Monitoring of cardiovascular disease and risk factor trends: experiences from the WHO/MONICA project

The WHO Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) Project was initiated in the early 1980s with the main objective of assessing the extent to which trends in coronary heart disease and cerebrovascular disease are related to changes in known risk factors, daily living habits, health care, or major socioeconomic features in defined communities in different countries. In 1994 the WHO/MONICA Project will have completed its 10-year course. To develop a strategy of integrating cardiovascular disease indicators in an overall health indicator system, the problems and opportunities of cardiovascular disease monitoring have to be assessed now. In the industrialized world, cardiovascular diseases are still the most important cause of death. According to WHO estimations, chronic diseases in general will soon, as in the developing areas of the world, be the major health problem. As has been the case for a long time now in the field of cancer, the international community should consider whether, based on the experience of the WHO/MONICA Project, there should be a permanent institution charged with the worldwide monitoring of the development of cardiovascular diseases.