One hundred years ago this week, six Chicago-based cardiologists got together to formally discuss America’s unfolding heart health crisis.
These regular pontifications would soon go on to become the most influential health organization in the country – and one of the biggest in the world; the American Heart Association.
And to mark the charity’s centennial birthday, the Association has released a fascinating trip down memory lane – documenting the astonishing changes in the treatment and burden of the disease that is the nation’s biggest killer.
Not least that, since its launch, the number of people dying from heart disease has been slashed by 70 percent.
Age-adjusted deaths per 100,000 people due to heart disease have been steadily declining since 1950. Death rates have plummeted from almost 600 per 100,000 in 1950 to around 160 per 100,000 deaths in 2018
Heart disease is the number one killer of Americans, accounting for one in every five deaths, followed by cancer
Senior members of the body have commented on the miraculous transformation in the outlook for patients – and told of the time when ‘natural’ remedies were the only treatments.
American Heart Association chief executive officer Nancy Brown said the organization came about at a time of ‘almost unbelievable ignorance’ about heart disease.
She said: ‘Through our relentless pursuit of lifesaving research, science and innovation, and our unwavering support of patients, families and caregivers, we are creating healthier communities everywhere and transforming the way we all live, work and play, to empower longer, healthier lives.’
The occasion has shed fresh light on the major strides America has taken in the war on heart disease.
While the condition was, back then, a guaranteed death sentence, today, roughly three-quarters of men who have a heart attack are still alive five years later. The same is true for roughly half of women.
However, heart disease remains the number one killer of Americans, accounting for one in every five deaths. Close to 700,000 people die of heart disease in the US every year.
So what have we achieved so far – and what are doctors doing right now to reduce deaths in the future?
The American Heart Association is the nation’s largest and oldest voluntary organization devoted to fighting heart disease and stroke.
The inspiration for the group’s formation came in 1911 from Mary Wadley, a nurse and social worker at Bellevue Hospital in New York City, who felt more could be done for people who suffered from heart disease.
The disease was a steadily rising problem due to skyrocketing obesity rates, a decrease in physical activity linked to increased office work and decreased factory and farming work.
Changes in diet, including more processed foods, and lifestyle behaviors such as smoking also contributed to the increase.
And as Americans gained more access to cars, this led to a decrease in regular exercise.
At that time, the outlook for heart disease was considered so dire that doctors were reluctant to tell their patients they had it – as there was little healthcare professionals could do to help.
‘One hundred years ago, heart disease was considered a death sentence,’ said the late Dr Paul Dudley White, one of the American Heart Association’s founders.
Little was known about what caused it and even less about how to care for people living with and dying from it,’ said Dr Paul Dudley White, one of the American Heart Association’s founders.
‘It was recommended that patients with serious heart disease not be informed of this, but that a friend or relative should be,’ said renowned cardiologist and preeminent scientist Dr Eugene Braunwald, who, aged 94, is often called the ‘father of cardiology.’
Dr Baunwald explained that, at the time, treatments for heart disease were restricted to lowering salt intake, bathing in warm water and regular irrigation of the colon.
And if someone survived a heart attack, there was no specific treatment apart from bed rest and a liquid diet, with the hope that rest would allow the heart muscle time to heal.
But some doctors were drawing on early evidence that suggested weight loss could slow the development of the condition.
The term heart disease refers to several types of heart conditions, the most common of which is coronary artery disease.
The conditions occur when plaque builds up in the arteries and blood vessels that lead to the heart, blocking oxygen and vital nutrients from reaching the heart.
Heart disease first emerged as a threat in the mid-20th century and has remained the leading cause of death worldwide.
In the early 1900s, treatments for heart disease were restricted to lowering salt intake, bathing in warm water and regular irrigation of the colon. Now, there are more than 350 drugs for heart disease, including ones that widen blood vessels, including ACE inhibitors and beta blockers, which help lower blood pressure and decrease how hard your heart is working
Southern states are more at risk of high death rates from heart disease, data from the CDC showed
One reason heart disease is so deadly is that it often doesn’t show many obvious signs until it’s already late stage.
But improved diagnosis methods are helping to spot the condition before it is too late.
In the 1920s, the first electrocardiogram (ECG) machine was installed in Los Angeles. This records the electrical signal from the heart to check it is functioning properly, which allows doctors to more accurately evaluate and diagnose heart conditions.
Echocardiograms followed in the 1950s, which can help detect heart failure and damage from a heart attack.
But the sometimes silent nature of the condition remains an issue. Plus, things like heart attacks manifest differently in the genders and are sometimes diagnosed weeks or months later.
Now, there is a host of treatments and prevention measures for heart disease, including artificial heart valves, pacemakers, cholesterol-lowering medications and techniques for CPR.
There has also been a reduction in risk factors linked to heart disease, such as high blood pressure, high cholesterol, smoking, and obesity.
American scientist Ancel Keys discovered in the 1950s that heart disease was rare in Mediterranean populations where people ate a lower-fat diet, which led to wider public awareness of how diet affected heart health.
In the 1960s and 1970s, treatments such as bypass surgery and percutaneous balloon angioplasty were first tried to help treat heart disease.
Stents entered the scene a decade later. These are small mesh tubes implanted in the artery to prevent it from narrowing.
There are a range of drugs that widen blood vessels, including ACE inhibitors and beta blockers, which help lower blood pressure and decrease how hard your heart is working.
Calcium channel blockers lower blood pressure by allowing blood vessels to relax.
Nitrates, such as nitroglycerin, dilate your coronary arteries and relieve or prevent angina (chest pain). Ranolazine treats coronary microvascular disease and the chest pain it may cause.
There are also medicines to manage cholesterol levels in the blood, including statins, which slow down plaque buildup.
Most recently, drugs for weight management, such as semaglutide, have been shown to reduce the risk of heart disease in people who are overweight or obese.
