Towards a new order in cardiovascular medicine: re-engineering through global collaboration

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The financial ‘meltdown’ that began in 2008 dramatically underscores the need for significant global changes in our fundamental institutions and interactions, and the field of medicine is no exception. Global ‘flattening’ encompassed by modern information and communication networks has increased our awareness of major health disparities at almost every level. At the same time, however, we have unprecedented access to knowledge that allows people to live longer and healthier lives. The field of cardiovascular medicine is particularly illustrative of this paradox. Despite decades of unprecedented improvements in prevention, treatment, and outcomes, cardiovascular medicine now faces a major global upswing in disease impact, driven by global demographic and cultural trends. Moreover, given the discipline's emphasis on technological and pharmacological treatments, it accounts for a major portion of healthcare costs. Outstanding emerging examples of local, national, and global collaboration among cardiovascular practitioners, however, suggest rapidly growing awareness of these challenges, as well as new opportunities for addressing them.1 In this article, we argue that leaders in the field of cardiovascular medicine have a fundamental responsibility to create, develop, and implement a global knowledge network that exemplifies the learning health system of the future. Numerous studies document the effects of cardiovascular disease (CVD), as well as the impact of its treatment and prevention, on rates of death and disability among the world's population. As life expectancies increase globally, the prevalence of ischaemic heart disease and heart failure will continue to grow even as age-specific risk drops due to application of existing measures for treatment and prevention.2,3 New and striking increases in obesity and diabetes mellitus threaten to compound the effects of age, creating a dramatic surge in CVD prevalence and potentially offsetting gains achieved through reductions in smoking and by the use of effective treatments aimed at lowering lipid …