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The events registration and survey procedures in the Northern Sweden MONICA Project
Birgitta Stegmayr1, Vivan Lundberg, Kjell Asplund
1Medicine, Department of Public Health and Clinical Medicine Umeå University Umeå, Sweden. birgitta.stegmayr@medicine.umu.se
Insights
The WHO MONICA Project monitored cardiovascular disease trends in Northern Sweden, correlating event rates with risk factors over 15 years. This study provides crucial data on cardiovascular health determinants.
Area of Science:
- Cardiovascular Epidemiology
- Public Health Surveillance
- Population Health
Background:
- The World Health Organization (WHO) MONICA (Multinational Monitoring of Trends and Determinants in Cardiovascular Disease) Project began in 1982.
- It aimed to link cardiovascular disease (CVD) mortality trends to changes in population-level cardiovascular risk factors.
- The project involved monitoring CVD events and risk factors in 38 populations globally over extended periods.
Purpose of the Study:
- To evaluate the extent to which mortality trends are explained by changes in conventional cardiovascular risk factors.
- To correlate time trends in cardiovascular event rates with trends in risk factor levels.
- To assess cardiovascular disease burden in Northern Sweden using standardized methodology.
Main Methods:
- Population-based registration of all acute myocardial infarction (MI) and stroke events in Norrbotten and Västerbotten counties, Sweden, from 1985 onwards.
- Utilized strict, standardized WHO MONICA criteria for event validation across all study years.
- Conducted population risk factor surveys in Northern Sweden in 1986, 1990, 1994, and 1999, including individuals aged 25-74 years.
Main Results:
- From 1985 to 2000, 13,908 acute strokes and from 1985 to 1998, 8,744 acute myocardial infarctions met MONICA criteria in Northern Sweden.
- A total of 6,952 participants (77% of invited) completed risk factor surveys across four distinct survey periods.
- Data covers a significant period, allowing for trend analysis of cardiovascular events and risk factors.
Conclusions:
- The WHO MONICA project in Northern Sweden has been conducted consistently from 1985 onwards.
- Strict adherence to standardized WHO criteria ensures the reliability and comparability of the collected data.
- The project provides a valuable dataset for understanding cardiovascular disease trends and determinants in the region.
Introduction:
The WHO MONICA Project (Multinational Monitoring of Trends and Determinants in Cardiovascular Disease) was initiated in 1982. The purpose was to evaluate to what extent mortality trends could be explained by changes over time in the population load of conventional cardiovascular risk factors. To test this hypothesis, time trends in cardiovascular event rates have been correlated with trends in levels of risk factors in 35- to 64-year-old men and women in 38 populations. In most MONICA populations, the study has covered a period of 10 years or more.
Methods:
All acute myocardial infarction and stroke events have been registered in a population-based setting in Norrbotten and Västerbotten counties from 1985 and onwards. The total population is approximately 510000 inhabitants. In the frame of the WHO MONICA Project, the same strict criteria have been used in all years. Another part of the MONICA Project is population risk factor surveys. In Northern Sweden the first survey took place in 1986 and the following surveys were performed in 1990, 1994, and 1999, including the age group 25-74 years (the first two surveys were of the age range 25-64 years).
Results:
From 1985 to 2000, in total 18105 suspected stroke events, aged 25-74 years, were scrutinized and validated at the central stroke office in Northern Sweden. Of these, 13908 were found to fulfil the MONICA criteria of an acute stroke. During the period 1985 to 1998, in total 13228 cases of suspected acute myocardial infarction, aged 25-64 years, were registered. Of these, 8744 fulfilled the MONICA criteria for acute myocardial infarction. In the four surveys, in total 9000 randomly selected men and women were invited for survey. Of these 6952 (77%) participated in the surveys.
Conclusion:
From 1985 and onwards, the WHO MONICA project has been going on in Northern Sweden. During the whole time the same strict WHO criteria have been followed.