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deaths classified under al “diseases of the heart” has been steadily dropping since the late 1940s, contrary to the public perception. As a World Health Organization committee said in 2001 about reports of a worldwide
    “epidemic” of heart disease that fol owed on the heels of the apparent American epidemic, “much of the apparent increase in [coronary heart disease]
    mortality may simply be due to improvements in the quality of certification and more accurate diagnosis….”
    The second event that almost assuredly contributed to the appearance of an epidemic, specifical y the jump in coronary-heart-disease mortality after 1948, is a particularly poignant one. Cardiologists decided it was time they raised public awareness of the disease. In June 1948, the U.S. Congress passed the National Heart Act, which created the National Heart Institute and the National Heart Council. Until then, government funding for heart-disease research had been virtual y nonexistent. The administrators of the new heart institute had to lobby Congress for funds, which required educating congressmen on the nature of heart disease. That, in turn, required communicating the message publicly that heart disease was the number-one kil er of Americans. By 1949, the National Heart Institute was al ocating $9 mil ion to heart-disease research. By 1960, the institute’s annual research budget had increased sixfold.
    The message that heart disease is a kil er was brought to the public forceful y by the American Heart Association. The association had been founded in 1924 as “a private organization of doctors,” and it remained that way for two decades. In 1945, charitable contributions to the AHA totaled $100,000. That same year, the other fourteen principal health agencies raised $58 mil ion. The National Foundation for Infantile Paralysis alone raised $16.5 mil ion.
    Under the guidance of Rome Betts, a former fund-raiser for the American Bible Society, AHA administrators set out to compete in raising research funds.
    In 1948, the AHA re-established itself as a national volunteer health agency, hired a public-relations agency, and held its first nationwide fund-raising campaign, aided by thousands of volunteers, including Ed Sul ivan, Milton Berle, and Maurice Chevalier. The AHA hosted Heart Night at the Copacabana.
    It organized variety and fashion shows, quiz programs, auctions, and col ections at movie theaters and drugstores. The second week in February was proclaimed National Heart Week. AHA volunteers lobbied the press to alert the public to the heart-disease scourge, and mailed off publicity brochures that included news releases, editorials, and entire radio scripts. Newspaper and magazine articles proclaiming heart disease the number-one kil er suddenly appeared everywhere. In 1949, the campaign raised nearly $3 mil ion for research. By January 1961, when Ancel Keys appeared on the cover o f Time and the AHA official y alerted the nation to the dangers of dietary fat, the association had invested over $35 mil ion in research alone, and coronary heart disease was now widely recognized as the “great epidemic of the twentieth century.”
    Over the years, compel ing arguments dismissing a heart-disease epidemic, like the 1957 AHA report, have been published repeatedly in medical journals. They were ignored, however, not refuted. David Kritchevsky, who wrote the first textbook on cholesterol, published in 1958, cal ed such articles
    “unobserved publications”: “They don’t fit the dogma and so they get ignored and are never cited.” Thus, the rise and fal of the coronary-heart-disease epidemic is stil considered a matter of unimpeachable fact by those who insist dietary fat is the culprit. The likelihood that the epidemic was a mirage is not a subject for discussion.

    “The present high level of fat in the American diet did not always prevail,” wrote Ancel Keys in 1953, “and this fact may not be unrelated to the indication that