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Evevident
Original paper
1982JAMAPreventive/Primary Care

MRFIT

Multiple risk factor intervention trial. Risk factor changes and mortality results

RCTCardiovascular prevention

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Overview

Multifactor risk counseling improved risk factors but did not significantly reduce CHD mortality overall.

Clinical takeaway

MRFIT is a prevention-history landmark showing how hard population risk-factor intervention trials are, even when individual risk factors clearly matter.

Key result

Coronary heart disease mortality was not significantly lower with the special intervention program.

Practice impact

Reinforced risk-factor prevention while highlighting limits of broad behavioral intervention trials.

Evidence

Study design

Randomized primary-prevention trial.

Enrollment

12,866

Follow-up

Mean about 7 years.

Geography

United States

Clinical question

Does an intensive multifactor risk-factor intervention reduce coronary heart disease mortality in high-risk middle-aged men?

Population

  • Middle-aged men at increased risk for coronary heart disease based on smoking, cholesterol, and blood pressure.

Intervention

Special intervention targeting smoking cessation, dietary cholesterol reduction, and stepped-care hypertension treatment.

Comparator

Usual care referral to community physicians.

Primary outcome

Coronary heart disease mortality.

The multifactor intervention did not significantly reduce coronary heart disease mortality overall.

Between-group comparison / p=not significant

Key results

  • Risk factors improved more in the special-intervention group.
  • Coronary heart disease mortality was not significantly reduced overall.
  • Interpretation was complicated by improving community care and subgroup signals.

Harms

  • No single drug toxicity signal defines the trial; intervention burden and unintended treatment effects were concerns.

Clinical Use

When to cite

  • When teaching prevention trial complexity and historical cardiovascular risk-factor management.

Practice impact

  • Important historical anchor for preventive cardiology and risk-factor modification.

Applicability

  • Population prevention and counseling discussions, especially when distinguishing risk-factor causality from trial implementation.

Limitations

  • Enrolled only men and predates modern statins, antihypertensives, and tobacco-control policy.
  • Community care contamination likely reduced contrast.

Common misinterpretations

  • Do not conclude that smoking, BP, and cholesterol do not matter; the trial tested an intervention package, not the biology of each risk factor.

Related evidence

ALLHAT - Later Trial4S - Later Trial

Citation

Multiple risk factor intervention trial. Risk factor changes and mortality results. Multiple Risk Factor Intervention Trial Research Group. JAMA. 1982;248(12):1465-1477.

DOI
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