In addition to determining the incidence, mortality, and morbidity associated with acute myocardial infarction (AMI), REGICOR has established the prevalence of cardiovascular risk factors in the study area and the level of control that has been achieved.

Between 1994 and 1996, the first cross-cutting REGICOR study analyzed other aspects in addition to the classic cardiovascular risk factors. These included physical activity, diet, genetics, and various biochemical factors related to inflammation and oxidation. A random sample of 1748 residents of Girona province was drawn from census data in two stages: first, from 33 communities, and second, from the population aged 25 to 74 years, stratified by age and sex. The response rate was 72%. Between May 1999 and October 2001, a new cohort of 3056 participants from 17 communities in Girona was selected by the same recruitment process and achieved similar measures. Finally, between 2003 and 2006 another representative sample of 6500 people was drawn from Girona, Sarrià and Celrà for the HERMES study, recently completed in collaboration with primary care professionals from Girona. The HERMES response rate was 71%.

These cross-cutting studies have allowed us to analyze trends in the prevalence of cardiovascular risk factors in our population. In addition, we have been able to design various studies of the association between risk factors and cardiovascular diseases, using AMI cases from the Girona registry and population controls.

In addition to the classic cardiovascular risk factors (diabetes, hypertension, dyslipidemia and tobacco use), other biochemical biomarkers have also been studied, including lipid profile, insulin resistance, oxidation, inflammation, hemostasis, and endothelial, cardiac and hemodynamic function, among others. The study uses LUMINEX X-Map/X-Mag technology to measure multiple biomarkers at the same time.
Cohort studies are also underway, with 10-year follow-up of participants recruited in the cross-cutting studies. These should provide information about the incidence of cardiovascular diseases and allow us to verify the precision of the cardiovascular risk functions adapted for this population by REGICOR investigators in recent years. Specifically, a study of the incidence of silent AMI uses imaging techniques to examine participants who have this diagnosis based on electrocardiography but who deny ever having had any type of cardiovascular event.

In 2007, REGICOR began a collaboration with the Centre for Environmental Epidemiology Research (CREAL) to reexamine participants in the 2000 crosscutting study, in an effort to determine whether there is a relationship between intima-media thickness of the carotid artery and exposure to air pollution (REGICOR-2000-AIR).

In addition to intima-media thickness of the carotid artery, other markers of subclinical arteriosclerosis are also available, such as ankle-brachial index (ABI) and endothelial dysfunction. The latter is assessed by laser Doppler echography as post-ischemic reactive hyperemia (IRH), the increased blood flow after an ischemic event, measured at suprasystolic pressure with a sphygmomanometer.

Fa-Binefa M, Clarà A, Perez-Fernandez S, Grau M, Dégano IR, Martí-Lluch R, Ramos R, Marrugat J, Elosua R

Early smoking-onset age and risk of cardiovascular disease and mortality.

Prev Med 2019 Jul; 124 17-22, PMID: 31054906


Baena-Díez JM, Grau M, Forès R, Fernández-Bergés D, Elosua R, Sorribes M, Félix-Redondo FJ, Segura A, Rigo F, Cabrera de León A, Sanz H, Marrugat J, Sala J

Prevalence of atrial fibrillation and its associated factors in Spain: An analysis of 6 population-based studies. DARIOS Study.

Rev Clin Esp 2014 Dec; 214 (9): 505-12, PMID: 25087090


Agüero F, Dégano IR, Subirana I, Grau M, Zamora A, Sala J, Ramos R, Treserras R, Marrugat J, Elosua R

Impact of a partial smoke-free legislation on myocardial infarction incidence, mortality and case-fatality in a population-based registry: the REGICOR Study.

PLoS ONE 2013 8 (1): e53722, PMID: 23372663


Grau M, Marrugat J, Elosua R

Carotid Intima-media Thickness in the Spanish Population: Reference Ranges and Association With Cardiovascular Risk Factors. Response to Related Letters.

Rev Esp Cardiol (Engl Ed) 2013 Apr; 66 (4): 327, PMID: 23434248


Dégano IR, Elosua R, Marrugat J

Epidemiology of acute coronary syndromes in Spain: estimation of the number of cases and trends from 2005 to 2049.

Rev Esp Cardiol (Engl Ed) 2013 Jun; 66 (6): 472-81, PMID: 23664322


Dégano IR, Elosua R, Kaski JC, Fernandez-Berges DJ, Grau M, Marrugat J

Plaque stability and the southern European paradox.

Rev Esp Cardiol (Engl Ed) 2013 Jan; 66 (1): 56-62, PMID: 23078876


Félix-Redondo FJ, Grau M, Baena-Díez JM, Dégano IR, de León AC, Guembe MJ, Alzamora MT, Vega-Alonso T, Robles NR, Ortiz H, Rigo F, Mayoral-Sanchez E, Tormo MJ, Segura-Fragoso A, Fernández-Bergés D

Prevalence of obesity and associated cardiovascular risk: the DARIOS study.

