A comprehensive analysis of cardiovascular mortality trends in Peru from 2017 to 2022: Insights from 183,386 deaths of the national death registry

Hugo G Quezada-Pinedo; Noushin Sadat Ahanchi; Kim N Cajachagua-Torres; Jordan A Obeso-Manrique; Luis Huicho; Christoph Gräni; Taulant Muka

doi:10.1016/j.ahjo.2023.100335

A comprehensive analysis of cardiovascular mortality trends in Peru from 2017 to 2022: Insights from 183,386 deaths of the national death registry

Am Heart J Plus. 2023 Oct 20:35:100335. doi: 10.1016/j.ahjo.2023.100335. eCollection 2023 Nov.

Authors

Hugo G Quezada-Pinedo^{1

2

3}, Noushin Sadat Ahanchi^{4

5

6}, Kim N Cajachagua-Torres^{1

3

7}, Jordan A Obeso-Manrique³, Luis Huicho^{3

8}, Christoph Gräni⁴, Taulant Muka⁹

Affiliations

¹ The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
² Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland.
³ Centro de Investigación en Salud Materna e Infantil and Centro de Investigación para el Desarrollo Integral y Sostenible, Universidad Peruana Cayetano Heredia, Lima, Peru.
⁴ Institute of Social and Preventive Medicine (ISPM), Graduate School of Health Sciences, University of Bern, Bern, Switzerland.
⁵ Graduate School for Health Sciences, University of Bern, Bern, Switzerland.
⁶ Department of Internal Medicine, Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland.
⁷ Department of Pediatrics, New York University Grossman of Medicine, New York, USA.
⁸ Facultad de Medicina "Alberto Hurtado", Universidad Peruana Cayetano Heredia, Lima, Peru.
⁹ Epistudia, Bern, Switzerland.

Abstract

Background/objectives: Cardiovascular diseases are the leading cause of global mortality. Systematic studies on cardiovascular-related mortality at national and subnational levels in Peru are lacking. We aimed to describe the trends in cardiovascular-related mortality between 2017 and 2022 in Peru at national and subnational levels and by socioeconomic indicators.

Subjects/methods: We used data from the Peruvian death registry 2017-2022. Using ICD-10 codes, mortality was categorized into: hypertensive-, coronary-, and cerebrovascular- related deaths. We estimated age-standardized cardiovascular-related mortality rates by sex at national and regional levels, and by natural regions (Coast, Highlands, Amazon). We estimated the change in mortality rates between 2017-2019 and 2020-2022 and explored factors that contributed to such a change. We explored ecological relationships between mortality rates and socioeconomic indicators.

Findings: Overall 183,386 cardiovascular-related deaths were identified. Coronary-related deaths (37.2 %) were followed by hypertensive-related (25.1 %) and cerebrovascular-related deaths (22.6 %). Peru showed a marked increasing trend in cardiovascular-related mortality in 2020-2022 (77.8 %). The increase clustered in the Coast and Highlands, with the highest change observed in Lima (132.1 %). Mortality was highest in subjects with lower education and subjects with public health insurance. Gini coefficient was associated with lower mortality rates while unemployment was associated with higher mortality rates.

Interpretation: There was a notable rise in cardiovascular-related mortality in Peru, particularly during the Covid-19 pandemic with a slight decrease in 2022. Gaining a comprehensive understanding of the factors that contribute to the increase in cardiovascular deaths in Peru will facilitate the development of precise interventions at both the national and regional levels.

Keywords: Cardiac mortality; Cardiovascular health; Death registry; Low- and middle-income countries; Peru.