[Coronary disease in France: data from the MONICA registers (1985-1991)].

The MONICA Project is an international project co-ordinated by the World Health Organisation. The objective of this study is to assess fluctuations in coronary heart disease (CHD) mortality and morbidity. From 1985 to 1991 a continuous and exhaustive registration of acute coronary events (15,775 cases among which 12,789 men and 2,986 women) was carried out in the 3 French MONICA Centres Lille, Strasbourg and Toulouse. During this period, the average rate of CHD mortality according to the death certificates was higher for men in Lille (93/100,000 inh) and Strasbourg (84/100,000 inh) than in Toulouse (57/100,000 inh). The official rates are close to those found by the MONICA Registers if documented myocardial infarctions only are taken into account. If sudden deaths are included, these rates must be multiplied by 1.6. In terms of evolution, official statistics showed an improvement with a mortality decrease of 33%. For the MONICA Registers which include sudden deaths, the decrease was only 20%. Official statistics underestimate coronary death rate and overestimate the decrease tendency. Morbidity rates between the South and the North of France are close, and when compared to Northern Europe countries, France is in an area of moderate incidence. The favourable evolution of coronary disease frequency hides in fact a contrasted evolution: improvement in myocardial infarction recurrence and worsening of incidence. The example of CHD proves that registers provide relevant information for a prevention policy.