OBJECTIVES: Cardiovascular disease remains the leading cause of death in Portugal and across the world. Atherosclerosis is the most common pathophysiologic process underlying CVD. The objective of this study was to estimate the burden of disease attributable to atherosclerosis in Portugal for 2016.

METHODS: The burden of disease was measured in Disability-Adjusted Life Years (DALY) estimated as the sum of Years of Life Lost (YLL) due to premature mortality and Years Lost due to Disability (YLD). YLL were calculated from the number of atherosclerosis deaths in 2016 (data source: Portuguese Directorate-General of Health) multiplied by a standard life expectancy at the age of death. Atherosclerosis deaths included ischaemic heart disease, ischaemic cerebrovascular disease (ICD), peripheral artery disease (PAD) and atherosclerosis/arterial embolism and thrombosis of other territories as a cause of death. YLD were computed as the number of cases of acute myocardial infarction, stable angina, ischaemic heart failure (HF), ICD and PAD multiplied by the disability weight for each clinical manifestation presented by the Global Burden of Disease Study 2017. Prevalence of the different clinical presentations were estimated using the microdada of the 2014 National Health Survey, the microdata of a national community-based epidemiological survey on HF prevalence, the national diagnostic-related-group database and a national PAD prevalence study. A national primary care database covering 318,692 patients with AS in 2016 was used to estimate the overlap of different clinical presentations.

RESULTS: In 2016, the 15,123 deaths attributed to atherosclerosis resulted in the loss of approximately 196,438 YLL. The YLD caused by morbidity were estimated at 64,505. Overall, DALY totaled 260,943, with 75% due to YLL underlining the mortality impact of this disease.

CONCLUSIONS: Atherosclerosis is an important cause of disease burden in Portugal and should be an important target for health policy interventions.