Figure 1
Trends in mortality from stroke in America and the Caribbean, 1979–2015. 
, men (age-standardized mortality rated); 
, women (age-standardized mortality rated).
Table 1
Joinpoint analysis for stroke mortality trends in Latin America and the Caribbean, 1979–2015.
| TOTAL STUDY PERIOD | PERIOD 1 | PERIOD 2 | PERIOD 3 | |||||
|---|---|---|---|---|---|---|---|---|
| YEARS | APC (95% CI) | YEARS | APC (95% CI) | YEARS | APC (95% CI) | YEARS | APC (95% CI) | |
| LAC | 1979–2015 | –1.9* (–2.4, –1.5) | 1979–1992 | –0.5 (–1.1, 0.1) | 1992–2010 | –2.3* (–2.7, –1.9) | 2010–2015 | –4.3* (–6.8, –1.7) |
| Antigua and Barbuda | 1985–2015 | –1.5 (–5.5, 2.8) | 1985–1992 | 6.6 (–1.7, 15.6) | 1992–2009 | –7.3* (–9.6, –5.0) | 2009–2015 | 7.0 (–11.7, 29.6) |
| Argentina | 1979–2015 | –2.5* (–3.0, –2.1) | 1979–1990 | –0.5 (–1.1, 0.1) | 1990–2012 | –4.1* (–4.3, –3.9) | 2012–2015 | 2.0 (–2.8, 7.0) |
| Bahamas | 1980–2013 | –2.2* (–3.3, –1.1) | ||||||
| Barbados | 1979–2013 | –2.3 (–5.0, 0.4) | 1979–1995 | –2.4* (–3.7, –1.2) | 1995–2004 | –7.7 (–16.9, 2.6) | 2004–2013 | 3.5* (0.4, 6.7) |
| Belize | 1980–2015 | 0.8 (–3.7, 5.6) | 1980–2000 | 1.3 (–0.4, 2.9) | 2000–2003 | –12.7 (–49.2, 49.9) | 2003–2015 | 3.8* (0.6, 7.2) |
| Brazil | 1979–2015 | –2.0* (–2.8, –1.1) | 1979–1988 | –2.1* (–3.0, –1.1) | 1988–1991 | 7.0 (–3.4, 18.6) | 1991–2015 | –3.0* (–3.2, –2.8) |
| Chile | 1980–2015 | –2.8* (–3.5, –2.1) | 1980–2008 | –2.9* (–3.1, –2.7) | 2008–2012 | –0.1 (–5.1, 5.2) | 2012–2015 | –6.0* (–10.7, –1.0) |
| Colombia | 1984–2015 | –3.4* (–4.5, –2.3) | 1984–1988 | –16.3* (–21.4, –10.9) | 1988–1994 | 4.7* (0.2, 9.4) | 1994–2015 | –3.0* (–3.5, –2.5) |
| Costa Rica | 1980–2014 | –2.2* (–3.2, –1.1) | 1980–1988 | 2.2 (–0.8, 5.2) | 1988–2008 | –5.1* (–5.8, –4.3) | 2008–2014 | 2.0 (–2.5, 6.8) |
| Cuba | 1979–2015 | –1.2* (–1.4, –0.9) | 1979–1988 | –0.0 (–1.0, 1.0) | 1988–2015 | –1.5* (–1.7, –1.4) | ||
| Ecuador | 1979–2015 | –1.7 (–5.0, 1.8) | 1979–1993 | 0.2 (–1.7, 2.2) | 1993–1996 | –12.5 (–42.3, 32.7) | 1996–2015 | –1.2 (–2.4, 0.0) |
| El Salvador | 1981–2014 | –1.9* (–3.0, –0.7) | 1981–1992 | 3.7* (1.6, 5.9) | 1992–2008 | –6.3* (–7.4, –5.1) | 2008–2014 | 0.3 (–4.3, 5.0) |
| Grenada | 1985–2015 | –0.4 (–1.5, 0.7) | ||||||
| Guatemala | 1979–2015 | 0.6 (–1.9, 3.2) | 1979–1988 | –5.0 (–10.3, 0.7) | 1988–1995 | 13.1* (2.1, 25.2) | 1995–2015 | –0.9 (–2.5, 0.8) |
