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...ww.._..~...'...........'.tl:.~°a ..~.L....~-.. .. U.S. DEPARTMENT OF HIEALTM. EDUGATION.AND WELFARE National Heart and Lung Institu FIILLIAM E. SANDERS (301) 496-42, FOR RELEASE in a.m. papers Wednesday, March 27, 1974 Screening and enrollment of men between the ages of 35-57 to take part in a six-year cardiovascular study is underway in 20 centers throughout the United States, Dr. Theodore Cooper, Director of H EW's National Heart and Lung InstitutE announced today. The Multiple Risk Factor Intervention Trial (MRFIT) will assess the effec- tiveness of measures to reduce elevated blood cholesterol, high blood pressure and cigarette smoking in preventing first heart attacks and reducing death rates from cardiovasculer• diseases. The study is supported by the National Heart and Lung Institute, National Institutes of Health. NIH is one of the six agencies comprising the Public Health Service. Elevated blood cholesterol, high blood pressure, and cigarette smoking are . factors strongly associated with increased s usceptibility to premature coronary ' heart disease (CND) and such consequences as heart attacks and sudden cardiac deaths. It is estimated that approximately 80 percent of death and disability from coronary heart disease occurs among individuals having one or more of these risk factors working against them. All three risk factors can be modified. It is hoped that measures directed against these factors will reduce the threat that they pose to the individual's health or life. To test this hypothesis, each of the 20 clinical centers taking part in the Multiple Risk Factor Intervention Trial will conduct screening procedures to (more)

-.2- identify and enroll some 600 volunteers toward the total of 12,000 needed for the study. Volunteers will be selected from men, age 35-57, who are at above average CHD risk because of various combinations of elevated blood cholesterol, high blood pressure, or cigarette smoking; do not already have definite clinical coronary heart disease; and are willing to commit themselves to a six-year prevention progran. The study will only ihclude men because of the much higher frequency of coronary disease in men than in women at this age. At the primary screening visit potential participants will be asked to fill out a brief medical questionnaire and will have their blood cholesterol and blood pressure levels checked. At two subsequent screening visits, potentially eligible men will receive more extensive workups. Subsequently, eligible and willing participants will be divided at i random into two groups. Half will be referred to their personal physicians or usual source of inedical care (together with the results of the screening test) and invited to return to the cliuical center each year for a cardio- vascular examination. The other half will enter a special intervention program, designed to - reduce blood cholesterol levels - lower elevated levels of diastolic blood pressure - elimi nate cigarette smoking The interventions in this group will involve changing some living and health habits, and so will have a strong educational component. "The goal of the Nultiple Risk Factor Intervention Trial is to answer a critical question as yet unanswered by direct experiment: Can the reduction of these three common risk factors for coronary heart disease prevent or (more)

- 3- reduce the incidence of heart attacks and premature death in a higher risk segment of the U.S. population," explained Dr. Theodore Cooper, Director of the National Heart and Lung Institute. "it will be the largest and most difficult prevention trial ever undertaken against our most important contemporary health problem." Althoui this effort is expected to cost about411.0 million a year for the next seven years, this is a relatively small amount when compared with the estimated annual cost to the Nation from arteriosclerotic and hypertensive disease of more than423 billion. The total program includes 20 clinical centers; a coordinating center; a central laboratory; an electrocardiographic center; and professional supporting activi ties from the National Heart and Lung Institute, tMe Nation Center for Disease Control, and the Drug Supply Center of the PHS at Perry Point, Maryland. Planning and organizing for this study have been in progress over the past 18 months by a Steering Committee of the Principal Investigators under the Chairmanship of Dr. Oglesby Paul, Vice-President for Health Sciences, Northwestern University, Chicago. Staffing of each clinical center will include a cardiologist far, •diagnostic evaluations. Nutritionists will be available to help in dietary changes for reduc tion of.blood cholesterol levels. Behaviorai scientists will be helping i n the program for smoking cessation. Physicians will direc the management of medical intervention procedures. Men will be invited to participate in screening in a number of dAfferen ways in different cities. Some centars will contact employee groups, others will approach the general population. Each clinical center will have a 12-m period to enroll its 600 eligible participants. "It is gratifying to see the degree of cooperation being provided locally from management, unions, physicians and health agencies in many of these areas," said Dr. Cooper. Reports from centers that have already begun their screening and enrollment are very encouraging. The procedures planned for this study have been successfully tested in the Baltimore and New York City MRFIT ClinicAl Centers since November 1973. All other centers will initiate screening within the next few months.

