Age-adjusted overall death rates in men and women in the Soviet Union began to rise in the mid-1960s; an 18 per cent increase occurred in the entire population from 1964 to 1975. The epidemic of coronary heart disease (CHD) appears to be the primary cause of this trend and has been particularly widespread among middle-aged men. Prospective epidemiologic studies and autopsy reports confirm the high prevalence rates of atherosclerosis and its complications. The major risk factors for CHD occur frequently in the Soviet population. The epidemic nature of the modern chronic diseases is dramatically apparent in the secular trends in Soviet vital statistics. A similar pattern of life style as related to risk of CHD in the Soviet Union and in Western capitalist countries further suggests a similar social basis for this epidemic in both areas.