Cardiovascular disease (CVD), the number one cause of death and disability in the Western world, now holds this same distinction worldwide. Despite improvements in treatment, the aging of the population, the global spread of smoking, and the growing epidemics of obesity and diabetes ensure that CVD rates will continue to increase.
Yet, the current generation has similarly seen remarkable progress in the treatment of CVD. In 1955, when President Eisenhower had his myocardial infarction, about a third of such patients died during hospitalization. Among those who survived, their long-term prognosis was poor. In Eisenhower's time, treatment was limited to supportive care and bed rest. Since then, acute outcomes have improved from the wide availability of first responder systems, cardiopulmonary resuscitation, cardiac defibrillators, coronary care units, antithrombotic agents, as well as cardiac catheterization and acute coronary revascularization. Therapeutic options for reducing secondary events have also expanded to include chronic antiplatelet agents, β-blockers, angiotensin-converting enzyme inhibitors, and statins. Moreover, the current generation has benefited from earlier identification and control of cardiac risk factors and better tools for diagnosis of CVD. Combined, deaths from CVD have declined in the United States by 33.6% from 1997 to 2007.1