ABSTRACT
A historical perspective Cardiovascular disease is the number one killer in the United States. Though it has remained high on the mortality statistics for a long time, the fact that cardiovascular disease causes more deaths than cancer on an annual basis still comes as a surprise to many. This may be in part due to the fact that factors that lead to the development of cardiovascular disease and its eventual bleak outcome in terms of both morbidity and mortality have remained largely elusive since the mid-20th century. In the early half of the 20th century, deaths due to cardiovascular diseases were extremely high, and it was observed that the association of mortality due to cardiovascular disease with advancing age alone was at best a simplistic approach to this complex problem since younger people suffering from cardiovascular diseases also faced bleak outcomes. The fact that President Truman established the National Heart, Lung, and Blood Institute at the National Institutes of Health in 1948 to focus tax dollars on the epidemic of cardiovascular disease clearly establishes the seriousness and the huge negative impact it was having, and still continues to have, on the American society and economy (National Heart, Lung, and Blood Institute 2015). Later in that century, the milestone Farmingham clinical study was undertaken to try to identify the etiology and the risk factors associated with the development of cardiovascular disease, recognizing that its pathogenesis was complex and perhaps multifactorial (Farmingham Heart Study 2015).
