Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide, accounting for an estimated 20.5 million deaths in 2025,1 with a disproportionate burden borne by low- and middle-income countries (LMICs).1,2 In Latin America, the ongoing epidemiologic transition and demographic aging have shifted the disease landscape toward a predominance of non-communicable diseases, particularly CVD, which increasingly affects younger populations and those from socioeconomically disadvantaged backgrounds.3

Absolute cardiovascular risk estimation is a cornerstone of global CVD prevention strategies, enabling the identification of individuals at highest risk and guiding population-level health policies.4 The World Health Organization (WHO) and other international bodies advocate for the use of total risk assessment tools to inform the allocation of preventive interventions such as lifestyle modification and pharmacotherapy.5 However, despite the increasing availability of risk prediction algorithms adapted to LMIC settings, few countries in Latin America have systematically monitored national trends in cardiovascular risk over time.6,7

Peru, a LMIC country with marked geographic and socioeconomic heterogeneity, has experienced substantial shifts in demographic, nutritional, and health profiles over the past two decades.8,9 While hypertension and obesity rates have risen in urban populations, rural regions continue to face limited access to preventive services.10 In this context, understanding temporal and regional patterns of cardiovascular risk is essential for developing effective and equitable public health interventions.

Although some countries have evaluated the trend in cardiovascular risk at the population level or in specific subgroups, to date, no study has comprehensively evaluated national trends in estimated cardiovascular risk in Peru.11,12 Using ten years of nationally representative data, we aimed to quantify changes in both absolute cardiovascular risk and the proportion of individuals at high or very high cardiovascular risk between 2015 and 2024. Additionally, we examined trends across key sociodemographic subgroups, including sex, age, area of residence, and region of origin, to identify disparities and inform targeted strategies for CVD prevention in Peru.