Trends and regional inequalities in cerebrovascular disease mortality in Peru: An ecological time-series analysis, 2017–2025

Background: Cerebrovascular disease remains a leading cause of mortality worldwide. In Peru, evidence on recent mortality trends and regional disparities is limited. Objective: To evaluate temporal trends and regional disparities in cerebrovascular disease mortality in Peru between 2017 and 2025. Methods: An ecological time-series study was conducted using national mortality data from the National Death Information System (SINADEF). Deaths with cerebrovascular disease as the underlying cause (ICD-10: I60–I69) were included. Age-standardised mortality rates (ASMRs) per 100,000 person-years were calculated using the SEGI world standard population. Temporal trends were analyzed using Joinpoint regression models to estimate annual percent change (APC) and average annual percent change (AAPC) with 95% confidence intervals (95% CI). Results: National cerebrovascular disease mortality rates remained relatively stable between 2017 and 2025 in both men and women. However, marked regional disparities were identified. The highest mortality rates were concentrated in Huancavelica, San Martín, and Apurímac. Among men, a significant increase was identified in Huanuco (APC: 7.6%; 95% CI: 2.6 to 12.9), whereas significant decreasing trends were observed in Lambayeque (APC: −8.0%; 95% CI: −14.0 to −1.6), Madre de Dios (APC: −5.9%; 95% CI: −11.3 to −0.2), Tacna (APC: −5.8%; 95% CI: −9.7 to −1.7), and Tumbes (APC: −5.9%; 95% CI: −10.7 to −0.9). Among women, Huanuco also showed a significant increase (APC: 7.0%; 95% CI: 4.0 to 10.1), while significant decreasing trends were identified in Callao (APC: −5.3%; 95% CI: −8.2 to −2.3), La Libertad (APC: −5.7%; 95% CI: −11.0 to −0.02), Moquegua (APC: −8.6%; 95% CI: −14.0 to −2.9), and Tacna (APC: −6.5%; 95% CI: −11.2 to −1.5). Conclusion: Cerebrovascular disease mortality in Peru remained relatively stable at the national level but showed important regional heterogeneity. These findings highlight geographic disparities in mortality patterns and underscore the need for further research and region-specific public health strategies to improve cerebrovascular disease prevention and care.