OBJECTIVES: Cardiovascular disease remains the leading cause of death in Portugal and across the world. Atherosclerosis is the most common pathophysiologic process underlying CVD. Its clinical manifestations include coronary artery disease (CAD), cerebrovascular disease (CVD) and peripheral artery disease (PAD). This study aims to determine the clinical and demographic characteristics of adult patients with atherosclerosis in a Portuguese primary care comprehensive administrative database.

METHODS: Population-based study with real data from a large health region in Portugal with a population of 3.6 million. The data covers patients attending primary care services in 2016 and eligible patients included adults with at least one GP visit in 2016. Patients were selected for inclusion by fulfilling at least one of the following criteria: diagnosis for clinical manifestations (CAD, CVD or PAD), dispensing of antiplatelet drugs or peripheral vasodilators or the presence of at least three cardiovascular risk factors. These criteria were used as a proxy for atherosclerosis (either clinical or subclinical), since some patients might be either not diagnosed or the condition not registered. We analyzed patients’ characteristics, comorbidities and resource use in 2016.

RESULTS: We identified 318,692 patients that that fulfilled at least one of the criteria for atherosclerosis. About half of these (155,312) had at least three cardiovascular risk factors without mention of clinical manifestations. Among those with clinical manifestations (93,847), CAD was the most common (52%). Patients with atherosclerosis are mostly women (51%) and on average 72±11 years old. Common comorbidities were hypertension (75%), dyslipidemia (54%) and diabetes (41%). During the year 73% had at least one cardiovascular medical test or diagnostic procedure done; almost all patients had at least one cardiovascular medication dispensed. The average number of GP visits were 4 per patient.

CONCLUSIONS: Atherosclerosis, either clinical or subclinical, is common in primary care users in Portugal. CAD is the most frequent clinical manifestation.