- To measure the trends in cardiovascular mortality and coronary heart disease and cerebrovascular morbidity.
- To assess the extent to which these trends are related to changes in known risk factors, daily living habits, health care and major socio-economic factors measured at the same time in defined communities in different countries.
- To make recommendations concerning risk factor control and methods of cardiovascular disease surveillance.
After the Second World War death rates from coronary heart disease (CHD) had increased in most industrialized countries, but stroke events were falling. Subsequently, CHD mortality declined in several countries, particularly in Australia and the USA, whereas trends were stable or rising in many others. The WHO MONICA Project was established in the early 1980s in many Centres around the world to investigate the reason for these changes. It set out to MONItor trends in CArdiovascular diseases to a common protocol (CHD event registration is obligatory, stroke optional), and to relate these to risk factor changes in the population over a ten year period. There is a total of 17 Centres in 9 out of the 15 European Union member countries. Iceland is also affiliated, giving a European study population of 5.9 million people. There are a further 14 centres elsewhere in the world giving a total study population of 10.6 million persons. The activities planned over 1996-8 will allow the 10 year analyses of the MONICA Project to be carried out. These activities will include coordination, the holding of periodic Principal Investigators' meetings and organising writing workshops. Support will be provided to the MONICA Data Centre and for financing visits of staff from the MONICA EU Centres to the Data Centre. The fact that Centres outside the EU are involved will bring community added value by greatly increasing MONICA's power to reliably answer its hypotheses. MONICA has formed a framework on which to build further research, to monitor the effects of intervention programmes, and to plan new strategies.