Introduction

As Americans and citizens of other industrializing countries began to enjoy lives of increasing affluence and ease during the first half of the 20th century, a rising tide of heart attacks and strokes displaced infectious diseases as the leading cause of death, killing millions in the United States and throughout the world. Although cardiovascular disease remains serious and widespread, the significant decline of per capita deaths is one of the greatest accomplishments of modern public health and medicine. Death rates from heart attack and stroke have fallen dramatically by 80% in the past 50 years -- the progress has been hard won by a combination of basic and applied laboratory research, broad and far-reaching epidemiological studies by physicians, scientists, and public health experts. Cardiovascular disease is no longer viewed as an as an inevitable feature of the natural course of aging, and complacency has given way to hope. This book focuses on developments that influenced the rise and decline of cardiovascular mortality since 1900, but also includes insider insights from the author, a 42-year NIH employee.