Background: Echocardiography has emerged as the test of choice for the evaluation of cardiac diseases.

Aim: To assess the prevalence of a spectrum of cardiac abnormalities detected by echocardiography in a representative sample of an urban adult population.

Methods: Transthoracic echocardiography was performed in a random sample of 511 men (47%) and women (53%) aged 48–76 years selected from population registers in Krakow. Body surface area (BSA) was used to adjust echocardiographic parameters for variations in body size. Disease history and cardiovascular risk factors were assessed in all patients.

Results: Men smoked more frequently than women and had higher blood pressure and triglycerides and lower high density lipoprotein cholesterol. The most common finding was increased left ventricular (LV) end-diastolic diameter (EDd) (37%), followed by mitral (32%), aortic (24%), or tricuspid (17%) regurgitations, LV posterior wall (24.1%) and interventricular septum (17.5%) thickening, increased indexed LVEDd (23%), increased left atrial diameter (LAd; 15.7%), reduced LV ejection fraction (LVEF; 15.3%), segmental wall motion abnormalities (13.9%), increased indexed LAd (8.8%), dilation of the ascending aorta (8%), enlargement of the right ventricle (RV) (2%) and elevation of RV systolic pressure (0.6%). When adjusted for main cardiovascular risk factors and the presence of coronary artery disease, male sex was associated with a higher prevalence ofen largement of LV (LVEDd/BSA): OR = 1.8 (1.1–2.9), dilation of ascending aorta (aortic diameter/BSA): OR = 2.7 (1.3–5.8), and LA (LA/BSA) = OR 2.7 (1.3–5.6), as well as a decrease of LVEF: OR = 3.6 (1.9–6.5).

Conclusions: Approximately a quarter of urban adults aged 48 to 76 can be expected to have some abnormalities on echocardiographic examination. Some of these abnormalities such as aortic dilation, LA enlargement, LV enlargement and decreased LVEF are more frequently found in males than in females, even after adjustment for BSA, main cardiovascular disease risk factors, and the presence of coronary artery disease. The use of raw instead of indexed LAd and LVEDd over estimates the prevalence of LA and LV enlargement.