OBJECTIVES: Heart Fatilure (HF) has become a public health problem reaching epidemic levels especially for the elderly population. The objetive of this study was the description of patients with HF been treated (followed) in a primary care (PC) area in Madrid by the use of data extracted from electronic medical records. METHODS: A retrospective study was carried out to follow a cohort of 224,320 patients (18yo or older visiting PC at least once in 2006) from 01/01/2006 to 12/31/2010. Study outcomes: HF prevalent and incident cases, mortality of HF, time diagnosis to dead, GP, Nurse, cardiologist visit, hospitalizations and treatment (grouped by ATC-code).  RESULTS: HF prevalence during the period of study was 2.09% (4,680 patients), 63% women. Of these prevalent patients,  1,356 were diagnosed before 2006.  The mean age of diagnose was 77.28 years (SD 11.52), 74.96 years for males (SD 11.53) and 78.65 (SD 11.29) for females. Incident cases during the study period was 3,324 (631 in 2006, 652 in 2007, 677 in 2008, 703 in 2009 and 661 in 2010). 1,106 had at least one admisión to hospital. Average number of admisions 1.618 (SD 1.086). And 1028 patients died (22.61%). Average time from diagnosis to dead was 1,162 days (SD 1,064). The average yearly rate of visits per patient was 14.17 (SD 8.03) for GPs and 10.22 (SD 9.03) for Nurses, for consultant cardiologist was 0.10 (SD 0.16). The patients treatment mainly include Diuretics (72.93% of patients), Antithrombotic agents (70.96%), Agents acting on the renin-angiotensin system (69.89%), Calcium channel blockers (49.12%), Drugs used in diabetes (44.89%), Lipid modifying agents (44.17%), Cardiac therapy (38.29%) and Beta Blocking agents (37.63%). CONCLUSIONS: Despite the improvement of pharmacological treatments and the better control of the cardiovascular risk factors. HF continues to be responsible for high mortality and a high resource consumption.