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 (p80 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.