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Cardiovascular diseases (CVD) continue to be the main cause of death in Brazil, a middle-income country. As such, it is essential to understand the trends of risk factors (RFs) for CVDs in order to implement effective and tailored public policies. Purpose The present study sought to analyze the trend of RF for CVD and the disease burden attributable to these from 1990 to 2019, in Brazil and its states, based on estimates from the Global Burden of Disease Study 2019 (2019 GBD). Methods To estimate RF exposure, the Summary Exposure Value (SEV) (risk-weighted prevalence) was used, whereas for disease burden attributed to RFs, mortality and Disability-adjusted life-years (DALY) by CVD were used. For comparisons over time and between states, the age-standardized rates were considered. The sociodemographic index (SDI) was used as a marker of socioeconomic conditions. Results In 2019, 82% of CVD mortality in Brazil was attributable to RFs. For SEV, there was a reduction in smoking and environmental RFs, as well as an increase in metabolic RFs. High systolic blood pressure and dietary risks continue to be the main RFs for CVD mortality and DALY (Figure 1). While there was a decline in age-standardized mortality rates attributable to the evaluated RFs, there was also a stability or increase in crude mortality rates, with the exception of smoking. It is important to highlight the increase in the risk of death attributable to a high body mass index (BMI) (35 to 46/100,000 in habitants in 1990 and 2019). Regarding the analysis per state, SEVs and mortality attributable to RF were higher in those states with lower SDIs. Conclusion Despite the reduction in CVD mortality and DALY rates attributable to RF, the stability or increase in crude rates attributable to metabolic RFs is worrisome, requiring investments and a renewal of health policies. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Health Surveillance Secretariat, Brazilian Ministry of Health Figure 1

Burden of cardiovascular diseases attributable to risk factors in Brazil: data from the Global Burden of Disease 2019 study