MONICA (Multinational MONItoring trends and determinants of CArdiovascular diseases) study was carried out in Kaunas in 1983-2002 in four random samples of population aged 35-64 years (overall 3292 men and 3548 women - response rate 65.1%). Over the 20-year period, mean levels of systolic blood pressure (BP) (in men and women), diastolic BP (in women), body mass index (in men and women) decreased while mean levels of total serum cholesterol increased (in men and women). In the final survey as compared with initial survey arterial hypertension (AH) (BP > 140/90 mm Hg) became less prevalent in women (39.4% and 51.3%, p<0.001) and mild hypertension - less prevalent in men (25.9% and 33%, p<0,001). Over the study period, prevalence of mild hypercholesterolemia (total cholesterol 5.0-6.49 mmol/l) decreased and prevalence of severe hypercholesterolemia (total cholesterol =7.8 mmol/l) increased both in men and women. The prevalence of excessive weight increased in men and the prevalence of obesity increased in women. No statistically significant changes were detected in the prevalence of smoking in men during the study period while in women the prevalence of regular smoking increased (from 4.1% to 11.3%, p 0,001). The observed levels and trends of main risk factors of coronary heart disease require intensification of implementation of primary prevention measures in the studied population.