Physician practice for cardiovascular disease risk-factor reduction in six upper Midwestern communities. Preventive practice for coronary heart disease risk is increasingly accepted in the medical community. To determine the extent and characteristics of treatment advice for high blood pressure, blood cholesterol, and cigarette smoking, 274 randomly selected primary care physicians were interviewed by telephone in six Midwestern cities. Participation in the survey was 90%. Reported care for high blood pressure was consistent with national guidelines. Management of high blood cholesterol varied significantly among physicians and frequently differed from national recommendations. Although consensus existed on the importance of advising cigarette smoking cessation, reported approaches differed. The results observed indicate improved preventive practice compared with earlier surveys and recent national reports. Continued improvement, however, is needed in cholesterol and smoking-cessation management. 