{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T11:23:20Z","timestamp":1783596200376,"version":"3.55.0"},"reference-count":27,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Vice-Rectory for Research of the Universidad Nacional Toribio Rodr\u00edguez de Mendoza de Amazonas"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Predicted cardiovascular age (heart age) translates the risk-factor profile into an equivalent age, which may facilitate interpretation of estimated cardiovascular risk. Excess cardiovascular age describes, in years, the integrated burden of modifiable risk factors and its distribution in the population. This study aimed to quantify socioeconomic and geographic inequalities in predicted excess cardiovascular age among Peruvian adults using standardized inequality measures, and to describe its temporal variation from 2014 to 2024. We analyzed ENDES Peru 2014\u20132024 data for adults aged 30\u201374 years. Cardiovascular age was estimated using the body mass index (BMI)\u2013based non-laboratory Framingham equation, and excess was defined as the difference between cardiovascular age and chronological age. Weighted means and 95% confidence intervals were estimated accounting for the complex survey design. Socioeconomic inequalities were assessed using absolute and relative gaps between extreme wealth quintiles (Q5\u2013Q1), the Slope Index of Inequality (SII), the Relative Index of Inequality (RII), and the concentration index\/curve. Among 163,889 participants, mean excess cardiovascular age was 9.64 years (95% CI: 9.48\u20139.80), with similar estimates in women (9.73; 95% CI: 9.52\u20139.94) and men (9.54; 95% CI: 9.33\u20139.75). Temporal variation was observed, peaking in 2021 (10.91; 95% CI: 10.57\u201311.25). Excess increased with wealth (Q1: 7.14 vs. Q5: 11.25 years), with an SII of 5.04 years (95% CI: 4.71\u20135.37) and a concentration index of 0.087. The gradient was steeper in men (SII 6.14) than in women (SII 3.90). Geographically, Metropolitan Lima had higher excess than the Highlands (11.17 vs. 7.45 years), and urban areas exceeded rural areas (10.28 vs. 7.25 years). In Peru, adults aged 30\u201374 years had a mean predicted excess cardiovascular age of about 10 years, with a consistent pro-rich and urban\/coastal concentration pattern, more pronounced among men. Because this metric is derived from a risk prediction equation, these findings should be interpreted as surveillance-oriented evidence of inequalities in estimated risk-factor burden, not as evidence of observed cardiovascular disease, subclinical cardiovascular damage, causal mechanisms, or tested intervention effects.<\/jats:p>","DOI":"10.3390\/jcdd13070318","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T10:16:22Z","timestamp":1783592182000},"page":"318","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predicted Excess Cardiovascular Age and a Reverse Socioeconomic Gradient in a Middle-Income Latin American Country: A Population-Based Analysis of 163,889 Peruvians"],"prefix":"10.3390","volume":"13","author":[{"given":"V\u00edctor Juan","family":"Vera-Ponce","sequence":"first","affiliation":[{"name":"Facultad de Medicina (FAMED), Universidad Nacional Toribio Rodr\u00edguez de Mendoza de Amazonas (UNTRM), Chachapoyas 01001, Amazonas, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7070-7434","authenticated-orcid":false,"given":"Jhosmer","family":"Ballena-Caicedo","sequence":"additional","affiliation":[{"name":"Facultad de Medicina (FAMED), Universidad Nacional Toribio Rodr\u00edguez de Mendoza de Amazonas (UNTRM), Chachapoyas 01001, Amazonas, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4242-0292","authenticated-orcid":false,"given":"Jhofree Einstein","family":"Brice\u00f1o-Chavez","sequence":"additional","affiliation":[{"name":"Facultad de Medicina (FAMED), Universidad Nacional Toribio Rodr\u00edguez de Mendoza de Amazonas (UNTRM), Chachapoyas 01001, Amazonas, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Cusma-Regalado","sequence":"additional","affiliation":[{"name":"Facultad de Medicina (FAMED), Universidad Nacional Toribio Rodr\u00edguez de Mendoza de Amazonas (UNTRM), Chachapoyas 01001, Amazonas, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiorella E.","family":"Zuzunaga-Montoya","sequence":"additional","affiliation":[{"name":"Facultad de Medicina (FAMED), Universidad Nacional Toribio Rodr\u00edguez de Mendoza de Amazonas (UNTRM), Chachapoyas 01001, Amazonas, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julio C\u00e9sar","family":"Bautista Zuta","sequence":"additional","affiliation":[{"name":"Facultad de Medicina (FAMED), Universidad Nacional Toribio Rodr\u00edguez de Mendoza de Amazonas (UNTRM), Chachapoyas 01001, Amazonas, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1764-7414","authenticated-orcid":false,"given":"Rossmery Leonor","family":"Poemape Mestanza","sequence":"additional","affiliation":[{"name":"Facultad de Medicina (FAMED), Universidad Nacional Toribio Rodr\u00edguez de Mendoza de Amazonas (UNTRM), Chachapoyas 01001, Amazonas, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"ref_1","unstructured":"(2025). 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