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The Cover
November 7, 2012

Ritratto del Cuore (Portrait of the Heart)

JAMA. 2012;308(17):1718-1719. doi:10.1001/jama.2012.3299

For the first two thirds of the 20th century, there was a rapid increase in the age-adjusted death rates from heart disease, making it the No. 1 killer in the United States. The heart disease death rate peaked in the United States in the 1960s, and then this trend reversed itself, beginning a steady decline that continues today. What was responsible for this 50-year decline? It was equal parts the deployment of diagnostic tools and treatments for higher-risk patients with known or suspected heart disease and the dissemination of preventive strategies for the entire population that are responsible for the durable trend in reducing the rate of cardiovascular death.