Trends in coronary heart disease in France from 2006 to 2014: Results from the MONICA registers

Introduction In the past decades, decreasing trends in coronary heart disease (CHD) morbidity and mortality rates have been observed in all of the western world, including France. Objective We aimed to assess whether gender- and age-specific trends were still favourable between 2006 and 2014 in France. Method We analysed data from the three geographical areas covered by the French MONICA population registers (inhabitants aged 35–74 years from the Urban Community of Lille in the north of France, the district of Bas-Rhin in the north-east and the district of Haute Garonne in the south-west. Registered events were all hospitalised/non-hospitalised fatal/non-fatal acute coronary events. Log-linear Poisson regression models were used to analyse trends. Results There was still a decrease in standardized event rates of CHD from 2006 to 2014 in the 35–74 age-group (annual decrease of 1.6% in average in men ( P  = 0.0003) and of 1.8% in women ( P  = 0.003)). This decrease was significant in women only in the 65–74 age-group (-3.9%, P  = 0.0005) and in men in the 55–64 and 65–74 age-groups (-0.8%, P  = 0.002 and -2.2%, P  = 0.006, respectively). No significant decrease could be observed in the younger individuals. Standardized mortality rates followed the same pattern. Conclusion A clear decline in CHD event rates and CHD mortality rates was observed between 2006 and 2014, especially among subjects above 54 years, but not in younger subjects, particularly in women. Primary and secondary prevention still need to be strengthened, in particular in the youngest.