The findings of the Framingham Heart Study–begun in 1948–have been nothing short of revolutionary. Over the years, they have provided conclusive evidence that cardiovascular disease is largely the result of measurable and modifiable risk factors, and that individuals can gain control over their heart health by looking carefully at their diet and lifestyle and changing their intake of saturated fat, cholesterol, and tobacco smoke; losing weight or becoming physically active; and regulating their levels of stress and blood pressure. It is principally because of the Heart Study that this understanding of what was once deemed a “silent killer” today seems intuitive. The Framingham Heart Study was launched not long after Franklin Delano Roosevelt succumbed to a massive stroke, the result of runaway blood pressure, at a time when cardiologists in the United States numbered fewer than 400 and heart disease was the nation’s number- one cause of death. The study asked 5,209 citizens of Framingham, Massachusetts–who overate, smoked, and suffered heart attacks and strokes to the same extent as the rest of the United States–to undergo biennial physicals, blood tests, and detailed interviews concerning their behavior. The results changed the course of medical history. Written by the Study’s current director and a national health reporter, A Change of Heart is the first account of this heroic cooperation between the U.S. Public Health Service and the people of Framingham. It is a fascinating, clear-eyed assessment of the achievements and challenges of the Framingham Heart Study to date, and of its continuing importance. When a cerebral hemorrhage killed President Franklin D. Roosevelt in 1945, so little was known about heart disease that high blood pressure was considered benign. Three years later, some 5,000 Framingham, Massachusetts, citizens began having their blood pressure and other cardiovascular indicators regularly checked. They neither paid nor were paid for this monitoring; if cause for concern arose, personal physicians were notified. Increasingly, causes of concern did arise, for the data gathered were correlated with the volunteers' health and longevity to ascertain the conditions of heart disease. Eventually, the Framingham study, by freely sharing its data with clinical researchers, sped identification of the causes of heart disease and the development of effective prophylaxis and treatment. Some of the best chapters of this book, which faintly exudes authorized-history propriety (Levy is the study's current director, Brink a journalist and perhaps responsible for the book's high readability), are about that facilitated research. The study, now conducted with the original volunteers' children and grandchildren, is probably the most important research achievement in medical history. Ray Olson Copyright © American Library Association. All rights reserved Daniel Levy, M.D., is the director of the Framingham Heart Study. Susan Brink is a senior writers for U.S. News & World Report . ONE A Killer of Paupers and Presidents It was April 12, 1945, and the country was heartbroken. Franklin D. Roosevelt, the thirty-second president of the United States, died suddenly in what had come to be known as the Little White House, a cottage in the woods of Pine Mountain near Warm Springs, Georgia. The public was unprepared for his death, though for many months his doctors knew that he was gravely ill. In keeping with the culture of the times, his personal physicians hid the grim reality of the president’s failing health from the press, from the public, from his family—even from FDR himself. Casualty of an as yet unrecognized epidemic, the leader of the free world slipped away. Roosevelt, his doctors, and the media had colluded to portray him as the picture of health. Long before he was elected president, in the summer of 1921 when he was thirty-nine years old, he fell victim to another epidemic. Polio rendered his legs nearly useless, his ability to walk nothing more than a simulation. He supported dead weight from the waist down with braces locked at the knee, and he would swing himself forward in a practiced rhythm between crutches. Throughout his life, the public saw him as strong, self-assured, and independent. No American was privy to the scene of Arthur Prettyman, FDR’s personal valet, strapping full-leg braces on the president as he lay supine in bed. The metal of each brace was painted black, and the president always wore black shoes and socks so as not to draw undue attention to the contraption. It was, like the title of Hugh Gregory Gallagher’s book, FDR’s Splendid Deception.1 His walk was seldom photographed, nor was the wheelchair on which he often depended. When a rare photographer violated the White House rule, Secret Service agents would seize the film and expose it. Only pictures of Roosevelt in a strong, erect stance or a comfortably seated position were permitted. Rumors that Roosevelt was in po