[Regular assessment of cardiovascular risk factors and diseases: a valuable tool or not? (The MONICA experience)]

An important aspect of public health policy is the information system through which the health of the whole population and of particular groups at risk can be monitored. In Switzerland, a first national health survey (SOMIPOPS) was carried out in 1981-1982 by questionnaire and interview and paved the way for implementation of the Swiss Health Survey, whose first test run is currently ongoing. Periodic health examination surveys including measurements of physical characteristics have been conducted only at a regional level in the framework of the WHO project MONICA (MONItoring of trends and determinants in CArdiovascular disease). The mainly French-speaking cantons of Vaud and Fribourg and the Italian-speaking canton of Ticino take part in this project and the levels of the major cardiovascular risk factors were measured on representative samples of the population in 1984-86 and in 1988-89. A similar survey was conducted in the German-speaking city of Basel in 1989/89. These studies allow time trend and geographical analysis, and some comparisons are presented in terms of age-standardized prevalence rates of the risk factors. The discussion focuses on the desirability of implementing a periodic health examination survey at the national level. One main advantage of such surveys is that variables of particular interest at a given time can be added to the usual set of measurements, as was the case for blood lead, vitamin D and apolipoproteins in the MONICA surveys.