BMC Public Health 2013 13 542, PMID: 23738609


Félix-Redondo FJ, Grau M, Fernández-Bergés D

Cholesterol and cardiovascular disease in the elderly. Facts and gaps.

Aging Dis 2013 Jun; 4 (3): 154-69, PMID: 23730531


Fernández-Bergés D, Cabrera de León A, Sanz H, Elosua R, Guembe MJ, Alzamora M, Vega-Alonso T, Félix-Redondo FJ, Ortiz-Marrón H, Rigo F, Lama C, Gavrila D, Segura-Fragoso A, Lozano L, Marrugat J

Metabolic syndrome in Spain: prevalence and coronary risk associated with harmonized definition and WHO proposal. DARIOS study.

Rev Esp Cardiol (Engl Ed) 2012 Mar; 65 (3): 241-8, PMID: 22305818


Muñoz MA, Subirana I, Elosua R, Covas MI, Baena-Díez JM, Ramos R, Verdú JM, Marrugat J

Utility of a short quality of life questionnaire to predict cardiovascular events.

Int. J. Cardiol. 2011 Sep; 151 (3): 392-4, PMID: 21839527


Baena-Díez JM, Félix FJ, Grau M, Cabrera de León A, Sanz H, Leal M, Elosua R, Rodríguez-Pérez Mdel C, Guembe MJ, Torán P, Vega-Alonso T, Ortiz H, Pérez-Castán JF, Frontera-Juan G, Lapetra J, Tormo MJ, Segura A, Fernández-Bergés D, Marrugat J

[Risk factor treatment and control in relation to coronary disease risk in the Spanish population of the DARIOS Study].

Rev Esp Cardiol 2011 Sep; 64 (9): 766-73, PMID: 21764497


Elosua R

[Commentary. Physical activity in adolescents: a seed of our future health].

Gac Sanit 2009 23 (6): 518, PMID: 19932370


Gómez M, Valle V, Arós F, Sanz G, Sala J, Fiol M, Bruguera J, Elosua R, Molina L, Martí H, Covas MI, Rodríguez-Llorián A, Fitó M, Suárez-Pinilla MA, Amezaga R, Marrugat J

Oxidized LDL, lipoprotein (a) and other emergent risk factors in acute myocardial infarction (FORTIAM study).

Rev Esp Cardiol 2009 Apr; 62 (4): 373-82, PMID: 19401122


Flores-Mateo G, Carrillo-Santisteve P, Elosua R, Guallar E, Marrugat J, Bleys J, Covas MI

Antioxidant enzyme activity and coronary heart disease: meta-analyses of observational studies.

Am. J. Epidemiol. 2009 Jul; 170 (2): 135-47, PMID: 19465742


Foguet Q, Martí H, Elosua R, Sala J, Masiá R, Vázquez S, Oliveras A, Bielsa O, Marrugat J

Hypertension confirmation and blood pressure control rates in epidemiological surveys.

Eur J Cardiovasc Prev Rehabil 2008 Jun; 15 (3): 263-9, PMID: 18525380


O'Donnell CJ, Elosua R

[Cardiovascular risk factors. Insights from Framingham Heart Study].

Rev Esp Cardiol 2008 Mar; 61 (3): 299-310, PMID: 18361904


Gabriel R, Alonso M, Segura A, Tormo MJ, Artigao LM, Banegas JR, Brotons C, Elosua R, Fernández-Cruz A, Muñiz J, Reviriego B, Rigo F

Prevalence, geographic distribution and geographic variability of major cardiovascular risk factors in Spain. Pooled analysis of data from population-based epidemiological studies: the ERICE Study.

Rev Esp Cardiol 2008 Oct; 61 (10): 1030-40, PMID: 18817679


Merino J, Planas A, de Moner A, Gasol A, Contreras C, Marrugat J, Vidal-Barraquer F, Clarà A

The association of peripheral arterial occlusive disease with major coronary events in a mediterranean population with low coronary heart disease incidence.

Eur J Vasc Endovasc Surg 2008 Jul; 36 (1): 71-6, PMID: 18396072


Grau M, Subirana I, Elosua R, Solanas P, Ramos R, Masiá R, Cordón F, Sala J, Juvinyà D, Cerezo C, Fitó M, Vila J, Covas MI, Marrugat J

Trends in cardiovascular risk factor prevalence (1995-2000-2005) in northeastern Spain.

Eur J Cardiovasc Prev Rehabil 2007 Oct; 14 (5): 653-9, PMID: 17925624


Grau M, Guxens M, Subirana I, Fitó M, Covas MI, Jacquemin B, Sunyer J, Lanki T, Picciotto S, Bellander T, Katsouyanni K, Schneider A, Peters A, Marrugat J

South-to-North gradient in lipid peroxidation in men with stable coronary artery disease in Europe.

