Time trends in the incidence of cardiovascular disease, hypertension and diabetes by sex and socioeconomic status in Catalonia, Spain: a population-based cohort study

Abstract

Objective We aimed to estimate how longitudinal trends in cardiovascular disease, hypertension and type 2 diabetes mellitus incidence in Catalonia, Spain from 2009 to 2018 may differ by age, sex and socioeconomic deprivation.Design Cohort study using prospectively collected data.Setting Electronic health records from primary healthcare centres in Catalonia, Spain.Participants 3 247 244 adults (≥40 years).Outcome measures We calculated the annual incidence (per 1000 persons-year) and incidence rate ratios (IRR) between three time periods of cardiovascular disease, hypertension and type 2 diabetes mellitus to measure trends and changes in incidence during the study period.Results In 2016–2018 compared with 2009–2012, cardiovascular disease incidence increased in the 40–54 (eg, IRR=1.61, 95% CI: 1.52 to 1.69 in women) and 55–69 age groups. There was no change in cardiovascular disease incidence in women aged 70+ years, and a slight decrease in men aged 70+ years (0.93, 0.90 to 0.95). Hypertension incidence decreased in all age groups for both sexes. Type 2 diabetes mellitus incidence decreased in all age groups for both sexes (eg, 0.72, 0.70 to 0.73 in women aged 55–69 years), except for the 40–54 year age group (eg, 1.09, 1.06 to 1.13 in women). Higher incidence levels were found in the most deprived areas, especially in the 40–54 and 55–69 groups.Conclusions Overall cardiovascular disease incidence has increased while hypertension and type 2 diabetes mellitus incidence have decreased in the last years in Catalonia, Spain, with differences in trends by age group and socioeconomic deprivation.