‘In the 1912 edition of “The Principles and Practice of Medicine”, William Osler described angina pectoris as serious but uncommon and observed that chronic lead intoxication played “an important role in the causation of arteriosclerosis." Coronary thrombosis was not yet the defining illness of modern life. Within a few decades--during the age of industrial combustion and the rise of leaded gasoline--coronary heart disease became the leading cause of death in the US.’https://jamanetwork.com/journals/jama/fullarticle/2846867‘In the US, coronary heart disease mortality rose in the 1930s and 1940s alongside expanding production of leaded gasoline. By 1968–the year production peaked-- coronary heart disease accounted for 1 in 3 deaths.’
‘Coronary heart disease mortality then began a steep and sustained decline. During this same period, production of leaded gasoline and blood lead levels dropped in parallel. Hypertension prevalence also declined–from roughly 1 in 3 adults in the mid-1970s to 1 in 5 by the early 1990s.’
‘In 1978, more than 80 physicians and scientists gathered in Bethesda, Maryland, at what became known as the Decline Conference, to understand why myocardial infarctions had suddenly decreased. Nearly 190 000 fewer deaths had occurred than expected. Antihypertensive medications were not yet widely used, and traditional risk factors did not fully explain the shift.’