A Quarter-Millenium of Cardiovascular Epidemiology

Abstract

According to George Rosen the roots of Epidemiology lie in the mid 17 th century, although Hippocrates was aware of some of its methods. Cardiovascular Epidemiology can be traced back to the mid 18 th century to the pioneering contribution of William Heberden (who coined the term 'angina pectoris') and John Fothergill. Proudfit in 1983 cited Jenner, Parry, Burns and Black as the originators of the ischaemic theory of angina pectoris. Of these four, Samuel Black's observations displayed a particularly epidemiological bent and he was the first to notice 'the French Paradox'. The description of myocardial infarction in living patients was not made until the late 19 th century. It was Sir James Mackenzie's community studies of disease in Scotland which ushered in modern Cardiovascular Epidemiology. His work influenced Paul Dudley White who was instrumental in the Framingham Study, where the term 'Risk Factor' was first ap- plied to cardiovascular disease, and involved at the inception of the Seven Counties study. Over the second half of the 20 th century the number and types of epidemiological studies mushroomed, but it is beyond the scope of this review to cover them exhaustively. We are now in the era of genomics and witnessing an 'Epidemiologi- cal Transition.' GENERAL BACKGROUND