The North Karelia Project began as a national pilot and demonstration programme for cardiovascular disease (CVD) prevention in Finland in 1972. A comprehensive community-based intervention involving health services, non-governmental organizations, industry, media and public policy was developed. The evaluation showed that the changes in risk factors among the population were in the 70’ significantly greater in North Karelia than in the original reference area. Because the experiences gained during the initial project period (1972–1977) have been actively used for the health programmes in Finland, the favourable changes have been since 80’s rather parallel in all parts of Finland. Consequently coronary heart disease mortality rate between 1970–1995 has reduced by 73% in North Karelia and by 65% in all of Finland.