• The participating centers, principa) investigators and dates for beginning enrollment of participants.in MRFIT are listed below. University of Maryland Baltimore, Maryland Maureen Henderson, ~l.D. Roger Sherwin, M.D. (Screening began Nov. 1973) University of Minnesota Minneapolis, Minnesbta Henry Blackburn, M.D. Henry Taylor, Ph.D. (January 29, 1974) St. Louis Heart Assti. St. Louis, Missouri Herbert Zimmerman, M.D. (February 18, 1974) Harvard University Boston; Massachusetts James M. Dalen, M.D. (Januairy 28, 1974) Kaiser Fdnd. Res. Inst. Portland, Oregon John Wf1d, M.D. John Grover, M.D. (February 14, 1974) Cox Heart Institute Kettering, Ohio Paul Kezdi, M.D. (March 4, 1974) L•ankeneu Hospital Philadelphia, Pennsylvania William Holmes, Ph.D. J. Edward Pickering, M.D. (March 11, 1974) University of Pittsburgh Pittsburgh, Pennsylvania Lewis Kuller, M.D. Robert McDonald, Jr., M.D. (March 1, 1974) U. of Southern California Los Angeles, California Jessie Marmorston, M.D. (April, 1974) Rutgers Medical School Piscataway, New Jersey Marise Gottlieb, M.D. (April, 1974) k 1 American Health Foundation New York, New York Peter Peacock, M.D. Ernest Wynder, M.D. (Screening began Nov. 1973) Pacific Medical Center S an Francisco, California Stephen Hulley, M.D. W. McFate Smith, M.D. (February 14, 1974) University of California Davis, California Nemat Borhani, M.D. Dean Mason, M.D. (February 18, 1974) Northwestern University Chicago, Illinois Jeremiah Stamler, M.D. Oglesby Paul, M.D. (January 28, 1974) Boston University Boston, Massachusetts Thomas Dawber, M.D. H. E:aerson Thomas, M.D. (March 11, 1974) New Jersey Medical School Newark, New Jersey Norman Lasser, M.D., Ph.D. (March 18, 1974) University of Alabama Birmingham, Alabama Harold Schnaper, M.D. Hugh Pratt, M.D. (March 18, 1974) University of South Carolina Columbia, South Carolina Warren Giese, Ph.D. Robert Kiger, M.D. (Apri 1, 1974) Dade County Department of Pub. Healt Miami, Florida Milton Saslaw, M.D. Janice Burr, M.D. (April, 1974) Rush Medical College Chicago, Illinois James Schoenberger, M.D. Milton Levine, M.D. (April, 1974)

- 5 Coopert.ting non-clinical centers patients) are: Coordinating Center University of Minnesota Minneapolis, Minnesota Marcus Kjelsberg, Ph.D. Electrocardiographic Center University of Dalhousie Halifax, Nova*Scotia Penta Rautaharju, M.D., Ph.D. Hermann Wolf, M.D. Lipid Standardization Center Center for Disease Control Atlanta, Georgia Gerald Cooper, M.D. Myron Kuchman, M.D. (which will not be enrolling Central Laboratory Pacific Medical Cente.r San Francisco, California Graham Widdowson, Ph.D. George Z. Williams, M.D. Electrocardiographic Coding Center University of Minnesota Minneapolis, Minnesota Ronald Prineas, M.D. Drug Distribution Center USPHS Supply Center Perry Point, Maryland Mr. Salvatore Gasdia Clinical Applications and Prevention Division of Heart and Vascular Diseases, NHLI Bethesda, Maryland William J. Zukel, M.D. Charles T. Kaelber, M.D. I A Policy Advisory toard has been appointed by the NHLI to oversee the plan and conduct of the study. The Chairman and members of thi s Policy Advisory Board are listed below: John C. Cassel, M.D. - Chairman Head, Department of Epidemiology University of North Carolina Chapel Hill, North Carolina . Harriet P. Dustan, M.D. Vice Chairman Research Division Cleveland Clinic Cleveland, Ohio William Insu 11, Jr., M.D. Adjunct Associate Professor and Physician Center for Prevention of Premature Arteriosclerosis Rockefeller University New York, New York C. David Jenkins, Ph.D. Professor, Depsrtment of Behavioral Epidemiology Division of Psychiatry Boston University School of Medicine Boston, Massachusetts

- 6 - I I Donovan J. Thompson, Ph.D. Profcssor of Biostati stics Department of Preventive Medicine University of Washington Seattle, Washington Charlotte M. Young, Ph.D. Professor of Medical Nutrition . Cornell University Ithaca, New York Wi1liam 3'. Zukel, M.D. (ex officia) Associate Director for Clinical Applications and Prevention Division of Heart and Vascular Diseases National Heart and Lung Institute Bethesda, Maryland ### I