Introduction - This study aims to report on recent trends in coronary heart disease among residents aged 35 to 74 in the three geographic areas monitored by the registries (the departments of Bas-Rhin and Haute-Garonne and the Lille Urban Community). Materials and Methods - The events recorded are myocardial infarctions (MI) or coronary deaths for which a thorough investigation was conducted with health services and/or physicians. Results - A comparison of the 2000–2003 and 2004–2007 periods shows an average 19% decline in MI and coronary death rates in both sexes, which was significant in all three regions. Among women, this decline is observed only after age 54. The incidence also decreases between the two periods (-16% among men; -19% among women). Again, among women, this decrease is observed only after age 54. Coronary mortality decreases by an average of 15% among men and 22% among women. In both sexes, this decline is observed only in Strasbourg and Toulouse and only among those aged 54 and older. The hospital mortality rate for IDM and coronary deaths tends to increase among men in Lille and Toulouse. Overall mortality exceeds 50%; it tends to increase among men and remains stable among women. Conclusions - A decline in coronary morbidity and mortality was observed between 2000 and 2007, primarily among individuals over 54 years of age. While the incidence of the disease is decreasing, hospital and overall mortality rates are holding steady. (R.A.)