names><![CDATA[MH]]></given-names>
</name>
<name>
<surname><![CDATA[Moran]]></surname>
<given-names><![CDATA[AE]]></given-names>
</name>
</person-group>
<source><![CDATA[N Engl J Med]]></source>
<year>2015</year>
<volume>372</volume>
<page-range>1333-41</page-range></nlm-citation>
</ref>
<ref id="B2">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013]]></article-title>
<collab>GBD 2013</collab>
<source><![CDATA[Lancet]]></source>
<year>2015</year>
<volume>385</volume>
<page-range>117-21</page-range></nlm-citation>
</ref>
<ref id="B3">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Years lived with disability(YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: A systematic analysis for the Global Burden of Disease Study 2010]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vos]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Flaxman]]></surname>
<given-names><![CDATA[AD]]></given-names>
</name>
<name>
<surname><![CDATA[Naghavi]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<source><![CDATA[Lancet]]></source>
<year>2012</year>
<volume>380</volume>
<page-range>2163-96</page-range></nlm-citation>
</ref>
<ref id="B4">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: A systematic analysis for the Global Burden of Disease Study 2010]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Murray]]></surname>
<given-names><![CDATA[CJ]]></given-names>
</name>
<name>
<surname><![CDATA[Vos]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Lozano]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<source><![CDATA[Lancet]]></source>
<year>2012</year>
<volume>380</volume>
<page-range>2197-223</page-range></nlm-citation>
</ref>
<ref id="B5">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Heart disease and stroke statistics 2012 update. A report from the American Heart Association]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Roger]]></surname>
<given-names><![CDATA[VL]]></given-names>
</name>
<name>
<surname><![CDATA[Go]]></surname>
<given-names><![CDATA[AS]]></given-names>
</name>
<name>
<surname><![CDATA[Lloyd-Jones]]></surname>
<given-names><![CDATA[DM]]></given-names>
</name>
</person-group>
<source><![CDATA[Circulation]]></source>
<year>2012</year>
<volume>125</volume>
<page-range>e2-220</page-range></nlm-citation>
</ref>
<ref id="B6">
<nlm-citation citation-type="book">
<article-title xml:lang=""><![CDATA[Análisis y determinantes sociales de la situación de salud]]></article-title>
<source><![CDATA[Memoria institutional 2014-2014]]></source>
<year>2014</year>
<publisher-name><![CDATA[Ministerio de Salud de Costa Rica]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B7">
<nlm-citation citation-type="book">
<article-title xml:lang=""><![CDATA[Análisis y determinantes sociales de la situación de salud]]></article-title>
<source><![CDATA[Memoria institucional 2011]]></source>
<year>2012</year>
<publisher-loc><![CDATA[San José, Costa Rica ]]></publisher-loc>
<publisher-name><![CDATA[Ministerio de Salud]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B8">
<nlm-citation citation-type="book">
<collab>Sistema de Mortalidad Regional</collab>
<source><![CDATA[Observatorio Regional de salud]]></source>
<year>2012</year>
<publisher-name><![CDATA[Organización Panamericana de la Salud (PAHO-WHO)]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B9">
<nlm-citation citation-type="">
<collab>Institute Health Metrics</collab>
<source><![CDATA[Evaluation. Global Burden Disease. Profile]]></source>
<year>2010</year>
<publisher-loc><![CDATA[Costa Rica ]]></publisher-loc>
</nlm-citation>
</ref>
<ref id="B10">
<nlm-citation citation-type="book">
<source><![CDATA[La carga de enfermedad y esperanza de vida saludable en Costa Rica]]></source>
<year>2014</year>
<publisher-loc><![CDATA[San José ]]></publisher-loc>
<publisher-name><![CDATA[Caja Costarricense del Seguro Social]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B11">
<nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Liebson]]></surname>
<given-names><![CDATA[PR]]></given-names>
</name>
</person-group>
<source><![CDATA[Cardiovascular disease in special populations. III: Stroke]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B12">
<nlm-citation citation-type="">
<collab>INEC</collab>
<source><![CDATA[Anuarios estadísticos 1920-1969]]></source>
<year></year>
<publisher-loc><![CDATA[San José, Costa Rica ]]></publisher-loc>
</nlm-citation>
</ref>
<ref id="B13">
<nlm-citation citation-type="">
<collab>Centro Centroamericano de Población</collab>
<source><![CDATA[Estadísticas Vitales de Mortalidad, Costa Rica 1970-2009]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B14">
<nlm-citation citation-type="book">
<collab>World Health Organization</collab>
<source><![CDATA[International Statistical Classification of Diseases, 10th Revision (ICD-10)]]></source>
<year>1992</year>
<publisher-loc><![CDATA[Geneva, Switzerland ]]></publisher-loc>
<publisher-name><![CDATA[World Health Organization]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B15">
<nlm-citation citation-type="">
<collab>Centro Centroamericano de Población</collab>
<source><![CDATA[Proyecciones Nacionales de Población de Costa Rica 1950-2100]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B16">
<nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Daniel]]></surname>
<given-names><![CDATA[W.]]></given-names>
</name>
</person-group>
<source><![CDATA[Bioestadística: base para el análisis de las ciencias de la salud]]></source>
<year>2008</year>
<edition>Cuarta</edition>
<publisher-loc><![CDATA[México D.F ]]></publisher-loc>
<publisher-name><![CDATA[Limusa S.A]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B17">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Morbilidad y mortalidad por cardiopatía isquémica en el Instituto Mexicano del Seguro Social. Estudio ecológico de tendencias en población amparada por el Instituto Mexicano del Seguro Social entre 1990 y 2008]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[de la Peña]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Rodríguez-Abrego]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Buitrón]]></surname>
<given-names><![CDATA[LV]]></given-names>
</name>
</person-group>
<source><![CDATA[Arch Cardiol Méx]]></source>
<year>2010</year>
<volume>80</volume>
<page-range>242-8</page-range></nlm-citation>
</ref>
<ref id="B18">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Trends in mortality from coronary heart and cerebrovascular diseases in the Américas: 1970-2000]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rodríguez]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Malvezzi]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Chatenoud]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<source><![CDATA[Heart]]></source>
<year>2000</year>
<volume>92</volume>
<page-range>453-60</page-range></nlm-citation>
</ref>
<ref id="B19">
<nlm-citation citation-type="">
<collab>PAHO Health Information Platform</collab>
<source><![CDATA[Basic Indicator Browser - by Countries and selected year]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B20">
<nlm-citation citation-type="">
<collab>Organización Panamericana de la Salud</collab>
<collab>Organización Mundial de la Salud, Enfermedades Transmisibles y Análisis de Salud/Información y Análisis de Salud</collab>
<source><![CDATA[Situación de Salud en las Américas: Indicadores Básicos 2013]]></source>
<year>2013</year>
<publisher-loc><![CDATA[Washington, D.C., Estados Unidos de América ]]></publisher-loc>
</nlm-citation>
</ref>
<ref id="B21">
<nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Murray Christopher]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
<name>
<surname><![CDATA[Salomon Joshua]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Mathers Colin]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A critical examination of summary measures of population health]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Murray]]></surname>
<given-names><![CDATA[CJL]]></given-names>
</name>
<name>
<surname><![CDATA[Salomon]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Mathers]]></surname>
<given-names><![CDATA[CD]]></given-names>
</name>
<name>
<surname><![CDATA[López]]></surname>
<given-names><![CDATA[AD]]></given-names>
</name>
</person-group>
<source><![CDATA[Summary measures of populatation health]]></source>
<year>2002</year>
<publisher-loc><![CDATA[Geneve ]]></publisher-loc>
<publisher-name><![CDATA[World Health Organization]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B22">
<nlm-citation citation-type="book">
<collab>World Bank</collab>
<source><![CDATA[World Development Report 1993. Investing in health]]></source>
<year>1993</year>
<publisher-loc><![CDATA[New York ]]></publisher-loc>
<publisher-name><![CDATA[Oxford University Press for the World Bank]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B23">
<nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mathers Colin]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[López Alan]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Murray Cristopher]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The Burden of Disease and Mortality by Conditions: Data, Methods and Results for 2001]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Mathers]]></surname>
<given-names><![CDATA[CD]]></given-names>
</name>
<name>
<surname><![CDATA[Sabaté]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[López]]></surname>
<given-names><![CDATA[AD]]></given-names>
</name>
</person-group>
<source><![CDATA[Guidelines for epidemiological reviews: the global burden of disease 2000 project]]></source>
<year>2001</year>
<publisher-loc><![CDATA[Ginebra ]]></publisher-loc>
<publisher-name><![CDATA[World Health Organization]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B24">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[América Latina y el Caribe. El envejecimiento de la población. 1950-2050]]></article-title>
<source><![CDATA[CEPAL]]></source>
<year>2003</year>
<volume>XXXVI</volume>
<numero>72</numero>
<issue>72</issue>
<publisher-loc><![CDATA[Santiago de Chile ]]></publisher-loc>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
