Table 5-2. – Metrics related to valvular heart diseases (infective endocarditis, rheumatic and non-rheumatic valvular diseases).

Location	DALYs per 100 000				Deaths per 100 000
	Estimate	95% CI Lower	95% CI Upper	Estimate	95% CI Lower	95% CI Upper
Infective endocarditis
Acre	47.58	44.62	52.12	1.44	1.35	1.57
Alagoas	39.68	35.65	43.64	1.20	1.07	1.32
Amapá	40.17	35.89	45.96	1.25	1.12	1.43
Amazonas	27.73	25.52	29.70	0.87	0.78	0.94
Bahia	36.24	31.65	40.22	1.03	0.89	1.15
Brazil *	34.42	32.74	36.17	1.11	1.03	1.18
Ceará	29.70	26.16	33.78	0.93	0.80	1.07
Distrito Federal	27.51	24.92	30.41	1.05	0.94	1.15
Espírito Santo	35.11	31.16	38.36	1.10	0.97	1.20
Goiás	36.46	32.77	40.25	1.21	1.10	1.34
Maranhão	27.52	23.78	30.90	0.82	0.72	0.93
Mato Grosso	34.07	30.33	37.53	1.07	0.95	1.16
Mato Grosso do Sul	38.25	34.19	41.61	1.23	1.11	1.34
Minas Gerais	40.02	36.43	43.26	1.30	1.16	1.41
Pará	32.72	28.59	37.08	0.99	0.84	1.12
Paraíba	29.60	26.64	32.13	0.93	0.84	1.01
Paraná	29.20	26.74	31.85	0.97	0.89	1.06
Pernambuco	27.78	24.90	30.46	0.88	0.78	0.98
Piaui	30.78	26.89	34.85	0.93	0.81	1.05
Rio de Janeiro	39.18	35.82	43.74	1.24	1.12	1.39
Rio Grande do Norte	30.24	26.88	33.56	0.91	0.81	1.01
Rio Grande do Sul	31.25	28.39	34.37	1.06	0.96	1.17
Rondônia	31.64	28.11	36.34	0.99	0.88	1.14
Roraima	30.30	25.93	35.05	0.98	0.84	1.14
Santa Catarina	33.69	30.04	36.88	1.16	1.03	1.28
São Paulo	34.97	31.42	38.19	1.20	1.07	1.33
Sergipe	34.86	31.84	38.21	1.09	0.99	1.19
Tocantins	32.47	28.27	37.01	1.02	0.89	1.16
Non-rheumatic calcific aortic valve disease
Acre	25.58	23.44	28.45	1.28	1.14	1.40
Alagoas	27.35	24.63	30.74	1.31	1.16	1.48
Amapá	33.36	29.12	38.11	1.66	1.46	1.86
Amazonas	31.56	28.41	34.89	1.51	1.34	1.65
Bahia	27.59	24.20	30.69	1.26	1.10	1.40
Brazil *	31.78	29.43	34.01	1.63	1.44	1.73
Ceará	24.40	20.83	27.98	1.20	1.01	1.38
Distrito Federal	31.07	27.90	34.17	1.91	1.69	2.08
Espírito Santo	32.92	28.97	36.35	1.70	1.50	1.87
Goiás	33.39	30.52	36.86	1.64	1.44	1.80
Maranhão	24.89	21.43	28.84	1.20	1.06	1.37
Mato Grosso	29.35	26.49	32.44	1.43	1.26	1.57
Mato Grosso do Sul	32.11	29.01	35.47	1.60	1.42	1.79
Minas Gerais	30.41	27.23	33.45	1.51	1.31	1.66
Pará	27.56	24.18	32.02	1.32	1.09	1.54
Paraíba	20.74	18.71	22.92	0.99	0.88	1.10
Paraná	37.98	34.80	41.87	1.97	1.76	2.19
Pernambuco	29.92	27.05	33.17	1.50	1.30	1.68
Piaui	20.76	18.08	23.72	0.98	0.87	1.12
Rio de Janeiro	28.92	25.88	32.36	1.48	1.26	1.65
Rio Grande do Norte	25.42	22.54	28.36	1.24	1.07	1.36
Rio Grande do Sul	39.05	35.00	42.63	2.15	1.92	2.37
Rondônia	28.14	24.75	31.95	1.38	1.20	1.57
Roraima	31.14	26.92	36.69	1.64	1.39	1.88
Santa Catarina	43.17	38.26	47.68	2.42	2.09	2.65
São Paulo	35.93	32.37	40.13	1.94	1.69	2.18
Sergipe	19.87	17.77	21.78	0.96	0.85	1.05
Tocantins	28.34	24.92	32.19	1.40	1.22	1.60
Non-rheumatic degenerative mitral valve disease
Acre	14.41	13.37	15.79	0.57	0.52	0.63
Alagoas	18.97	17.01	21.30	0.72	0.64	0.83
Amapá	18.71	16.30	20.87	0.75	0.65	0.83
Amazonas	13.18	11.76	14.67	0.52	0.46	0.58
Bahia	16.09	14.11	18.14	0.58	0.51	0.65
Brazil *	17.25	16.28	18.18	0.70	0.64	0.74
Ceará	16.71	14.17	19.17	0.67	0.57	0.77
Distrito Federal	15.56	14.05	17.24	0.75	0.68	0.84
Espírito Santo	21.74	19.27	24.21	0.89	0.78	1.00
Goiás	17.83	16.02	19.86	0.72	0.64	0.80
Maranhão	13.13	11.26	15.07	0.50	0.43	0.57
Mato Grosso	16.71	15.08	18.41	0.66	0.58	0.72
Mato Grosso do Sul	18.98	17.04	20.77	0.75	0.67	0.83
