Decline attributable to lower levels of cholesterol (36%), blood pressure (26%), and reduced smoking (20%). In the 25 years between 1981 and 2006 mortality rates from coronary heart disease (CHD) in Iceland decreased by a remarkable 80% in men and women aged between 25 and 74 years. How could such a huge decline be explained? Were the health services of Iceland so much better, or were its citizens reducing their risks?