Objectives of the study

The objectives of the MONICA Project were to measure the trends in cardiovascular mortality and coronary heart disease and cerebrovascular disease morbidity and to assess the extent to which these trends are related to changes in known risk factors, daily living habits, health care, and major socioeconomic features measured at the same time in defined communities in different countries. For testing the relationships, the following null hypotheses were formulated:

First main null hypothesis:

For the population reporting units there is no relationship between:

• 10-year trends in the major CVD risk factors of serum cholesterol, blood pressure and cigarette consumption; and
• 10-year trends in incidence rate (fatal plus non-fatal attack rates) of coronary heart disease and of stroke.

Second main null hypothesis:

For the population reporting units there is no difference in:

• 10-year trends in case fatality rate (percentage of attacks that are fatal within 28 days); and
• 10-year trends in acute coronary care.

Second null hypothesis for stroke:

For the population reporting units there is no relationship between:

• 10-year trends in event rates or mortality rates between stroke and coronary events.

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