Twenty-year incidence rates of cardiovascular disease in Greece: A geospatial analysis in the Attica study context, 2002-2022

Aim: The aim of this study was to explore the geographical disparities in CVD incidence across the Attica region, over a 20-year period. Material and Methods: The 10-year and the 20-year CVD incidence data were provided by the ATTICA study, which was conducted during 2002-2022 in 3042 individuals living in Attica region. After excluding those lacking complete locality information and those lost in the 10-year and the 20-year follow-up, data for 1935 and 1902 individuals respectively, were used for the current analysis. CVD incidence rates at municipality level were mapped and hot spot analysis was implemented to recognize statistically significant spatial clusters in Attica region. Results: Mapping CVD incidence rates revealed a notable rise during the 20 years in most municipalities. The rise in female-specific CVD incidence appeared primarily in suburban areas, while a significant rise in male-specific CVD incidence was noticed in urban areas. Statistically significant spatial clusters of high values were indicated in the most urbanized municipalities of the study area, whereas clusters of low values were noticed in the more distant rural municipalities, which maintained lower CVD incidence rates during the monitoring period. Conclusions: A spatial heterogeneity of the sex-specific 20-year CVD incidence rate was observed in the Attica region of Greece.