Coronary heart disease (CHD) mortality has decreased markedly in the U.S.A., Finland, Australia and other countries. Although the data are lacking, a decline in incidence is likely. Possible reasons include increased dietary consumption of essential fatty acids and decreased consumption of saturated fat and cholesterol, reduction in smoking, increased control of high blood pressure and increase in exercise. Not all countries fit this schema. Sweden has an increased CHD mortality which is not easily explained. Japan has had a continued decline in CHD mortality despite apparent increases in dietary fat. In the U.K., a decrease in CHD mortality began late, but there are encouraging signs both of changes in life style and of decreased mortality.