In the last 50 years, mean life span has increased by almost 8 years. Cardiology has played an important role in this achievement. It has been estimated that the contribution of cardiology to the extension of life accounts for almost 6 years! This depends in part, of course, on the fact that cardiovascular disease itself contributes to more than 50% of total mortality of population, but also largely on the success of interventional cardiology and cardiovascular therapy. The contribution of revascularization by any means, but particularly by primary angioplasty, has changed the natural history of acute myocardial infarction (MI) to the extent that, today, the need for intensive care units to treat acute MI is often questioned. Equally, there have been huge advances in heart surgery for revascularization of complex coronary, valvular, and congenital diseases, and transplantation. Of similar, if not greater, relevance is the contribution of drug therapy to the improved prognosis of patients with cardiovascular disease. The key to this success, at least in my opinion, relates to the recognition by Dzau and Braunwald of a rather simple concept: the continuous progression of cardiovascular diseases leading to different, but related, clinical events. They called this pathophysiological and clinical concept the ‘cardiovascular continuum’. In this model, the progression of cardiovascular diseases starts from risk factors such as hypertension and diabetes, and leads through coronary artery disease (CAD) to myocardial ischaemia (in its own manifestation: angina, infarction, and sudden death), heart failure (HF), and end-stage heart disease. We do not know in detail the intimate cause of this continuum, although atherosclerosis and endothelial damage seem to play a major role.

Key Lessons from morbidity/mortality trials: evidence for benefits of the perindopril/amlodipine combination

FERRARI, Roberto
2008

Abstract

In the last 50 years, mean life span has increased by almost 8 years. Cardiology has played an important role in this achievement. It has been estimated that the contribution of cardiology to the extension of life accounts for almost 6 years! This depends in part, of course, on the fact that cardiovascular disease itself contributes to more than 50% of total mortality of population, but also largely on the success of interventional cardiology and cardiovascular therapy. The contribution of revascularization by any means, but particularly by primary angioplasty, has changed the natural history of acute myocardial infarction (MI) to the extent that, today, the need for intensive care units to treat acute MI is often questioned. Equally, there have been huge advances in heart surgery for revascularization of complex coronary, valvular, and congenital diseases, and transplantation. Of similar, if not greater, relevance is the contribution of drug therapy to the improved prognosis of patients with cardiovascular disease. The key to this success, at least in my opinion, relates to the recognition by Dzau and Braunwald of a rather simple concept: the continuous progression of cardiovascular diseases leading to different, but related, clinical events. They called this pathophysiological and clinical concept the ‘cardiovascular continuum’. In this model, the progression of cardiovascular diseases starts from risk factors such as hypertension and diabetes, and leads through coronary artery disease (CAD) to myocardial ischaemia (in its own manifestation: angina, infarction, and sudden death), heart failure (HF), and end-stage heart disease. We do not know in detail the intimate cause of this continuum, although atherosclerosis and endothelial damage seem to play a major role.
2008
Ferrari, Roberto
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11392/1378851
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