| Guyana | 1979–2013 | –1.1* (–1.8, –0.5) | ||||||
| Jamaica | 1980–2011 | –1.1* (–1.7, –0.6) | ||||||
| Mexico | 1979–2015 | –0.7* (–1.4, –0.1) | 1979–1989 | 3.2* (1.1, 5.2) | 1989–2015 | –2.2* (–2.7, –1.7) | ||
| Nicaragua | 2010–2015 | –3.7* (–6.5, –0.7) | ||||||
| Panama | 1979–2015 | –1.5 (–3.3, 0.3) | 1979–2005 | –0.8* (–1.5, –0.1) | 2005–2011 | –5.2 (–12.5, 2.8) | 2011–2015 | –0.7 (–11.4, 11.3) |
| Paraguay | 1979–2014 | –0.8 (–2.7, 1.3) | 1979–1995 | 1.4* (0.4, 2.5) | 1995–1998 | –10.2 (–29.1, 13.8) | 1998–2014 | –1.1* (–2.0, –0.2) |
| Saint Lucia | 1979–2014 | –2.2* (–2.9, –1.5) | ||||||
| St. Vincent | 1982–2015 | 0.9* (0.0, 1.8) | ||||||
| Suriname | 1979–2014 | –0.6 (–2.6, 1.5) | 1979–1995 | –2.5* (–4.9, –0.1) | 1995–2004 | 10.4* (4.4, 16.8) | 2004–2014 | –6.7* (–10.3, –2.9) |
| Trinidad and Tobago | 1979–2011 | –2.0* (–3.0, –0.9) | 1979–1981 | 12.8 (–3.8, 32.3) | 1981–1999 | –2.0* (–2.6, –1.5) | 1999–2011 | –4.2* (–5.1, –3.3) |
| Uruguay | 1980–2015 | –3.0* (–3.8, –2.2) | 1980–2005 | –2.2* (–2.4, –1.9) | 2005–2012 | –6.5* (–9.2, –3.7) | 2012–2015 | –1.5 (–7.8, 5.3) |
| Venezuela | 1979–2013 | –1.5* (–2.3, –0.6) | 1979–1986 | –3.0* (–5.0, –1.0) | 1986–1992 | 1.6 (–2.8, 6.2) | 1992–2013 | –1.8* (–2.2, –1.4) |
[i] APC, annual percent change; CI, confidence interval. * P < 0.05 for change in trend.
Table 2
Joinpoint analysis for stroke mortality trends in men in Latin America and the Caribbean, 1979–2015.
| TOTAL STUDY PERIOD | PERIOD 1 | PERIOD 2 | PERIOD 3 | |||||
|---|---|---|---|---|---|---|---|---|
| YEARS | APC (95% CI) | YEARS | APC (95% CI) | YEARS | APC (95% CI) | YEARS | APC (95% CI) | |
| LAC | 1979–2015 | –1.4* (–1.7, –1.1) | 1979–1994 | –0.1 (–0.7, 0.5) | 1994–2015 | –2.3* (–2.6, –1.9) | ||
| Antigua and Barbuda | 1985–2015 | –2.4 (–8.9, 4.6) | 1985–1988 | 2.4 (–2.2, 7.3) | 1998–2001 | –29.3 (–64.6, 41.0) | 2001–2015 | 0.0 (–3.2, 3.4) |
| Argentina | 1979–2015 | –2.1* (–2.6, –1.7) | 1979–1992 | –0.4 (–0.9, 0.2) | 1992–2012 | –4.0* (–4.3, –3.7) | 2012–2015 | 2.9 (–2.3, 8.3) |
| Bahamas | 1980–2013 | –2.2* (–3.4, –0.9) | ||||||
| Barbados | 1979–2013 | –2.1 (–5.6, 1.4) | 1979–1995 | –1.9* (–3.5, –0.3) | 1995–2004 | –9.2 (–20.7, 4.0) | 2004–2013 | 5.1* (1.0, 9.2) |
| Belize | 1980–2015 | 0.4 (–0.4, 1.3) | ||||||
