Increase in cardiovascular deaths during the COVID-19 pandemic in Peru: a 5-year analysis of the national death system.

INTRODUCTION

Cardiovascular diseases (CVDs) are the leading cause of death globally, with increasing prevalence and mortality rates. The COVID-19 pandemic has exacerbated CVD-related morbidity and mortality, particularly in vulnerable populations. Peru, a country with significant socioeconomic disparities and one with the highest COVID-19 mortality rates worldwide, experienced a dramatic rise in CVD deaths during the pandemic.

OBJECTIVE

To evaluate the impact of the COVID-19 pandemic on CVD mortality in Peru, comparing pre-pandemic (2017-2019) and pandemic periods (2020-2021), and to describe the distribution of CVD deaths by age, sex and region.

METHODS

This observational study analysed data from Peru's National Death Information System from 2017 to 2021. CVD-related deaths were categorised by type (acute coronary syndrome, heart failure, arrhythmia, heart attack and stroke), age, sex and region. Statistical analyses included one-way analysis of variance, paired t-tests and geographical mapping using ArcGIS.

RESULTS

A total of 28 197 CVD deaths were recorded, with 8821 in the pre-pandemic period and 19 376 during the pandemic (p<0.001). Deaths due to heart attack and stroke increased 1.7 (3551 vs 6017, p=0.016) and 62.7 (109 vs 6833, p<0.001) times, respectively. The >80 age group accounted for the highest proportion of deaths (44.7-48.4%), followed by the 60-80 age group. Males exhibited higher mortality than females across all years. Heart attack was the leading cause of death, peaking in 2020 (3148 (36.8%) and 2626 (30.7%)). Stroke-related deaths surged in 2021 (32.7% males, 30.1% females). Regionally, Lima and Arequipa had the highest CVD mortality rates, with Lima reporting the highest stroke (23.9%) and arrhythmia (54.8%) deaths.

CONCLUSIONS

The COVID-19 pandemic significantly increased CVD mortality in Peru, with marked rises in heart attack and stroke-related deaths. Older adults and males were disproportionately affected. Regional disparities highlight the need for targeted interventions in high-burden areas.