MULTIPLE RISK FACTOR INTERVENTION TRIAL - RISK FACTOR CHANGES AND MORTALITY RESULTS (REPRINTED FROM JAMA, VOL 248, PG 1465-1477, 1982)

Authors
PAUL O ARNOLD CB MANDRIOTA R AMES RP EISENBACH JR BOHN E THOMAS HE KANNEL WB ROTONDO R CONNORS J BRAND FN SMITH LK PRISCO MT GREENE P KEZDI P STANLEY EL BLACK WL ERNST FA CASE EJ BENTLEY V COVERT D LUCIUS M PARIS F SEMMETT R SKOTKO L CHRISTAKIS G BURR JM GERACE TA WILCOX ME BRAMSON D BENEZRA J WEDDLE J KAYE J PADRON M RAUTAHARJU PM WOLF H BENFARI RC MCINTYRE KM DANIELSON E OCKENE J KOUSCHHOWARD D BALDWIN AD WILD JB GREENLICK M GROVER J LAMB S BAILEY J DYER J BROKOP B STEVENS V BAILEY G HOLMES W PICKERING JE ALLAIRE J DUFFY EL FELLON D FEINSTEIN B HUTCHINS D RUBEL G COOPER GR BAYSE DD MILLER DT HAINLINE A KUCHMAK M WIEBE DA WINN CL TAYLOR L BOTERO BL GILL JB LASSER NL HYMOWITZ N MEZEY KC MUNVES B PARELL E BURGIO S LASSER V JOHNSON B JEFFREY S RICE E STAMLER J MOSS D PERSKY V ROBINSON E VANHORN L SHANNON K MEYERS D COHEN L MORGAN J GRUNDMANN G VESTAL TD HUANG B BERKSON DM LAUGER G GRUJIC S OBRADOVIC D PARDO E DUA S MCGOWAN S BILLINGS J HULLEY SB SMITH WM SYME SL COHEN R DZVONIK L ROOS L KAHN M WIDDOWSON GM WILLIAMS GZ KUEHNEMAN ML SCHOENBERGER JA SCHOENENBERGER JC SHEKELLE RB NERI GS DOLECEK T BETZ E SKWERES L OPPENHEIMER F GERNHOFER N HARDY GG MCGILL E HALL Y WRIGHT NH KOPEL SA SUCKERMAN KR SCHORIN M SIMON N COHEN JD BUNKERS E RONCHETTO B GRODSKY E FRESSOLA A DANIELGENTRY J TREIMAN R SULLIVAN W SCHNAPER HW HUGHES GH OBERMAN A HILL CC ALLEN R BRAGG C STOKES S JOHNSON P BORHANI NO SUGARS C KIRKPATRICK K LEE M DEBOURELANDO S LABAW F TURNERTUCKER J SHERWIN RW SEXTON MS CUSACK NE DEBARROS QTF DISCHINGER PC SPIZLER JF HEINER JD PILKINGTON MB SCANLON BL GRIMM RH MITTELMARK M CROW RS BLACKBURN H JACOBS D RAINS D MCDONALD M LENZ K PRINEAS RJ CROW RC BUZZARD IM GRAMBSCH PV WENZ J KJELSBERG MO BARTSCH GE NEATON JD AUS BM BENDICKSON J BROSTE SK CONNETT JE DUCHENE AG DURKIN DA GORDER DL GRANDITS GA HULTGREN DH KNICKERBOCKER A RASMUSSEN WL SVENDSEN KH WILLE L KULLER LH MCDONALD R CAGGIULA A FALVOGERARD L MEILAHN E MILAS NC RUSSELL R HORBIAK J ALMAN M SOUTHWICK K MOYER R GAHAGAN E GIESE WK MARTIN JF KEITH JA HARRISON HH MATHIS DE BROWN CK FISHMAN E WAMPLER L NEWMARK G ROSENFIELD F SIDDIQUI S SAVAGE W BRADFORD A INSULL W FARQUHAR JW JENKINS CD RAPAPORT E THOMPSON DJ TYROLER HA WILLIS PW FRIEDEWALD WT ZUKEL W DOYLE JT BURCHELL HB YU PN WILLIS PW FURBERG CD CUTLER JA ZUKEL WJ PASSAMANI ER KAELBER CT FARRAND ME TILLOTSON JL VERTER JI WU MC GORDON T HALPERIN M MCGEE DL BLASZKOWSKI TP EBERLEIN KA HARRIS CE DERN PL FRIEDMAN LM MAY GS VARGOSKO AJ
Citation
O. Paul et al., MULTIPLE RISK FACTOR INTERVENTION TRIAL - RISK FACTOR CHANGES AND MORTALITY RESULTS (REPRINTED FROM JAMA, VOL 248, PG 1465-1477, 1982), JAMA, the journal of the American Medical Association, 277(7), 1997, pp. 582-594
Citations number
35
Categorie Soggetti
Medicine, General & Internal
Journal title
JAMA, the journal of the American Medical Association → ACNP
ISSN journal
00987484
Volume
277
Issue
7
Year of publication
1997
Pages
582 - 594
Database
ISI
SICI code
0098-7484(1997)277:7<582:MRFIT->2.0.ZU;2-E
Abstract
The Multiple Risk Factor Intervention Trial was a randomized primary p revention trial to test the effect of a multifactor intervention progr am on mortality from coronary heart disease (CHD) in 12,866 high-risk men aged 35 to 57 years. Men were randomly assigned either to a specia l intervention (SI) program consisting of stepped-care treatment for h ypertension, counseling for cigarette smoking, and dietary advice for lowering blood cholesterol levels, or to their usual sources of health care in the community (UC). Over an average follow-up period of seven years, risk factor levels declined in both groups but to a greater de gree for the SI men. Mortality from CHD was 17.9 deaths per 1,000 in t he SI group and 19.3 per 1,000 In the UC group, a statistically nonsig nificant difference of 7.1% (90% confidence interval, -15% to 25%). To tal mortality rates were 41.2 per 1,000 (SI) and 40.4 per 1,000 (UC). Three possible explanations for these findings are considered: (1) the overall intervention program, under these circumstances, does not aff ect CHD mortality; (2) the intervention used does affect CHD mortality , but the benefit was not observed in this trial of seven years' avera ge duration, with lower-than-expected mortality and with considerable risk factor change in the UC group; and (3) measures to reduce cigaret te smoking and to lower blood cholesterol levels may have reduced CHD mortality within subgroups of the SI cohort, with a possibly unfavorab le response to antihypertensive drug therapy in certain but not all hy pertensive subjects. This last possibility was considered most likely, needs further investigation, and lends support to some preventive mea sures while requiring reassessment of others.