| Brazil | 1979–2015 | –1.5* (–2.2, –0.9) | 1979–1988 | –0.5 (–1.2, 0.3) | 1988–1991 | 8.3 (–0.0, 17.4) | 1991–2015 | 8.3 (–0.0, 17.4) |
| Chile | 1980–2015 | –2.4* (–2.5, –2.3) | ||||||
| Colombia | 1984–2015 | –3.3* (–4.3, –2.3) | 1984–1988 | –15.5* (–20.5, –10.2) | 1988–1995 | 3.5* (0.2, 6.9) | 1995–2015 | –3.0* (–3.5, –2.5) |
| Costa Rica | 1980–2014 | –1.8* (–3.1, –0.5) | 1980–1988 | 4.4* (0.8, 8.2) | 1988–2007 | –5.4* (–6.4, –4.4) | 2007–2014 | 1.3 (–3.0, 5.8) |
| Cuba | 1979–2015 | –0.8* (–1.1, –0.5) | 1979–1986 | 0.4 (–1.0, 1.7) | 1986–2015 | –1.1* (–1.3, –0.9) | ||
| Ecuador | 1979–2015 | –1.6 (–3.5, 0.3) | 1979–1992 | 0.2 (–1.9, 2.4) | 1992–1997 | –8.2 (–19.2, 4.4) | 1997–2015 | –1.1 (–2.4, 0.2) |
| El Salvador | 1981–2014 | –1.8* (–3.0, –0.5) | 1981–1992 | 4.2* (1.9, 6.5) | 1992–2008 | –6.8* (–8.1, –5.5) | 2008–2014 | 1.4 (–3.6, 6.7) |
| Grenada | 1985–2015 | 0.3 (–0.9, 1.4) | ||||||
| Guatemala | 1979–2015 | 0.8 (–1.7, 3.2) | 1979–1989 | –3.9 (–8.1, 0.5) | 1989–1995 | 14.5* (1.2, 29.6) | 1995–2015 | –0.7 (–2.2, 0.8) |
| Guyana | 1979–2013 | –1.7* (–2.3, –1.1) | ||||||
| Jamaica | 1980–2011 | –0.9* (–1.5, –0.3) | ||||||
| Mexico | 1979–2015 | –0.5 (–1.1, 0.0) | 1979–1989 | 3.5* (1.7, 5.3) | 1989–2015 | –2.0* (–2.4, –1.6) | ||
| Nicaragua | 2010–2015 | –4.2* (–7.1, –1.2) | ||||||
| Panama | 1979–2015 | –1.2 (–2.6, 0.3) | 1979–2005 | –0.6* (–1.1, –0.1) | 2005–2010 | –4.9 (–13.0, 4.1) | 2010–2015 | –0.4 (–6.5, 6.2) |
| Paraguay | 1979–2014 | –0.8 (–3.1, 1.6) | 1979–1995 | 1.5* (0.3, 2.7) | 1995–1998 | –10.4 (–31.9, 17.8) | 1998–2014 | –1.1* (–2.2, –0.1) |
| Saint Lucia | 1979–2014 | –1.9* (–2.6, –1.2) | ||||||
| St. Vincent | 1982–2015 | 1.4* (0.5, 2.2) | ||||||
| Suriname | 1979–2014 | –0.5 (–3.0, 2.1) | 1979–1995 | –3.0 (–5.9, 0.1) | 1995–2004 | 11.8* (4.2, 20.0) | 2004–2014 | –6.6* (–11.2, –1.8) |
| Trinidad and Tobago | 1979–2011 | –1.5* (–2.9, –0.2) | 1979–1982 | 8.6 (–4.2, 23.1) | 1982–2003 | –1.8* (–2.5, –1.1) | 2003–2011 | –4.4* (–7.0, –1.8) |
| Uruguay | 1980–2015 | –2.8* (–3.1, –2.4) | 1980–2004 | –1.6* (–1.9, –1.3) | 2004–2015 | –5.3* (–6.2, –4.4) | ||
| Venezuela | 1979–2013 | –0.9 (–1.8, 0.0) | 1979–1986 | –2.3* (–4.4, –0.1) | 1986–1992 | 1.8 (–2.8, 6.7) | 1992–2013 | –1.2* (–1.6, –0.8) |
[i] APC, annual percent change; CI, confidence interval. * P < 0.05 for change in trend.
