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 stroke event in patients under program care. METHODS:  We started follow-up of a cohort of 47.877 patients with hypertension and/or diabetes mellitus without previous history of confirmed cardiovascular events between June 2014 and December 2015. First event were considered to be first admissions due to stroke. Incidence is reported by 100 person years follow-up. Kaplan-Meier curves were used to evaluate time a first stroke events. Differences between survival curves were compared using Long-Rank test. Multivariate Cox proportional-hazards models were used to evaluate the risk for first stroke 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 1.1 + 0.4 years. The proportion of hypertension, diabetes mellitus and hyperlipidemia was 97.1%, 41.3% and 89.1%, respectively. Incidence of first stroke event was 1.35 events per 100 person-years. At 18 months follow-up, the incidence of first stroke event was higher in women patients compared with male patients (301 vs. 250 events; p <0.001; Long-Rank test). Age (HR 1.04; 95% IC 1.03-1.05), male (HR 1.6; 95% IC 1.3-1.9), blood pressure non-control >140/90 mmHg (HR 1.5; 95% IC 1.2-1.9), dyslipidemia (HR 1.90 95% IC 1.2-2.8) and high cardiovascular risk >20% 20% Coronary heart disease (CHD) risk at 10 years (HR 1.3, 95% IC 1.1-1.5) were significantly associated with the incidence of first stroke event. CONCLUSIONS: The incidence of the first stroke event was significantly higher in patients with blood pressure control >140/90 mmHg under program care.