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Multiple Risk Factor Intervention Trial

Marc Hertzman, MD
JAMA. 1976;235(25):2717. doi:10.1001/jama.1976.03260510011006.
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To the Editor.—  We wish to express a slightly discordant view of the Multiple Risk Factor Intervention Trial (MRFIT) outlined in JAMA (235:825, 1976). Despite substantial advice to the contrary, the MRFIT has chosen to exclude alcohol use as a factor for consideration in correlation with other variables of high risk for coronary heart disease. This is most unfortunate because (1) relationships between alcohol and coronary heart disease morbidity and mortality are well established, and (2) alcohol use is highly correlated with most of the factors under study, eg, smoking and elevated blood lipid levels.1The protocols for the trial are designed specifically to exclude heavy drinkers of alcohol from consideration as subjects. The justification for this is that alcohol abuse may confound the study results. Instead, a calorie conversion factor is being used to take into account the contribution of alcohol to total caloric intake. To our knowledge,


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