A century of progress in the fight against cardiovascular disease

Over the past century, the American Heart Association (AHA) has been pivotal in advancing the understanding and treatment of heart disease and stroke, significantly impacting millions of lives globally. 

Established in 1924, the AHA has been at the forefront of research and advocacy, striving towards the eradication of cardiovascular diseases and stroke.

Monumental journey 

This monumental journey and the vision for future advancements in cardiovascular health were recently presented in the article “The American Heart Association at 100: A Century of Scientific Progress and the Future of Cardiovascular Science – A Presidential Advisory,” published in the journal Circulation. 

This advisory, uniquely authored by a collective of current and past AHA volunteer presidents, provides an introspective look into the AHA’s contributions over the past century, while also projecting future challenges and opportunities in cardiovascular science and health.

Overcoming future challenges 

The advisory serves as a comprehensive narrative that intertwines the AHA’s historical milestones with a forward-looking perspective on overcoming future cardiovascular challenges. It issues a robust call to action for the medical and scientific communities, alongside public and private sectors, to intensify efforts in research, clinical care, and public health to pave the way for a future where optimal patient care, scientific advancement, and health equity are realized for all. 

This collaborative approach aims to continue the reduction of cardiovascular disease and stroke, building on the legacy of the AHA’s centennial achievements.

Remarkable achievements 

Reflecting on the AHA’s foundational mission, Dr. Mitchell S.V. Elkind, chair of the advisory writing committee and 2020-21 volunteer president of the AHA, remarked: “Scientific research that identifies causes, prevention, diagnosis, and treatment of cardiovascular diseases is a foundational pillar the American Heart Association was built on in 1924.”

“The evolution of this science since 1924 has led to remarkable achievements in prevention and therapy of heart disease and stroke – essentially cutting heart disease death rates by more than half (70%) from 1950 to 2021 and stroke deaths rates by nearly a third since 1998.”

Advancing cardiovascular science 

Underpinning the advisory is a recognition of the AHA’s role in fostering a global leadership position in cardiovascular science and medicine. The association’s efforts in supporting the scientific community through funding, publications, educational programs, and advocacy have been instrumental in advancing cardiovascular health. 

Dr. Elkind noted the AHA’s comprehensive approach to health promotion, extending beyond disease prevention to include the active promotion of ideal cardiovascular health.

Dr. Mariell Jessup, vice-chair of the advisory writing committee and the Association’s chief science and medical officer, highlighted the exponential advancements in cardiovascular science. “Advancements over the past century are far beyond anything the founders of the American Heart Association could imagine,” she said. 

“We know so much more about the molecular and cellular mechanisms of cardiovascular disease and how to treat it; we’ve learned how genetics can play a role in the development of disease; through advances in imaging we can look inside the body and see where clots are formed or where there are structural issues; we can perform open and closed heart surgery, bring a heart back to life through resuscitation and defibrillation and even provide people with a second chance at life through heart transplants.”

Complex challenges 

However, Jessup also acknowledges the existing healthcare disparities, emphasizing the need for equitable access to care and the importance of addressing social and structural determinants of health. 

“It is no longer enough to understand the biological mechanisms of cardiovascular diseases. Future scientific approaches must also look at the epigenetic mechanisms, those behavior and environmental interactions that may lead to the development of cardiovascular disease. That encompasses fundamental social and structural factors such as education, housing, transportation, quality of neighborhood resources, air and water quality, access to care and chronic psychosocial stress,” she explained.

Looking ahead, the advisory outlines a future where enhanced scientific literacy, adoption of nontraditional healthcare approaches, appreciation for the interconnectedness of organ systems, and increased funding for research are paramount. These strategies are vital for addressing the complex challenges of cardiovascular health in the 21st century and beyond.

Unwavering commitment 

In a commentary accompanying the advisory, Nancy Brown, Chief Executive Officer of the American Heart Association, reflected on the organization’s unwavering commitment to science and research. “This century of scientific know-how means we have many proven solutions to offer. Our next century is a thrilling opportunity for advancing our knowledge and hopefully even defeating heart disease and stroke,” she said.

Brown’s statement encapsulates the advisory’s overall outlook and the AHA’s enduring mission, underscoring the organization’s dedication to improving and extending lives through scientific research and advocacy. As the AHA embarks on its next century, the advisory stands as both a testament to the organization’s historical impact and a clarion call for continued innovation, collaboration, and advocacy in the fight against cardiovascular diseases and stroke.

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