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Despite the apparently benign situation of acute myocardial infarction (AMI) incidence and mortality in our region, the prevalence of classical cardiovascular risk factors (CRF) is very high, in some instances higher than that of countries with incidence rates that are two and three times higher than ours. This surprising situation has led to discussion of the paradox of southern Europe.

In this context, there is a fundamental need for epidemiological information about atherosclerotic disease, the associated CRF and the evolving trends, to optimize and justify with objective data the clinical decisions that must be made in primary care, the recommended strategies for cardiovascular disease prevention, and the management and administration of healthcare resources.

REGICOR (Registre Gironí del Cor) is a clinical epidemiology project, both hospital and population based, with the primary objective of studying the magnitude of ischemic heart disease (IHD) in Girona and the associated CRF at population scale. The study area includes all of the counties in the Girona Healthcare Region except Ripollès.

Since 1994, five-year cross-sectional studies of CRF (1995, 2000 and 2005) have been conducted with a population base. All of the studies are carried out using a standard methodology to identify CRF prevalence, distribution, and evolution. CRF improved between 1995 and 2005 in the area of cholesterol (even in the untreated population) and blood pressure. In addition to specific institutional preventive campaigns, we must also assume that the population has experienced a growing interest in their health in the case of cholesterol, and that primary care has improved the detection and effective treatment of hypertension.

Unfortunately, tobacco consumption has increased substantially among young women in recent decades. The most important impact of this change in women’s habits, together with the sustained increase in body mass index observed in men over the past 10 years, will take some time to translate into higher rates of AMI incidence and mortality.

The Mediterranean diet, which has been shown to be the best choice for cardiovascular prevention, is associated with ideal weight and better lifestyle and CRF profiles. Surely there is room within public health policy for the protection and promotion of the ingredients in this food consumption pattern, so rooted in our customs.

On the other hand, it is necessary to promote physical activity among younger people so that they acquire the habit early, and help the working age population to find ways of engaging in regular physical activity.

In future cross-sectional studies we will do special emphasis on the effects of anti-smoking laws and in the immigration phenomena to determine the risk dimensions and the magnitude of the problem of IHD in this subpopulation, which is still quite youthful.