20th YEARS MONICA PROJECT IN NOVI SAD - INFLUENCE OF SOCIOPOLITICAL AND ECONOMIC CIRCUMSTANCES ON STROKE EPIDEMIOLOGY

  • Milorad T Žikić Medicinski fakultet Novi Sad, Klinika za neurologiju KCV Novi Sad
Keywords: MONICA project, cardiovascular diseases, stroke, risk factors, prevention, epidemiology

Abstract


Objective. To measure trends in CVD, acute myocardial infarction (AMI), and MU morbidity and mortality, assessing the extent to which these trends are associated with changes in known risk factors (RF), daily lifestyle habits, health care, and major socioeconomic characteristics. Measurements were carried out at the same time in defined communities in different countries on several inhabited continents.
Methods MONICA combined the old with the new, routine standardized measurements of epidemiological parameter’s, RF and medical care were combined with quality control and publication of results on the internet, hypothesis testing and publication of study results in prestigious scientific journals. The hypothesis couldn’t be tested only on one population and without cooperation with the WHO, and the main activities were recording the incidence of AMI and stroke, coronary care, analysis of population samples and implementation of the intervention program. Incidence, morbidity, lethality and mortality of stroke, sociopolitical and economic characteristics, as well as stroke RF in the area of Novi Sad were investigated from 1979-1983-2002. in order to establish and implement the aforementioned protocols.
Results The levels and distribution of the main RF that determined the undertaking of preventive activities and the implementation of intervention programs to protect residents from CVD are presented. The results of the MONICA project in Novi Sad were achieved by reducing the epidemiological indicators of stroke in a period of favorable social, political and economic conditions, and by worsening them in the opposite circumstances in all expressed aspects of people's lives and state functioning.
Conclusion The hypothesis has been proven that the social community achieves a successful final mission of reducing stroke rates of morbidity and mortality by undertaking prophylactic measures, so that despite the development of reperfusion therapies for patients with acute ischemic stroke, prevention remains the approach of choice for reducing the its risk.

