ABSTRACT
This chapter demonstrates that a pandemic of coronary heart disease developed in the United States during the 1930s, reached a peak in the 1950s and 1960s, and began to decline about 1970. Trends in ischemic heart disease mortality rates can therefore be compared to trends in mortality rates from other chronic diseases caused by smoking. If lower rates of cigarette smoking were responsible for the decrease in ischemic heart disease mortality, mortality rates from other chronic diseases caused by cigarette smoking should decrease at appropriate times. Thus changes in diet prior to the decline of the pandemic were too small and inconsistent to have produced the substantial decreases in ischemic heart disease mortality rates that occurred after 1970. The statin drugs to lower blood cholesterol levels became popular almost thirty years after the beginning of the decrease in ischemic heart disease mortality rates and therefore did not contribute to the decline in the pandemic.
