The American Cardiovascular Pandemic

As Americans and citizens of other industrializing countries began to enjoy lives of increasing affluence and ease during the first half of the 20th century, a rising tide of heart attacks and strokes displaced infectious diseases as the leading cause of death, killing millions in the United States and throughout the world. Although cardiovascular disease remains serious and widespread, the significant decline of per capita deaths is one of the greatest accomplishments of modern public health and medicine. Death rates from heart attack and stroke have fallen dramatically by 80% in the past 50 years — the progress has been hard won by a combination of basic and applied laboratory research, broad and far-reaching epidemiological studies by physicians, scientists, and public health experts. Cardiovascular disease is no longer viewed as an as an inevitable feature of the natural course of aging, and complacency has given way to hope. This book focuses on developments that influenced the rise and decline of cardiovascular mortality since 1900, but also includes insider insights from the author, a 42-year NIH employee.

David Gordon is a cardiovascular epidemiologist and an internationally recognized expert on clinical trials, who recently retired after 42 years with the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health. He is an author or co-author of 90 peer-reviewed scholarly articles plus invited chapters in 13 medical monographs and textbooks. He lives in Chevy Chase, Maryland.

Elaine A. Moore has worked in hospital laboratories for more than 30 years, primarily in immunohematology and toxicology. She is a freelance medical writer and laboratory consultant. For more information, visit her website at www.elaine-moore.com. She lives in Sedalia, Colorado.

David Gordon

Series Editor Elaine A. Moore

Format: softcover (6 x 9)
Pages: 257
Bibliographic Info: 18 photos, appendix, glossary, notes, bibliography, index
Copyright Date: 2021
pISBN: 978-1-4766-8512-0
eISBN: 978-1-4766-4415-8
Imprint: McFarland
Series: McFarland Health Topics

Acknowledgments vii
Preface 1
1. A Gentle Pandemic? 5
2. Framingham, Massachusetts 13
3. Clinical Trials 20
4. Lowering the Pressure 33
5. Fighting Cholesterol 45
6. The Tobacco Bane 59
7. The Rise of Diabetes 67
8. “Good” Cholesterol 80
9. The Mother of All Trials 86
10. Unclogging the Pipes 92
11. Secondary Prevention Drugs 112
12. Sudden Cardiac Arrest 121
13. The Fire Within 129
14. Diet, Exercise, and Obesity 133
15. Racial Cardiovascular Health Disparities 148
16. Wrap-Up 160
Appendix: Details of Calculation of Attributable Declines in Mortality 165
Glossary of Medical Terms and Acronyms 173
Chapter Notes 183
Bibliography 215
Index 239