Background The demographic-epidemiological transition and the increasing of cardiovascular risk factors warrant epidemiological studies to identify coronary heart disease (CHD) prevalence and correlates in the Brazilian population.

Objectives To identify the prevalence of CHD and correlates in adults from Ribeirão Preto, São Paulo, Brazil.

Methods Cross-sectional population-based epidemiological study using three-stage cluster sampling. The variability introduced in the third sampling fraction was corrected by attributing equal weights to the number of eligible units in each domicile, resulting in a weighted sample of 1532 participants aged 30 years or older. The design effect was 1.33. Rose Questionnaire and ECG tracings classified by Novacode criteria (Q waves and ST-T abnormalities) were used to estimate CHD prevalences (95% CI). To investigate correlates, crude and adjusted prevalence ratios (PR) according to Novacode were estimated by points and 95% CIs, using Poisson regression.

Results The age-adjusted prevalence was 12.52% (10.11% to 15.39%) or 26.32% (22.87% to 30.10%) using Rose Questionnaire or Novacode, respectively. The Rose sensitivity and specificity compared to Novacode were, respectively, 16.08% and 88.76%, and the area under the curve AUC=0.52 (0.49 to 0.55). Age-gender-adjusted prevalence ratios in the final model were represented by “age” PR=1.02 (1.01 to 1.03); “hypertension” PR=1.65 (1.23 to 2.19); “waist/height ratio” PR=1.54 (1.05 to 2.25-2° tertile) and 2.02 (1.15 to 3.56-3° tertile); “hospitalisation” PR=1.36 (1.04 to 1.78) and “moderate physical activity” PR=0.57 (0.34 to 0.94), compared to the reference category. Trend test for PR across waist/height ratio tertiles were statistically significant (p<0.05).

Conclusion The results show high CHD prevalence in the study population as well as identified correlates liable to public intervention policies.