SETTING: As part of the WHO-MONICA study, acute coronary events have been registered 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 and Charleroi in the southern French speaking part. Registration of events was done according to an international standard protocol. OBJECTIVE: To study trends in total, fatal and non-fatal event rates and trends in case fatality rates in these two cities. MAIN RESULTS: Incidence of CHD was on average 50% higher in Charleroi compared 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 between the two cities for total and non-fatal event rates, while parallel declining trends were observed in fatal event rates and in case fatality rates. In both sexes, total attack rates showed a significant decrease in Ghent and a significant increase in Charleroi. Also in the two sexes, attack rates of non-fatal events increased significantly in Charleroi and remained stable in Ghent. Attack rates of fatal events decreased significantly in men and women in Ghent and in men in Charleroi. Both "total" and "in hospital" case fatality rates declined significantly in both sexes in the two cities. CONCLUSIONS: Important differences in coronary heart disease (CHD) incidence and CHD trends between Ghent and Charleroi were observed. These differences and trends are interpreted in the context of existing and still growing differences 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 and trends for case fatality rates.
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