The validity of the routine mortality statistics on coronary heart diseasein Finland: Comparison with the FINMONICA MI register data for the years 1983-1992

We compared the diagnoses obtained from the routine mortality statistics wi th the standardized World Health Organization (WHO) MONICA (multinational M ONItoring of trends and determinants in CArdiovascular disease) classificat ion in suspect coronary heart disease (CHD) deaths registered in the FINMON ICA myocardial infarction (MI) register during 1983-1992. All CHD deaths fr om routine mortality statistics (International Classification of Diseases c odes 410-414) were registered in the MI register. Of the CHD deaths in rout ine mortality statistics 1.7% in men and 4.8% in women did not fulfill the MONICA criteria for CHD death (P < 0.001 for the difference between the sex es). In men 4.7% and in women 7.3% (P = 0.004) of the deaths registered in the MI Register and classified as CHD deaths by MONICA criteria had another underlying cause of death than CHD in routine mortality statistics; this p roportion increased over time in both sexes (P = 0.002 in men and P = 0.77 in women). The CHD mortality trends obtained separately from the routine mo rtality statistics and from the FINMONICA MI Register were very similar. In conclusion, the high CHD mortality in Finland reported by the routine mort ality statistics is real. It is possible that some CHD deaths have escaped registration, but the decline seen in the CHD mortality is also real. I CLI N EPIDEMIOL 52;2:157-166, 1999. (C) 1999 Elsevier Science Inc.