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

Moya-Salazar J.; Rivera J.; Marín E.A.; Palomino-Leyva C.B.; La Torre R.; Cañari B.; Peralta-Hilario A.; Goicochea-Palomino E.A.; Pardo-Villarroel C.; Uribe-Veloso S. · Open Heart (2026) · DOI: 10.1136/openhrt-2025-003729

Resumen

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. © Author(s) (or their employer(s)) 2026. Re- use permitted under CC BY- NC. No commercial re- use. See rights and permissions. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY- NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non- commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non- commercial. See: https://creativecommons.org/licenses/by-nc/4.0/.

Instituciones: Universidad Tecnológica del Perú; Universidad Señor de Sipán