The mortality from ischaemic heart disease is higher in predominantly rural northern and western Sweden than in the more urban eastern and southern districts. This study was performed in a small semirural area in mid-Sweden with lower mortality from ischaemic heart disease in middle-aged men and higher mortality in middle-aged women than the national average. Smoking habits, serum cholesterol, and blood pressure were measured in all 50-year-old men and women in the community (n = 314) during a four-year period. In addition, the feasibility of using the local health care centre as a base for the study was tested. The health centre provided an excellent base for this population study. The non-response rate was less than 3%, indicating that using local facilities and staff well known to the population might be an advantage. The risk factor levels seemed to be higher in Kungsör than in Uppsala, a community with low mortality from ischaemic heart diseases. The differences in risk factor levels could explain some, but not all of the differences in mortality from ischaemic heart diseases. Thus, other risk factors appear to be operating as well.