Cardiovascular risk factors and disease among non-European immigrants living in Catalonia

Heart. 2019 Aug;105(15):1168-1174. doi: 10.1136/heartjnl-2018-314436. Epub 2019 Feb 28.


Objective: To describe the prevalence and incidence of cardiovascular risk factors, established cardiovascular disease (CVD) and cardiovascular medication use, among immigrant individuals of diverse national origins living in Catalonia (Spain), a region receiving large groups of immigrants from all around the world, and with universal access to healthcare.

Methods: We conducted a population-based analysis including >6 million adult individuals living in Catalonia, using the local administrative healthcare databases. Immigrants were classified in 6 World Bank geographic areas: Latin America/Caribbean, North Africa/Middle East, sub-Saharan Africa, East Asia and South Asia. Prevalence calculations were set as of 31 December 2017.

Results: Immigrant groups were younger than the local population; despite this, the prevalence of CVD risk factors and of established CVD was very high in some immigrant subgroups compared with local individuals. South Asians had the highest prevalence of diabetes, and of hyperlipidemia among adults aged <55 years; hypertension was highly prevalent among sub-Saharan Africans, and obesity was most common among women of African and South Asian ancestry. In this context, South Asians had the highest prevalence of coronary heart disease across all groups, and of heart failure among women. Heart failure was also highly prevalent in African women.

Conclusions: The high prevalence of risk factors and established CVD among South Asians and sub-Saharan Africans stresses the need for tailored, aggressive health promotion interventions. These are likely to be beneficial in Catalonia, and in countries receiving similar migratory fluxes, as well as in their countries of origin.

Keywords: coronary artery disease; diabetes; epidemiology; global disease patterns.

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Cardiovascular Diseases / epidemiology*
  • Continental Population Groups / statistics & numerical data*
  • Cross-Sectional Studies
  • Emigrants and Immigrants / statistics & numerical data*
  • Ethnic Groups / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Risk Factors
  • Sex Distribution
  • Spain / epidemiology
  • Young Adult