In 1964, the two agencies together held a second national conference on heart disease in Washington.

The 2nd National Conference on Cardiovascular Diseases was held in Washington, DC, November 22-24, 1964, sponsored by the National Heart Institute, U.S. Public Health Service, the Heart Disease Control Program of the U.S. Public Health Service, and The American Heart Association and chaired by Ralph Knutti, Director of the National Heart Institute, and Carleton Chapman, president of the American Heart Association. Honorary Co-Chairmen were Mrs. Albert D. Lasker, Harold M. Marvin, Luther L. Terry, C.J. van Slyke, James Watt, and Paul Dudley White. Conference Director was E. Cowles Andrus, Executive Secretary – Cyrus Maxwell, and the Conference Manager – Helen Lemp, with a very large central advisory committee. (About the only survivors I can recognize are Bob Brandenburg, Howard Burchell, Michael DeBakey, and Jerry Stamler. Maybe a couple others of these are still alive.)

The Conference opened on the day and the hour of the first anniversary of the assassination of John F. Kennedy and the program began with a moment of silent tribute, followed by a note of support from Lyndon Johnson. In Dr. Andrus’ editorial in the JAMA announcing the Second National Conference he referred, of course, to the First National Conference of 1950, and spoke of how both the government along with voluntary health agencies and private philanthropy had risen steadily in the years since the first conference, including investments of $90 million by the American Heart Association and $640 million by the Public Health Service in heart disease research. This was, of course, before the decline in coronary disease mortality had begun, but there was much to say about the decline in deaths from hemorrhagic stroke and hypertensive disease but that coronary heart disease continued to increase, compelling a critical review of progress.

The objectives of the Conference were 1) to examine the cost of cardiovascular diseases in human financial and social resources; 2) to focus on advances since 1950; 3) to report on the state of knowledge and the application of knowledge at the community level; 4) to project the opportunities and future needs in research, training and applications; and 5) to assist physicians and health personnel and the public in application of current knowledge. Four hundred scientists worked on the summary interpretations for the conference.

In all this time, the NHLBI and AHA have regularly issued joint reports as well as co-hosted conferences and task forces. These, along with the activities of top cardiology societies, have together constituted the official history of heart disease research. Put another way, any event from the early 1950s on that was not convened by the AHA, the NHLBI, or one of these few societies has had virtually no impact on the writing of that history.

The nucleus of control steering these groups was a tiny group of experts with overlapping responsibilities. The number of those in this nutrition elite was small enough for them all to be on a first-name basis with each other and they came to control pretty much every large clinical trial on diet and disease. These were the nutrition “aristocrats,” to use a term coined by Thomas J. Moore, a journalist who wrote an explosive critique of the cholesterol hypothesis in 1989.VIII They came from the academic faculties of medical schools, teaching hospitals, and research establishments, mainly along the Eastern Seaboard but also in Chicago. (As air travel grew less expensive, experts from California and Texas were able to join.) The group of nearly all men worked closely with the AHA and the NHLBI. Members of this academic haut monde were appointed to official committees and expert panels; they co-authored influential articles, sat on the editorial boards of major scientific journals, and peer-reviewed each other’s papers. They attended and dominated the major professional conferences.

In all these contexts, the same names continually come up. For example, AHA founder Paul Dudley White was also appointed by President Harry S. Truman to be the first director of the National Heart Advisory Council, which guided all NHI activities with respect to cardiovascular disease. White then established a number of joint AHA-NHI scientific committees, including the community service and education committee, which he himself chaired before passing the mantle to Keys. AHA presidents “almost routinely” directed the NIH Advisory Council orserved as members, noted the AHA’s official history. AHA leaders also dominated the professional medical societies. White helped found the International Society for Cardiology, and he, together with Keys, co-chaired its research committee. And in 1961, the AHA and the NHI jointly began planning the huge National Diet Heart Study, the biggest-ever endeavor to test the diet-heart hypothesis, for which the executive committee read like a Who’s Who of nutrition science, including, of course, both Keys and Stamler.

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