Table 3
Joinpoint analysis for stroke mortality trends in women in Latin America and the Caribbean, 1979–2015.
| TOTAL STUDY PERIOD | PERIOD 1 | PERIOD 2 | PERIOD 3 | |||||
|---|---|---|---|---|---|---|---|---|
| YEARS | APC (95% CI) | YEARS | APC (95% CI) | YEARS | APC (95% CI) | YEARS | APC (95% CI) | |
| LAC | 1979–2015 | –2.4* (–2.8, –2.0) | 1979–1993 | –1.1* (–1.7, –0.6) | 1993–2010 | –2.4* (–2.8, –2.0) | 2010–2015 | –5.9* (–8.2, –3.4) |
| Antigua and Barbuda | 1985–2015 | –0.6 (–5.1, 4.2) | 1985–1992 | 6.9 (–3.7, 18.7) | 1992–2012 | –7.0* (–9.7, –4.3) | 2012–2015 | 31.4 (–11.1, 94.3) |
| Argentina | 1979–2015 | –2.7* (–3.3, –2.2) | 1979–1988 | –0.4 (–1.3, 0.4) | 1988–2013 | –4.2* (–4.3, –4.0) | 2013–2015 | 5.2 (–4.2, 15.6) |
| Bahamas | 1980–2013 | –2.4* (–3.6, –1.3) | ||||||
| Barbados | 1979–2013 | –2.6* (–4.1, –1.2) | 1979–1994 | –2.4* (–3.7, –1.1) | 1994–2001 | –8.3* (–14.1, –2.3) | 2001–2013 | 0.5 (–1.4, 2.5) |
| Belize | 1980–2015 | 0.7 (–5.1, 6.8) | 1980–2000 | 0.5 (–1.5, 2.6) | 2000–2003 | –13.2 (–56.6, 73.5) | 2003–2015 | 4.7* (0.5, 9.1) |
| Brazil | 1979–2015 | –2.3* (–3.5, –1.2) | 1979–1989 | –3.0* (–4.0, –1.9) | 1989–1992 | 6.2 (–7.6, 22.1) | 1992–2015 | –3.1* (–3.4, –2.8) |
| Chile | 1980–2015 | –2.9* (–3.8, –2.0) | 1980–1992 | –2.7* (–3.3, –2.1) | 1992–1995 | –6.5 (–16.0, 4.0) | 1995–2015 | –2.5* (–2.8, –2.2) |
| Colombia | 1984–2015 | –3.5* (–4.8, –2.3) | 1984–1988 | –17.4* (–22.6, –11.8) | 1988–1993 | 6.6 (–0.1, 13.8) | 1993–2015 | –3.0* (–3.5, –2.5) |
| Costa Rica | 1980–2014 | –2.7* (–3.7, –1.7) | 1980–1992 | –1.2 (–2.8, 0.3) | 1992–2007 | –5.6* (–6.8, –4.4) | 2007–2014 | 1.1 (–2.4, 4.8) |
| Cuba | 1979–2015 | –1.6* (–1.9, –1.3) | 1979–1995 | –0.8* (–1.2, –0.3) | 1995–2015 | –2.3* (–2.6, –1.9) | ||
| Ecuador | 1979–2015 | –1.6 (–5.1, 2.0) | 1979–1993 | 0.4 (–1.6, 2.4) | 1993–1996 | –13.1 (–43.7, 34.2) | 1996–2015 | –1.2 (–2.4, 0.1) |
| El Salvador | 1981–2014 | –2.3 (–5.0, 0.5) | 1981–1990 | 4.5 (–6.2, 16.4) | 1990–2014 | –4.7* (–5.4, –4.0) | ||
| Grenada | 1985–2015 | –1.1 (–2.4, 0.3) | ||||||
| Guatemala | 1979–2015 | 0.6 (–2.2, 3.4) | 1979–1988 | –5.1 (–11.0, 1.2) | 1988–1995 | 13.6* (1.4, 27.4) | 1995–2015 | –1.1 (–2.9, 0.8) |
| Guyana | 1979–2013 | –0.7 (–1.5, 0.1) | ||||||
| Jamaica | 1980–2011 | –1.1 (–2.8, 0.7) | 1980–1983 | 8.0 (–10.2, 29.9) | 1983–2011 | –2.0* (–3.1, –0.9) | ||