Eur. Heart J. 2007 Dec; 28 (23): 2841-9, PMID: 17947215


Arquer A, Elosua R, Covas MI, Molina L, Marrugat J

Amount and intensity of physical activity, fitness, and serum lipids in pre-menopausal women.

Int J Sports Med 2006 Nov; 27 (11): 911-8, PMID: 16761222


Garcia M, Rohlfs I, Vila J, Sala J, Pena A, Masiá R, Marrugat J

Comparison between telephone and self-administration of Short Form Health Survey Questionnaire (SF-36).

Gac Sanit 2005 19 (6): 433-9, PMID: 16483520


Ramos R, Marrugat J, Basagaña X, Sala J, Masiá R, Elosua R

The role of age in cardiovascular risk factor clustering in non-diabetic population free of coronary heart disease.

Eur. J. Epidemiol. 2004 19 (4): 299-304, PMID: 15180099


Masiá R, Sala J, Rohlfs I, Piulats R, Manresa JM, Marrugat J

[Prevalence of diabetes mellitus in the province of Girona, Spain: the REGICOR study].

Rev Esp Cardiol 2004 Mar; 57 (3): 261-4, PMID: 15056431


Senti; M, Tomás M, Anglada R, Elosua R, Marrugat J, Covas MI, Fitó M

Interrelationship of smoking, paraoxonase activity, and leisure time physical activity: a population-based study.

Eur. J. Intern. Med. 2003 May; 14 (3): 178-184, PMID: 12798217


Elosua R, Molina L, Fitó M, Arquer A, Sanchez-Quesada JL, Covas MI, Ordoñez-Llanos J, Marrugat J

Response of oxidative stress biomarkers to a 16-week aerobic physical activity program, and to acute physical activity, in healthy young men and women.

Atherosclerosis 2003 Apr; 167 (2): 327-34, PMID: 12818416


Weinbrenner T, Cladellas M, Isabel Covas M, Fitó M, Tomás M, Sentí M, Bruguera J, Marrugat J

High oxidative stress in patients with stable coronary heart disease.

Atherosclerosis 2003 May; 168 (1): 99-106, PMID: 12732392


Covas MI, Elosua R, Fitó M, Alcántara M, Coca L, Marrugat J

Relationship between physical activity and oxidative stress biomarkers in women.

Med Sci Sports Exerc 2002 May; 34 (5): 814-9, PMID: 11984300


Pueyo G, Elosua R, Marrugat J

[Meta-analysis of the scientific evidence on the usefulness of sporadic intake of acetylsalicylic acid in the prevention of coronary heart disease].

Med Clin (Barc) 2002 Feb; 118 (5): 166-9, PMID: 11851991


Planas A, Clarà A, Pou JM, Vidal-Barraquer F, Gasol A, de Moner A, Contreras C, Marrugat J

Relationship of obesity distribution and peripheral arterial occlusive disease in elderly men.

Int. J. Obes. Relat. Metab. Disord. 2001 Jul; 25 (7): 1068-70, PMID: 11443508


Maron BJ, Araújo CG, Thompson PD, Fletcher GF, de Luna AB, Fleg JL, Pelliccia A, Balady GJ, Furlanello F, Van Camp SP, Elosua R, Chaitman BR, Bazzarre TL

Recommendations for preparticipation screening and the assessment of cardiovascular disease in masters athletes: an advisory for healthcare professionals from the working groups of the World Heart Federation, the International Federation of Sports Medicine, and the American Heart Association Committee on Exercise, Cardiac Rehabilitation, and Prevention.

Circulation 2001 Jan; 103 (2): 327-34, PMID: 11208698


Elosua R, Garcia M, Aguilar A, Molina L, Covas MI, Marrugat J

Validation of the Minnesota Leisure Time Physical Activity Questionnaire In Spanish Women. Investigators of the MARATDON Group.

Med Sci Sports Exerc 2000 Aug; 32 (8): 1431-7, PMID: 10949009


Marrugat J, Molina L, Elosua R, Pons S

Relation of maximum blood pressure during exercise and regular physical activity in normotensive men with left ventricular mass and hypertrophy

Am J Cardiol 1999 84 (890): 893, PMID: 10532505


Covas MI, Coca L, Ricós C, Marrugat J

Biological variation of superoxide dismutase in erythrocytes and glutathione peroxidase in whole blood.

Clin. Chem. 1997 Oct; 43 (10): 1991-3, PMID: 9342027


Marrugat J, Elosua R, Covas MI, Molina L, Rubiés-Prat J

Amount and intensity of physical activity, physical fitness, and serum lipids in men. The MARATHOM Investigators.

Am. J. Epidemiol. 1996 Mar; 143 (6): 562-9, PMID: 8610673


Elosua R, Marrugat J, Molina L, Pons S, Pujol E

Validation of the Minnesota Leisure Time Physical Activity Questionnaire in Spanish men. The MARATHOM Investigators.

Am. J. Epidemiol. 1994 Jun; 139 (12): 1197-209, PMID: 8209878