There can be little doubt that the MONICA project represents the most significant study of the epidemiology of coronary heart disease (CHD) that the world has seen thus far. Inspired in the late 1970s by the 1950s and 1960s CHD epidemic in developed countries and by the seven countries study (among others), it was established in the early 1980s to measure trends in CHD and stroke mortality, and to relate these to changes in risk factors, lifestyle, health care, and major socioeconomic factors in defined communities in different countries. Much of our current level of understanding of cardiovascular disease is derived from the numerous reports and publications resulting from this project.

This monograph is a “must” for all those hoping to obtain an understanding of how MONICA was planned and set up, of what it aimed to achieve, and of all the various studies, carried out under its umbrella, which contributed to its findings. However, it does not discuss these findings in the text, which is very largely descriptive, and the text describes important aspects of the project only in very general terms; it would, for example, be useful to obtain rapid access to the precise protocol for measurement of blood pressure, or collection of blood for serum cholesterol estimation. Such details are not provided in the text itself, perhaps because such matters varied somewhat between different MONICA collaborating centres; however, two CD ROMs are provided with the book and these provide massive quantities of background information (including on protocols), links to results, published papers, etc.

Overall, this book provides a splendid read; it is written by the leading partners in MONICA and edited by Hugh Tunstall-Pedoe, probably the single individual who, over 23 years, has held MONICA together more than any other single person. It provides a superb overview of what MONICA was all about, and of why it remains so important to us all.