Circulation, Vol 60, 1609-1612, Copyright © 1979 by American Heart Association
RS Ross
Medical treatment of heart disease has improved significantly in the past
30 years. The spectacular change in the natural history of rheumatic heart
disease is apparent from a 1948 article that reported that 42% of children
with rheumatic heart disease died of rheumatic infection or bacterial
endocarditis. Antibiotics and cardiac surgery have improved the outcome
from rheumatic heart disease. Cardiopulmonary resuscitation has had a major
impact on the treatment of myocardial infarction and on the management of
sudden death. The fundamental principle underlying the discovery of
cardiopulmonary resuscitation is reviewed, and recent developments
emphasizing the importance of intrathoracic pressure in the hemodynamics of
cardiopulmonary resuscitation are highlighted. The important new drugs of
the last 30 years include the oral diuretics, the antihypertensives and the
antiarrhythmic agents. The development of the beta-blocking agents is cited
as an example of the translation of basic physiological research to medical
care. Finally, the role of epidemiologic techniques in the design of
clinical trials to evaluate medical therapy and hence improve medical
management is discussed.
ARTICLES
Research related to medical treatment of cardiovascular disease