title: [Chronic diseases: recent trends, challenges and prospects for change].
abstract: BACKGROUND
  The objectives were to describe available sources for epidemiological surveillance of chronic diseases, recent trends, and underlying phenomena for these changes and to deduce possible scenarios for the future.
  
  
  METHODS
  Based on the examples of coronary heart disease, stroke, diabetes, chronic obstructive pulmonary disease (COPD) and lung cancer, the authors describe recent trends in mortality and hospitalizations in the general population.
  
  
  RESULTS
  Exceptfor diabetes, the morbidity and mortality of the diseases considered have globally declined over the last decade. However, trends varied according to age and gender and an increase in mortality from myocardial infarction, COPD and lung cancer was observed among women under the age of 55. Overall, decreased morbidity and mortality can be explained by improvements in primary prevention (blood pressure, cholesterol, smoking among men...) and prevention of recurrences and complications.
  
  
  CONCLUSIONS
  It is unclear whether these improvements will continue in the future. Aging, obesity, diabetes and smoking among women should negatively impact the medium-term morbidity and life expectancy (especially disability-free life expectancy). It is still difficult to predict future trends, as other factors could attenuate (electronic cigarettes, bariatric surgery...) or, on the contrary exacerbate (increased social inequalities in times of economic crisis, continued increase in smoking among women, diabetes...) these trends.
authors.forename: Michel
authors.initials: M
authors.lastname: Vernay
authors.forename: Christophe
authors.initials: C
authors.lastname: Bonaldi
authors.forename: Isabelle
authors.initials: I
authors.lastname: Grémy
mesh_terms: D002908:Chronic Disease / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009203:Myocardial Infarction / Q000453:epidemiology; D011322:Primary Prevention / Q000379:methods / Q000639:trends*; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology