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Original research article
Cardiovascular risk factors and disease among non-European immigrants living in Catalonia
  1. Miguel Cainzos-Achirica1,
  2. Emili Vela2,
  3. Montse Cleries2,
  4. Usama Bilal3,
  5. Josepa Mauri4,
  6. Maria Jesus Pueyo5,
  7. Alba Rosas5,
  8. Cristina Enjuanes1,
  9. Michael J Blaha6,
  10. Alka M Kanaya7,
  11. Josep Comin-Colet1
  1. 1 Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain
  2. 2 Healthcare Information and Knowledge Unit, Catalan Health Service, Barcelona, Spain
  3. 3 Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, Pennsylvania, USA
  4. 4 Interventional Cardiology, HU Germans Trias i Pujol, Badalona, Spain
  5. 5 Health Department of the Government of Catalonia, Barcelona, Spain
  6. 6 Medicine/Cardiology, Johns Hopkins Hospital, Baltimore, Maryland, USA
  7. 7 UCSF, San Francisco, California, USA
  1. Correspondence to Dr Miguel Cainzos-Achirica, Department of Cardiology, Hospital Universitari de Bellvitge, Barcelona 08907, Spain; miguel.cainzos{at}


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.

  • global disease patterns
  • epidemiology
  • coronary artery disease
  • diabetes

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  • Contributors MC-A, EV, MC, JM and JC-C participated in the conception, design and interpretation of the data, and on the drafting of the manuscript. EV and MC also conducted the statistical analyses. UB prepared the figures, interpreted the data and participated in the the drafting of the manuscript. MJP, AR, CE and AMK participated in the interpretation of the data and revised the manuscript critically for important intellectual content.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Ethics approval This study was approved by the research ethics committee of the Bellvitge Biomedical Research Institute (IDIBELL), and complied with the Declaration of Helsinki.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Not required.