References

1. Žikić M. The Last Three Decades of Stroke Epidemiology in Novi Sad. Global Journals of Science Frontier Research Inc. (US), 2013; vol XIII (1):1-6.
2. Meschia JF, Bushnell C, Boden-Albala B al. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2014;45(12):3754−832. DOI:10.1161/STR.0000000000000046.
3. Diener HC, Hankey GJ. Primary and Secondary Prevention of Ischemic Stroke and Cerebral Hemorrhage: JACC Focus Seminar. J Am Coll Cardiol 2020;75(15):1804−18. DOI: 10.1016/j.jacc.2019.12.072.
4. WHO MONICA Project: MONICA Manual Group of Authors (including Zikic M) (1990) Available at: http://www.ktl.fi/publications/monica/monograph_cd/manual90_html/mb10618.htmWHO URL:http://www.ktl.fi/publications/monica/index.htm, URN:NBN:fi-fe19981147
5. The WHO MONICA Project, Prepared by: Tunstall-Pedoe H for The WHO MONICA Project (including Žikić, M): The World Health Organization MONICA Project (Monitoring Trends and Determinants in Cardiovascular Disease): A major international collaboration, Journal of Clinical Epidemiology, 1988; 41(2):105-114. PMID:3335877.
6. Stojšić Đ, Stojšić-Milosavljević A. From Kannel’s magic name ’risk factors’to MONICA project. In: MONICA PROJECT – MESSAGES. Monograph of scientific meetings AMN SLD, vol 1, No 4, 2010: 23-34. ISBN 978-86-6061-009-8
7. Planojević M, Jakovljević Đ, Stojšić Đ, Đapić T, Žikić M, Šolak Z. Grujić V. MONICA Monograph and Multimedia Sourcebook. Prepared by Hugh Tunstall-Pedoe et all. for the WHO MONICA Project. WHO Geneva, 2003:126 ISBN 92 4 156223 4. (NLM classification: WG 16).
8. VITATOPS Trial Study Group, Principal investigator Graeme J Hankey (including Zikic M). B vitamins in patients with recent transient ischaemic attack or stroke in the VITAmins TO Prevent Stroke (VITATOPS) trial: a randomised, double-blind, parallel, placebo-controlled trial. Lancet Neurol. 2010 Sep;9(9):855-65. doi: 10.1016/S1474-4422(10)70187-3. PMID: 20688574
9. Žikić M, Novosel O, Rabi Žikić T, and Žarkov M. ATRIAL FIBRILLATION AND POSSIBILITIES OF STROKE PREVENTION. Acta Clin Croat, Vol. 50, (Suppl) No. 2, 2011:58-60. URI https://hrcak.srce.hr/106112
10. WHO MONICA Project: MONICA Manual, Part I: Description and Organization of the Project, Section 1: Objectives and Outline Protocol (1990). Available at: URL:http://www.ktl.fi/publications/monica/manual/part1/i-1.htm, URN: NBN: fi-fe19981147.
11. MONICA Project. MONICA Manual, Part IV: Event Registration, Section 2: Stroke Event Registration Data Component (1990). Available at: URL:http://www.ktl.fi/publications/monica/manual/part4/iv-2.htm, URN: NBN: fi-fe19981146.
12. Sakač D, Koraćević G, Sekulić S. Importance of MONICA project in evaluation of some risk factors for cardiovascular diseases. In: MONICA PROJECT – MESSAGES.Monograph of scientific meetings AMN SLD, vol 1, No 4, 2010: 139-158. ISBN 978-86-6061-009-8
13. Žikić M. The role of MONICA project in epidemiological, scientific and strategic activities during for the period 1984-2005. In: MONICA PROJECT – MESSAGES. Monograph of scientific meetings AMN SLD, vol 1, No 4, 2010: 97-128. ISBN 978-86-6061-009-8
14. Žikic M. Stroke Somewhere in the Balkans in Circumstances of Great Socio - Political Turmoil, Epidemiology and Stroke Prevention. LAP - LAMBERT Acad Publ, 2018;ISBN: 978-613-9-83798-4
15. Molarius A, Kuulasmaa K, Evans A, McCrum E, Tolonen H. for the WHO MONICA Project (including Zikić M): Quality assessment of data on smoking behaviour in the WHO MONICA Project ( 1999). http://www.ktl.fi/ publications/monica/smoking/qa30.htm.
16. Mähönen M, Asplund K, Tolonen H, Kuulasmaa K, for the WHO MONICA Project. (including Zikić M): Stroke event trend quality score for the WHO MONICA Project (2001), http://www.ktl.fi/publications/monica/strokescore/score.htm, http://www.ktl.fi/publications/monica/strokescore/annex.htm.
17. Mähönen M, Tolonen H, Kuulasmaa K, for the WHO MONICA Project (1998) Quality assessment of stroke event registration data in the WHO MONICA Project. Available at: URL:http://www.ktl.fi/publications/monica/strokeqa/strokeqa.htm, URN: NBN: fi-fe19991080.
18. Tolonen H, Kuulasmaa K, Asplund K, Mähönen M. for the WHO MONICA Project (including Zikić M): Do trends in population levels of blood pressure and other cardiovascular risk factors explain trends in stroke event rates? – methodological appendix to a paper published in Stroke (2002), http://www.ktl.fi/publications/monica/strokeh1/appendix.htm, http://www.ktl.fi/publications/monica/stroke_h1/annex.htm
19. Mähönen M, Tolonen H, Kuulasmaa K, for the WHO MONICA Project (2000). MONICA Stroke Event Registration Data Book 1982—1995. Available at: URL:http://www.ktl.fi/publications/monica/strokedb/strokedb.htm, URN:NBN:fi-fe20001205
20. The WHO MONICA Project, Prepared by A Molarius 1, R W Parsons, A J Dobson, A Evans, S P Fortmann, K Jamrozik, K Kuulasmaa, V Moltchanov, S Sans, J Tuomilehto, P Puska, for the WHO MONICA Project (including Zikić M): Trends in cigarette smoking in 36 populations from the early 1980s to the mid-1990s. Am J Public Health. 2001 Feb;91(2):206-12. doi: 10.2105/ajph.91.2.206. PMID: 11211628
21. Planojević M. Experiences from the MONICA project in Novi Sad. In: MONICA PROJECT – MESSAGES. Monograph of scientific meetings AMN SLD, vol 1, No 4, 2010: 69-96. ISBN 978-86-6061-009-8
22. Tunstall-Pedoe H (editor), for the WHO MONICA Project. MONICA Monograph and Multimedia Sourcebook. World Health Organization, Geneva, 2003.Include: MONICA Monograph and Multimedia Sourcebook Chapter: #83 Yugoslavia-Novi Sad (YUG-NOS, YU) By PI: Milutin Planojevic. Former PI 1984–1986: Djordje Jakovljevic. Other staff: A Svircevic, D Stojsic, T Djapic, M Zikic, P Terzic, Z Solak, V Grujic; 01/2003: pages – p. 126, and Dates - Coronary and stroke-event registration: 1984–1995. Coronary care: 1987–1995. Population surveys: 1984, 1988/1989, 1994/95; ISBN: 92 4 156223
23. Žikić M, Kuzmanović B, Jovanović A, Lučić A, Stefanović D, Žarkov M, Knežević S. Influence of Socio- Political and Economic Circumstances on Stroke Epidemiology in the Territory of Novi Sad during the WHO Prophylactic Programme. The 16th World Congress of Neurology, Buenos Aires. J Neurolog Sci. 150 (suppl) 1997; S192-192
24. Tolonen H, Mähönen M, Asplund J, Rastenyte D, Kuulasmaa K, Vanuzzo D, Tuomilehto J, for the WHO MONICA Project (including Zikić M): Do trends in population levels of blood pressure and other cardiovascular risk factors explain trends in stroke event rates? Comparisons of 15 populations in 9 countries within the WHO MONICA Stroke Project. Stroke, 2002;33(10):2367- 2375. PMID:12364723.
25. The WHO MONICA Project, Prepared by Thorvaldsen P, Kuulasmaa K, Rajakangas A-M, Rastenyte D, Sarti C, Wilhelmsen L, for the WHO MONICA Project (including Zikić M): Stroke trends in the WHO MONICA Project, Stroke, 1997;28(3):500-506. PMID: 9056602
26. Šolak Z, Avramović B, Žikic M. Appendix: WHO MONICA collaborative publications and citations in Web of Science database until July 25th, 2009. In: MONICA PROJECT – MESSAGES. Monograph of scientific meetings AMN SLD, vol 1, No 4, 2010:177-190. ISBN 978-86-6061-009-8
27. European Registers of Stroke (EROS) Investigators; Peter U Heuschmann, Antonio Di Carlo, Yannick Bejot, Daiva Rastenyte, Danuta Ryglewicz, Cinzia Sarti, Mattias Torrent, Charles D A Wolfe, al. Incidence of stroke in Europe at the beginning of the 21st century; Stroke 2009, May;40(5):1557-63. doi: 10.1161/STROKEAHA.108.535088. Epub 2009 Mar 26. PMID: 19325154 DOI: 10.1161/STROKEAHA.108.535088
Published
2025/11/24
Section
Historical Item