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April 22, 1992

Long-term Mortality After Primary Prevention for Cardiovascular Disease

Author Affiliations

University of California, San Francisco

JAMA. 1992;267(16):2183-2184. doi:10.1001/jama.1992.03480160041018

To the Editor.  —The report by Strandberg et al1 of the Finnish Multifactorial Heart Disease Prevention Program and the accompanying Editorial by Paul and Hennekens2 leave us with several questions. First, the Editorial states that the excess mortality in the treated group must be considered in the context of "possible biases that may have arisen from substantial losses to follow-up," yet the study describes the "recovery of deaths" as "100% complete in both groups." Which statement is correct?Second, the "Comment" section of the study states that the "absolute number of violent deaths was similar in the intervention group and the group initially excluded because of absence of risk factors." However, there were only 612 men in the intervention group and 2268 men (3490 - 1222) in the group excluded because of absence of risk factors. Unless the authors meant to say that the rates of violent deaths (rather