Following a peak in the mid 1960s, there has been a steady decline in coronary heart disease (CHD) mortality in the United States of 2.8%/y to 5.1%/y., This shift in mortality patterns is most dramatic in the age-adjusted rates. Age adjustment compensates for the transition of CHD in older age groups and the increase in the aged population. The absolute number of total CHD deaths showed little change until recently (Figure 1). Life expectancy of adults dramatically increased, largely as a result of these improved CHD outcomes. However, the reduction in mortality was not associated with a decline in hospital morbidity as CHD was pushed into the older age groups. Prevalence actually increased with more individuals diagnosed, treated, and surviving. CHD hospitalizations for those >65 years of age increased from 1965 to 2000 while declining in younger age groups.