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Mortality after 16 years for participants randomized to the Multiple Risk Factor Intervention Trial
Insights
A long-term study found that a 7-year intervention program significantly reduced coronary heart disease (CHD) mortality and acute myocardial infarction. This multifactor intervention for high-risk men demonstrated continuing mortality benefits years after the trial concluded.
Area of Science:
- Cardiovascular Medicine
- Public Health
- Preventive Cardiology
Background:
- The Multiple Risk Factor Intervention Trial (MRFIT) investigated long-term effects of cardiovascular risk factor intervention.
- A mortality follow-up involved 12,866 men randomized into special intervention (SI) or usual care (UC) groups.
Purpose of the Study:
- To assess the long-term impact of cardiovascular risk factor intervention on coronary heart disease (CHD), cardiovascular death (CVD), and total mortality.
- To evaluate the sustained benefits of a multifactor intervention program in high-risk men.
Main Methods:
- The study involved a 7-year active-intervention phase with dietary changes, antihypertensive medication, and smoking cessation counseling for the SI group.
- The control group (UC) received usual medical care.
- Mortality data was collected over 16 years post-randomization.
Main Results:
- After 16 years, the SI group showed an 11.4% lower CHD mortality rate compared to the UC group.
- Acute myocardial infarction mortality was 20.4% lower in the SI group.
- Total mortality also showed a trend towards reduction in the SI group, with differences being more pronounced post-trial.
Conclusions:
- A 7-year multifactor intervention program provides long-term, continuing mortality benefits.
- Interventions targeting blood pressure, serum cholesterol, and smoking cessation are effective in reducing cardiovascular mortality.
- The study reinforces the value of comprehensive risk factor management in high-risk populations.
Background:
A mortality follow-up of 12,866 men was conducted 16 years after randomization to special intervention (SI) or usual care (UC) groups of the Multiple Risk Factor Intervention Trial to assess the long-term effect of cardiovascular risk factor intervention on coronary heart disease (CHD), cardiovascular death (CVD), and total mortality.
Methods And Results:
During the 7-year active-intervention phase of the trial, 6428 of the men were given dietary recommendations to lower blood cholesterol, antihypertensive drugs to lower blood pressure, and counseling for cigarette smoking cessation. The remaining 6438 men were referred to their usual source of medical care. After 16 years, 370 SI and 417 UC men had died from CHD, which represents an 11.4% lower mortality rate for SI versus UC men (95% CI, -23% to 1.9%). Results for total mortality followed a similar pattern; 991 SI and 1050 UC men had died by the end of follow-up (relative difference, -5.7%; 95% CI, -13% to 2.8%). For acute myocardial infarction, a subcategory of CHD, the relative difference was -20.4% (95% CI, -34.4% to -3.4%). Differences between SI and UC men in mortality rates from acute myocardial infarction, CHD, and all causes were greater during the posttrial follow-up period than during the trial.
Conclusions:
Results of a 7-year multifactor intervention program aimed at lowering blood pressure and serum cholesterol and at cigarette smoking cessation among high-risk men give additional evidence of a long-term, continuing mortality benefit from the program.