The article presents data on the mortality trends in Russia during the last decade in comparison with other countries in Europe. It is shown that in spite the decline in death rates, Russia remains among the countries with the highest mortality rates from CVD. The specifics of mortality that distinguish Russia from other countries are described: a large variability between regions in mortality levels, differences between sexes, dependence on geographical location and socio-economic development of the regions, and late referral to a doctor in life-threatening conditions. The article emphasizes the role of risk factors and accessibility and quality of medical care to the population, as the two main components of the mechanism for changing mortality from CVD.