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A standardized cardiovascular risk factor examination was given to executives in the headquarters of the American Telephone and Telegraph Company and the Nippon Telegraph and Telephone Public Corporation. As expected from the national mortality data, evidence of ischaemic heart disease was more common among American than Japanese executives. The frequency of some but not all risk factors was consistent with the observed differences in ischaemic heart disease. Americans were fatter than their Japanese counterparts, obtained a higher proportion of their caloric intake from animal fats, had higher serum cholesterol levels, and more of them felt that their lives were highly stressful. On the other hand, Japanese executives were much more likely to be cigarette smokers and showed a greater increase in blood pressure with age. Serum high-density lipoprotein cholesterol levels and the ratio of saturated to unsaturated fatty acids in the serum were similar in the two groups.