Minas Gerais	15.04	13.60	16.39	0.60	0.52	0.66
Pará	17.90	15.33	20.93	0.70	0.59	0.82
Paraíba	12.22	10.95	13.53	0.47	0.41	0.52
Paraná	19.80	17.75	21.84	0.83	0.74	0.92
Pernambuco	21.79	19.54	23.85	0.87	0.77	0.96
Piaui	14.16	12.40	16.08	0.54	0.47	0.61
Rio de Janeiro	15.24	13.65	17.04	0.60	0.53	0.67
Rio Grande do Norte	13.30	11.81	14.69	0.51	0.45	0.57
Rio Grande do Sul	17.66	16.09	19.36	0.76	0.66	0.83
Rondônia	14.39	12.58	16.53	0.58	0.50	0.66
Roraima	11.52	9.72	13.71	0.46	0.38	0.55
Santa Catarina	18.37	16.35	20.34	0.80	0.71	0.89
São Paulo	18.97	16.94	21.13	0.81	0.72	0.91
Sergipe	13.67	12.25	15.05	0.54	0.49	0.60
Tocantins	21.95	19.47	24.99	0.90	0.79	1.02
Other non-rheumatic valve diseases
Acre	1.07	0.88	1.27	0.04	0.04	0.05
Alagoas	0.60	0.47	0.72	0.02	0.02	0.03
Amapá	0.99	0.80	1.22	0.04	0.03	0.05
Amazonas	0.70	0.57	0.85	0.03	0.02	0.03
Bahia	0.67	0.58	0.81	0.02	0.02	0.03
Brazil *	0.79	0.71	0.88	0.03	0.03	0.03
Ceará	1.19	0.98	1.45	0.05	0.04	0.06
Distrito Federal	0.71	0.59	0.86	0.03	0.03	0.04
Espírito Santo	0.98	0.80	1.16	0.04	0.03	0.05
Goiás	0.87	0.74	1.06	0.03	0.03	0.04
Maranhão	1.14	0.96	1.35	0.04	0.04	0.05
Mato Grosso	0.66	0.55	0.84	0.03	0.02	0.03
Mato Grosso do Sul	0.32	0.26	0.38	0.01	0.01	0.02
Minas Gerais	0.69	0.57	0.85	0.03	0.02	0.03
Pará	1.81	1.45	2.18	0.07	0.05	0.09
Paraíba	0.90	0.76	1.05	0.03	0.03	0.04
Paraná	1.06	0.87	1.29	0.04	0.04	0.05
Pernambuco	0.84	0.69	1.01	0.03	0.03	0.04
Piaui	0.77	0.62	0.96	0.03	0.02	0.04
Rio de Janeiro	0.44	0.37	0.53	0.02	0.01	0.02
Rio Grande do Norte	1.14	0.95	1.35	0.04	0.04	0.05
Rio Grande do Sul	0.90	0.77	1.08	0.04	0.03	0.04
Rondônia	0.92	0.75	1.09	0.04	0.03	0.04
Roraima	1.89	1.55	2.25	0.07	0.06	0.09
Santa Catarina	0.50	0.40	0.59	0.02	0.02	0.03
São Paulo	0.60	0.51	0.76	0.02	0.02	0.03
Sergipe	0.65	0.55	0.77	0.03	0.02	0.03
Tocantins	1.56	1.32	1.81	0.06	0.05	0.07
Rheumatic heart disease
Acre	93.71	72.25	120.60	1.13	1.02	1.25
Alagoas	98.41	75.74	123.81	1.18	0.99	1.37
Amapá	83.57	61.54	110.32	0.81	0.71	0.92
Amazonas	79.17	57.75	106.01	0.71	0.54	0.80
Bahia	102.46	77.61	134.08	1.22	1.06	1.41
Brazil*	93.66	70.92	122.70	1.11	0.97	1.20
Ceará	85.65	62.72	115.53	0.82	0.71	0.95
Distrito Federal	97.24	74.63	129.24	1.50	1.22	1.71
Espírito Santo	96.43	74.58	125.54	1.23	1.01	1.42
Goiás	102.86	80.71	133.75	1.45	1.19	1.65
Maranhão	92.06	69.06	120.67	1.02	0.85	1.16
Mato Grosso	87.12	64.35	116.87	0.95	0.75	1.09
Mato Grosso do Sul	89.44	66.95	120.27	0.95	0.80	1.08
Minas Gerais	98.87	74.13	128.93	1.33	1.16	1.46
Pará	86.80	63.37	115.89	0.89	0.77	1.03
Paraíba	92.53	69.89	119.40	1.02	0.86	1.16
Paraná	99.95	76.58	127.95	1.36	1.21	1.56
Pernambuco	103.62	80.45	131.52	1.32	1.08	1.54
Piaui	84.69	60.53	112.98	0.76	0.65	0.86
Rio de Janeiro	91.72	68.77	121.04	1.03	0.83	1.20
Rio Grande do Norte	94.03	71.73	123.51	1.06	0.90	1.19
Rio Grande do Sul	84.38	61.76	112.28	0.83	0.73	0.92
Rondônia	88.51	66.25	117.17	1.00	0.86	1.15
Roraima	85.87	65.88	110.36	0.94	0.80	1.11
Santa Catarina	91.62	69.41	123.48	1.10	0.95	1.24
São Paulo	90.94	67.73	122.63	1.07	0.89	1.22
Sergipe	98.83	74.55	135.42	1.19	0.98	1.34
Tocantins	93.75	71.02	123.10	1.15	0.99	1.32

* Estimates for Brazil. Source: Data derived from Global Burden of Disease Collaborative Network. Global Burden of Disease (GBD) Cardiovascular Burden Estimates 1990 and 2021, Institute for Health Metrics and Evaluation, University of Washington. ⁴⁸