Clinical and research challenges in risk factors for cardiovascular diseases.

Abstract

The European Society of Cardiology has a comparable organization in the U.S.A. in the American Heart Association, whose first president was Dr Lewis Atterbury Conner. Dr Connor was also the founding editor of the American Heart Journal. His contributions in the early 20th century were as significant as those of any single individual in focusing concerns about the emerging importance of cardiovascular disease. In the inaugural issue of the American Heart Journal of October 1925, Connor penned an editorial in which he stated ‘. . . this newly awakened interest in disorders of the cardiovascular system has led to a realization of the problem of heart diseases as extensive and important public health relations which can no longer be disregarded’. In the 40 years following Connor’s visionary editorial, an epidemic of cardiovascular disease emerged. This epidemic was later blunted, however, by remarkable gains in primary prevention as well as secondary prevention and treatment that have led to unprecedented declines in mortality from coronary heart disease and stroke during the last 35 years in many developed countries. Basic researchers, clinical investigators, epidemiologists and biostatisticians have contributed to a sufficient totality of evidence upon which to base rational clinical decisions and public policy. The European Society of Cardiology, the American Heart Association and other important organizations, in collaboration with health care providers, have translated research findings into clinical practice and effective public policy. Despite the fact that the remarkable gains in prevention and treatment have led to unprecedented life expectancies in the U.S.A. (76 years) and Europe (73