Abstract DP239: National Trends and Burden of Stroke in Peru: A Nationwide Population-Based Study

Introduction: Stroke remains a leading cause of mortality and disability, with a growing burden in Low and middle-income countries. In Peru, where regional and healthcare disparities persist, updated nationwide data are needed to inform policies and reduce its public health impact. Objective: To analyze nationwide trends in stroke incidence in Peru from 2016 to 2024, stratified by demographic and healthcare system factors. Design/Methods: We conducted a nationwide ecological analysis. Stroke cases were identified via ICD-10 codes. Age-standardized incidence rates (ASIRs) were calculated using WHO World Standard Population weights. Temporal trends were analyzed with quasi-Poisson regression, adjusting for age and sex. Subgroup analyses were performed by sex, age group, healthcare system, and region. Results: A total of 73,751 cases were identified. The crude incidence decreased slightly from 40.7 per 100,000 in 2018 to 35.5 per 100,000 in 2024. The ASIR rose from 38.17 (95% CI: 37.79–38.47) in 2018, reaching a low of 22.66 (95% CI: 21.38–21.88) in 2022, and then slightly increasing to 35.53 (95% CI: 31.79–32.37) in 2024, with an annual percentage change (APC) of –0.31% (95% CI: –8.0 to 8.04). Males consistently exhibited higher incidence than females (male-to-female ratio 1.3:1), and rates were highest in older adults (≥60 years). Public health systems (MINSA and EsSalud) concentrated more than 80% of cases. Regional disparities were evident, with Lima, La Libertad, and Cajamarca experiencing the highest burden. Conclusions: Stroke incidence in Peru shows a rising trend, disproportionately affecting public health systems and vulnerable regions. These findings highlight the need for equitable access to acute stroke care and targeted prevention strategies at the national level