CORONARY heart disease is the leading cause of death in the United States. During the past decade, medical and governmental leaders have proclaimed repeatedly that we are having an epidemic increase in death rate from this disease. Within the past few months an editorial in Circulation stated, "Cardiologists must be 'unreasonable men,' if they are to find a way to slow the rapidly increasing incidence of coronary heart disease."1 The preface to the proceedings of a recent postgraduate course sponsored by the American College of Cardiology indicates that the rate of deaths from myocardial infarction continues unabated.2 The introduction to Medical World News Cardiovascular Review 1973 contains a similar statement. A recent national television program, "The Killers: 'Heart Disease—20th Century Epidemic' " indicated that prevention was not working and medicine had failed to stop the rising death rate from coronary artery disease.
The vital statistics of the United States