MONTREAT, N.C. (AP) — The Rev. Billy Graham, who transformed American religious life through his preaching and activism, becoming a counselor to presidents and the most widely heard Christian evangelist in history, died Wednesday. He was 99.

Graham, who long suffered from cancer, pneumonia and other ailments, died at his home in North Carolina, spokesman Mark DeMoss told The Associated Press.

More than anyone else, Graham built evangelicalism into a force that rivaled liberal Protestantism and Roman Catholicism in the United States. His leadership summits and crusades in more than 185 countries and territories forged powerful global links among conservative Christians, and threw a lifeline to believers in the communist-controlled Eastern bloc. Dubbed "America's pastor," he was a confidant to U.S. presidents from Gen. Dwight Eisenhower to George W. Bush.

In 1983, President Reagan gave Graham the Presidential Medal of Freedom, America's highest civilian honor. When the Billy Graham Museum and Library was dedicated in 2007 in Charlotte, former Presidents George H.W. Bush, Jimmy Carter and Bill Clinton attended.

"When he prays with you in the Oval Office or upstairs in the White House, you feel he's praying for you, not the president," Clinton said at the ceremony.

Beyond Graham's public appearances, he reached untold millions through his pioneering use of prime-time telecasts, network radio, daily newspaper columns, evangelistic feature films and globe-girdling satellite TV hookups. Graham's message was not complex or unique, yet he preached with a conviction that won over audiences worldwide.

"The Bible says," was his catch phrase. His unquestioning belief in Scripture turned the Gospel into a "rapier" in his hands, he said.

A tall, striking man with thick hair, stark blue eyes and a firm jaw, Graham was a commanding presence at his crusades. He would make the altar call in his powerful baritone, asking the multitudes to stand, come down the aisles and publicly make "decisions for Christ," as a choir crooned the hymn "Just As I Am."

By his final crusade in 2005 in New York City, he had preached in person to more than 210 million people worldwide. No evangelist is expected to have his level of influence again.