Trends in Stroke and Coronary Heart Disease in the WHO MONICA Project
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Background and Purpose— Coronary heart disease (CHD) and stroke are leading causes of death and disability. Because they share major common risk factors, it would be expected that trends in mortality and incidence of these 2 major cardiovascular diseases would be similar. Methods— Data from the World Health Organization (WHO) Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) Project were used to compare 10-year trends in mortality, event rates, and case fatality from both CHD and stroke. Fifteen populations in the WHO MONICA Project provided data on both CHD (60 763 events) and stroke (10 442 events) in men and women aged 35 to 64 years (23.4 million person-years of observation in total). Results— Trends for the 2 cardiovascular diseases varied within and between populations, and when data from all populations were combined, trends in CHD and stroke mortality differed in men ( P =0.001) but not in women, whereas trends in event rates differed significantly in both men and women ( P <0.001 and P =0.011, respectively). The differences in trends for CHD and stroke case fatality were not statistically significant in either men or women. In sensitivity analyses, differences in trends in event rates remained statistically significant in men ( P <0.001) but not in women. Conclusions— Trends for CHD and stroke mortality rates, event rates, and case fatality differ substantially between and within the study populations.
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The paper did not find a strong parallel between changes in stroke incidence and mortality, suggesting that factors contributing to stroke incidence and mortality or their changes over time might differ.
“As in a previous study30 we did not note a strong parallel between changes in stroke incidence and mortality, suggesting that factors contributing to stroke incidence and mortality or their changes (including level of exposure to those factors) over time might be different.31”
From Global and regional burden of stroke during 1990-2010: findings from the Global Burden of Disease Study 2010 (2014) · cites this paper as [31]
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- Authors
- Truelsen, T., Mähönen, M., Tolonen, H., Asplund, K., Bonita, R., & Vanuzzo, D.
- Affiliations
- University Hospital of Umeå (SE)
- From the World Health Organization Noncommunicable Diseases and Mental Health/Cross Cluster Surveillance (NMH/CCS), Geneva, Switzerland (T.T., R.B.); Department of Epidemiology and Health Promotion, National Public Health Institute (KTL), Helsinki, Finland (M.M., H.T.); Department of Medicine, University Hospital, Umeå, Sweden (K.A.); and Centro Malattie Cardiovascolari, A.S.S.4 “Medico Friuli,” Udine, Italy (D.V.).
- Venue
- Stroke
- Published
- 2003-06
- Volume
- 34
- Issue
- 6
- Pages
- 1346-1352
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- OpenAlex
- W2012820125
- Cited by
- 157
- References
- 25
- Citations by year
- 2025: 1 · 2024: 3 · 2023: 2 · 2022: 2 · 2021: 6 · 2020: 3 · 2019: 8 · 2018: 7 · 2017: 2 · 2016: 6 · 2015: 11 · 2014: 7 · 2013: 10 · 2012: 8
- FWCI
- 6.55
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Servier
- National Institutes of Health
- Institut de Recherches Servier
- National Heart, Lung, and Blood Institute
- Topics
- Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Keywords
- coronary artery disease, cardiovascular disease trends, mortality trends, incidence, case fatality, sex differences, MONICA project, cardiovascular risk factors
- MeSH terms
- Adult, Coronary Disease, Female, Humans, Male, Middle Aged, Mortality, Sensitivity and Specificity, Sex Factors, Global Health, World Health Organization, Incidence, Sex Distribution, Stroke
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