The Epidemiology of Cardiovascular Disease in Primary Care. The Zona Franca Cohort Study in Barcelona, Spain

Introduction and objectives. Knowledge about the incidence of cardiovascular disease in Spain is limited, particularly about emergent conditions such as peripheral arterial disease and heart failure. The objective of this study was to determine the incidence of these conditions in a primary care setting. Methods. A prospective population-based cohort study was carried out in two health centers in Barcelona, Spain. It included 931 randomly selected individuals, aged 35 to 84 years, without cardiovascular disease who were followed for 10 years. We assessed the incidence of ischemic heart disease (i.e. myocardial infarction and angina), cerebrovascular disease (i.e. stroke and transient ischemic attack), peripheral arterial disease of the lower extremities, and heart failure. Results. The most frequently occurring condition was ischemic heart disease (cumulative incidence, 6.1%), followed by cerebrovascular disease (4.3%), heart failure (3.0%), and peripheral arterial disease (1.9%). These conditions were more frequent in patients aged >65 years (cumulative incidence, 9.6%, 8.9%, 4.6% and 3.1%, respectively). The most frequent comorbid conditions were ischemic heart disease and cerebrovascular disease. The incidence of acute myocardial infarction was greater in men (P<.001), but there was no significant difference for other conditions. The adjusted incidence (European population) per 100,000 inhabitants per year in men and women, respectively, was: 605 and 115 for acute myocardial infarction; 238 and 220 for angina; 300 and 327 for stroke; 125 and 115 for transient ischemic attack; 136 and 178 for peripheral arterial disease; and 219 and 267 for heart failure. Conclusions. The incidence of cardiovascular disease was lower than in other developed countries. Disease occurred more frequently in patients aged >65 years. lschemic heart disease remained the most common, with heart failure being a notable emergent condition.