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March 18, 1983

The Multiple Risk Factor Intervention Trial

Author Affiliations

Harvard University Cambridge, Mass

JAMA. 1983;249(11):1435-1436. doi:10.1001/jama.1983.03330350017010

To the Editor.—  The Journal is to be commended for its publication of the MRFIT mortality report. How many studies that do not show positive results are ever published? The Journal is also to be commended for the call to "responsible debate on controversial issues" contained in the accompanying editorial by Dr Lundberg.As to the MRFIT report itself, the reason for the striking failure of the trial lies in its erroneous basic assumption that reductions in CHD mortality would result from reductions in the three so-called major risk factors—cigarette smoking, high levels of BP, and serum cholesterol (SC).The MRFIT program failed to achieve an anticipated greater reduction in the overall CHD mortality rate in the special intervention (SI) group than in the control group receiving usual care (UC), despite the fact that the risk factor-reduction goals were essentially met. During the follow-up period, the SI group showed a