OBJECTIVES: De Todo Corazón (DTC) is a risk management program with the aim of reducing complications and improving the quality of life of patients with cardiovascular risks. The aim of this study was to compare the risk of first cardiovascular event in patients under program care. METHODS: We started follow-up of a cohort of 47,894 patients with hypertension and/or diabetes mellitus without previous history of confirmed cardiovascular events between June 2014 and December 2015. First cardiovascular event were considered to be first admissions due to coronary disease, cardiac insufficiency or stroke. Incidence is reported by 100 person years follow-up. Kaplan-Meier curves were used to evaluate time a first cardiovascular events. Differences between survival curves were compared using Long-Rank test. Multivariate Cox proportional-hazards models were used to evaluate the risk for first cardiovascular event, on the basis of any potentially significant predictor. RESULTS: The average age was 62.8 + 12.2 years and 67.6% female. Mean follow-up time was 11.6 + 6.1 months. The proportion of hypertension, diabetes mellitus and hyperlipidemia was 97.1%, 41.3% and 42.6%, respectively. Incidence of first cardiovascular event was 34 events per 100 person-years. At 18 months follow-up, the incidence of first cardiovascular event was higher in patients with < 11 months follow-up compared with patients with > 11 months follow-up (1173 vs. 350 events; p <0.001; Long-Rank test). Age (HR 1.02; 95% IC 1.02-1.03), male gender (HR 1.73; 95% IC 1.55-1.94), blood pressure non-control >140 mmHg (HR 1.31; 95% IC 1.12-1.54) and high cardiovascular risk >20% Coronary heart disease (CHD) risk at 10 years (HR 1.47; 95% IC 1.30-1.65) were significantly associated with the incidence of first cardiovascular event. CONCLUSIONS:  The incidence of the first cardiovascular event was significantly higher in patients with blood pressure non-control under program care.