| Mexico | 1979–2015 | –0.9* (–1.6, –0.2) | 1979–1988 | 3.6* (0.9, 6.3) | 1988–2015 | –2.3* (–2.8, –1.8) | ||
| Nicaragua | 2010–2015 | –3.1 (–6.2, 0.0) | ||||||
| Panama | 1979–2015 | –2.2 (–4.8, 0.4) | 1979–1989 | –2.4 (–5.1, 0.3) | 1989–2001 | 0.2 (–7.4, 8.4) | 2001–2015 | –4.1* (–5.7, –2.5) |
| Paraguay | 1979–2014 | –0.7 (–2.7, 1.3) | 1979–1995 | 1.4* (0.4, 2.5) | 1995–1998 | –9.8 (–28.7, 14.1) | 1998–2014 | –1.1* (–2.0, –0.2) |
| Saint Lucia | 1979–2014 | –1.8 (–3.6, 0.0) | 1979–1987 | 4.2 (–3.6, 12.6) | 1987–2014 | –3.5* (–4.6, –2.5) | ||
| St. Vincent | 1982–2015 | 0.5 (–0.7, 1.7) | ||||||
| Suriname | 1979–2014 | –0.8 (–2.6, 1.0) | 1979–1995 | –2.3* (–4.3, –0.1) | 1995–2014 | 9.2* (3.9, 14.7) | 2004–2014 | –6.7* (–10.0, –3.4) |
| Trinidad and Tobago | 1979–2011 | –3.0* (–3.6, –2.5) | 1979–1997 | –1.7* (–2.4, –0.9) | 1997–2011 | –4.8* (–5.8, –3.8) | ||
| Uruguay | 1980–2015 | –3.3* (–3.9, –2.7) | 1980–1986 | –1.2 (–3.7, 1.4) | 1986–2005 | –3.0* (–3.5, –2.5) | 2005–2015 | –5.2* (–6.3, –4.1) |
| Venezuela | 1979–2013 | –1.9* (–2.8, –1.1) | 1979–1986 | –3.6* (–5.6, –1.5) | 1986–1992 | 1.4 (–3.2, 6.1) | 1992–2013 | –2.3* (–2.7, –1.9) |
[i] APC, annual percent change; CI, confidence interval. * P < 0.05 for change in trend.
Table 4
Jointpoint analysis for stroke mortality trends by Latin America and the Caribbean regions, 1979-2015.
| TOTAL STUDY PERIOD | PERIOD 1 | PERIOD 2 | PERIOD 3 | |||||
|---|---|---|---|---|---|---|---|---|
| YEARS | APC (95% CI) | YEARS | APC (95% CI) | YEARS | APC (95% CI) | YEARS | APC (95% CI) | |
| Caribbean | 1979–2015 | –1.4 (–3.5, 0.8) | 1979–1998 | –0.3 (–1.4, 0.8) | 1998–2002 | –9.4 (–24.9, 9.2) | 2002–2015 | –0.4 (–2.4, 1.5) |
| Central | 1979–2015 | –0.7 (–2.4, 1.0) | 1979–1981 | 22.3 (–10.8, 67.6) | 1981–2015 | –1.9* (–2.3, –1.5) | ||
| South | 1979–2015 | –2.1* (–2.9, –1.4) | 1979–1982 | 3.5 (–3.3, 10.8) | 1982–2011 | –1.9* (–2.1, –1.7) | 2011–2015 | –7.8* (–11.6, –3.7) |
| High income | 1979–2015 | –2.7* (–3.4, –2.0) | 1979– 1992 | –1.1* (–2.1, –0.1) | 1992–2001 | –5.0* (–7.1, –3.0) | 2001–2015 | –2.5* (–3.5, –1.6) |
| Middle income | 1979–2015 | –1.9* (–2.3, –1.5) | 1979–2010 | –1.1* (–1.2, –0.9) | 2010–2015 | –6.8* (–9.2, –4.2) | ||
[i] APC, annual percent change; CI, confidence interval. * P < 0.05 for change in trend.