Changes in Indices of Airway Hyperresponsiveness During One Year of Treatment with Inhaled Corticosteroids in Patients with Asthma

Background. Mortality from asthma increased during the last decades but is now declining in some countries. Little is known about this trend in Brazil. Objective. The objective of the study was to determine the trends in asthma mortality in Southern Brazil. Methods. We reviewed death certificates of 566 people in the state of Rio Grande do Sul, Brazil, between 5 and 39 years of age in whom asthma was reported to be the underlying cause of death during the period of 1981-2003. Population data were available in 5-year age groups. Mortality rates were submitted to linear and quadratic regression procedures. Results. Among children and teenagers (5–19 years), there were 170 asthma deaths, ranging from 4 to 13 deaths each year with rates of 0.154/100,000 to 0.481/100,000. In young adults (20–39 years), 396 asthma deaths occurred, ranging from 9 to 32 each year, with rates from 0.276/100,000 to 1.034/100,000. There was an initial increase in rates, with later stabilization, and then the start of a decline beginning in the late 1990s and the early part of this decade. This trend occurred in both age subgroups examined but was more evident in males. Conclusions. Asthma mortality in southern Brazil remains low and appears to be decreasing after reaching a peak in the mid-1990s. The reason for these trends remains unknown.