NHLBI: fifty years of achievement in pulmonary biology and medicine.

Abstract

On June 16, 1948, the National Heart Act (P.L. 80-655) authorized the formation of the National Heart Institute (NHI) to “improve the health of the people of the United States through the conduct of researches, investigations, experiments, and demonstrations relating to the cause, prevention, and method of diagnosis and treatment of diseases of the heart and circulation; assist and foster such researches and other activities by public and private agencies, and promote the coordination of all such researches and activities and the useful application of their results; provide training in matters related to heart diseases, including refresher courses for physicians; and develop, and assist states and other agencies in use of the most effective methods of prevention, diagnosis and treatment of heart diseases.” Although the NHI focused its efforts mainly on heart disease, its programs from the beginning included many projects on cardiopulmonary physiology. Research on topics such as fluid balance, muscle biology, control of breathing, high-altitude physiology, and hyperbaric medicine were part of the grant portfolio. These investigations paved the way for formal recognition of a long-standing need for a national program committed to diseases of the lung when the Secretary of the Department of Health, Education, and Welfare announced in November 1969 an expansion of the NHI to the National Heart and Lung Institute (NHLI). * At that time, the National Institutes of Health (NIH) was providing $11.0 million for support of research and training in respiratory diseases, but these activities were dispersed among various institutes, with little integration and no mechanism for coordination. Shortly after issuance of the new charter, several administrative actions were taken: ( 1 ) the NIH Guidelines for Referral were modified to reflect the expanded role of the NHLI; ( 2 ) the National Heart and Lung Advisory Council was increased from 12 to 16 members (Table 1); ( 3 ) an Office of Lung Programs was established in the NHLI; and ( 4 ) an intramural pulmonary program was initiated with establishment of a Pulmonary Function Laboratory in March 1971 and, shortly thereafter, a Pulmonary Branch for Intramural Research. In September 1972 Congress enlarged the authority of the Institute through the National Heart, Blood Vessel, Lung, and Blood Act (P.L. 92-423), which provided for expanded, intensified, and coordinated Institute activities in lung disease research and training. This action launched the formation of the Division of Lung Diseases and the beginning of intense research efforts in all aspects of pulmonary biology and medicine (with the exception of lung cancer, which remained in the National Cancer Institute, and infectious lung diseases, which remained the responsibility of the National Institute of Allergy and Infectious Diseases). In this report, we highlight some of the administrative steps that were taken and acknowledge the contributions of some individuals and groups that played an important role in guiding the implementation and evaluation of the national pulmonary research effort. As we mark the 50th anniversary of the NHLBI, it is clear that throughout the history of the Institute, a close and valuable collaboration in cardiopulmonary medicine must be recognized as contributing to a vast knowledge base that served as the foundation for many important discoveries made in this last half-century.