Circulation. 1998;97:1095-1102
(Circulation. 1998;97:1095-1102.)
© 1998 American Heart Association, Inc.
Increasing Burden of Cardiovascular Disease
Current Knowledge and Future Directions for Research on Risk Factors
Charles H. Hennekens, MD, DrPH
From Harvard Medical School and Brigham and Women's Hospital,
Boston, Mass.
Correspondence to Charles H. Hennekens, MD, DrPH, Eugene Braunwald Professor of Medicine and Professor of Ambulatory Care and Prevention, Harvard Medical School, Chief, Division of Preventive Medicine, Brigham and Women's Hospital, 900 Commonwealth Ave E, Boston, MA.
Key Words: cardiovascular diseases • epidemiology • risk factors • trials
Lewis A. Conner was the
first president of the American Heart Association and founding editor
of the American Heart Journal. In the inaugural issue
of that journal, in October 1925, Dr Conner wrote that the "newly
awakened interest in disorders of the cardiovascular
system" has rapidly led to the recognition of heart disease as a
significant public health problem that "can no longer be
disregarded."1 In the ensuing years, the United
States first experienced a 40-year increasing epidemic of
cardiovascular disease, followed by remarkable gains in
prevention and treatment that led to a dramatic 30-year decline in
mortality from coronary heart disease (CHD) and stroke. At
present, however, heart disease remains far and away the leading
cause of mortality in the United States, responsible for about one of
every three deaths. Stroke accounts for 6% to 7% of all deaths, so
overall cardiovascular disease remains responsible for
about 40% of all US deaths.2
Further gains in the prevention and treatment of
cardiovascular disease will require concerted
efforts—and the necessary allocation of resources—on at least two
major fronts. First, public policy and health efforts must vigorously
promote those measures in prevention and treatment for which abundant
evidence of clear benefits already exists. Second, funding must be
provided for current research to evaluate new possible preventive and
therapeutic interventions and to expand frontiers in genetic,
thrombotic, atherogenic, and inflammatory markers of
cardiovascular disease risk.
Advances in knowledge proceed on several fronts, optimally
simultaneously. Basic researchers provide biological
mechanisms and answer the . . . [Full Text of this Article]
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