The article discusses the issue of the high prevalence of cardiovascular risk factors and extremely high mortality rates from cardiovascular disease, especially among people of working ages, in Russia. It justifies the need to reduce excess mortality. Further, it analyzes the trends, structure and the burden of cardiovascular diseases, demonstrates prevalence of major cardiovascular risk factors (psychosocial factors, alcohol abuse, smoking, eating habits, arterial hypertension, low physical activity, obesity, and dyslipidemy) in the Russian population. The measures required to control high mortality from cardiovascular disease and existing barriers in Russia are addressed. A conclusion is made that the lessons learned in western countries over the past 50 years need to be applied in Russia.