Trends in coronary heart disease in two Belgian areas: results from the MONICA Ghent-Charleroi study

Setting-As part of the WHO-MONICA study, acute coronary events have been re gistered from 1983 until 1992 in the general population aged 25-69 years in two Belgian cities-Ghent in the northern Dutch speaking part of Belgium an d Charleroi in the southern French speaking part. Registration of events wa s done according to an international standard protocol. Objective-To study trends in total, fatal and non-fatal event rates and tre nds in case fatality rates in these two cities. Main results-Incidence of CHD was on average 50% higher in Charleroi compar ed with Ghent in both men and women (attack rate ratio Charleroi/Ghent was 1.5 in both sexes). In both men and women, diverging trends were observed b etween the two cities for total and non-fatal event rates, while parallel d eclining trends were observed in fatal event rates and in case fatality rat es. In both sexes, total attack rates showed a significant decrease in Ghen t and a significant increase in Charleroi. Also in the two sexes, attack ra tes of non-fatal events increased significantly in Charleroi and remained s table in Ghent. Attack rates of fatal events decreased significantly in men and women in Ghent acid in men in Charleroi. Both "total" and "in hospital " case fatality rates declined significantly in both sexes in the two citie s. Conclusions-Important differences in coronary heart disease (CHD) incidence and CHD trends between Ghent and Charleroi were observed. These difference s and trends are interpreted in the context of existing and still growing d ifferences in the overall socioeconomic situation between the north and the south of the country. On the other hand, the efficacy of medical treatment of CHD is comparable in the two regions, as reflected by similar figures a nd trends for case fatality rates.