Aim: As comorbidities may impact treatment decisions, prognoses and quality of care, this study determined the rate of comorbid cardiovascular diseases in patients with metastatic colorectal cancer (mCRC). Methods: From the PHARMO Record Linkage Sytem in The Netherlands, all patients with a hospital discharge code for CRC and distant metastasis from 2000-2008 were selected. Prevalent cardiovascular comorbidities were assessed during the 12 months prior to the index date (the first discharge diagnosis defining metastases). Cardiovascular comorbidities were captured using cardiovascular drug use and hospital admission data. 2964 patients with mCRC were included in the analysis. Mean (± standard deviation) age at diagnosis was 68 (± 12) years and 53% were male. Results: Cardiovascular comorbidities were observed in 52% of patients. Of patients identified by drug use, the most commonly used agents were antithrombotic agents (54%), beta-blocking agents (46%), and agents acting on the renin-angiotensin system (45%). Of patients hospitalised for