Overview of heart disease

Heart disease is the number one killer of men and women in the United States today.

The Centers for Disease Control and Prevention (CDC) estimate that heart disease causes about 1 in 4 deaths in the United States each year. That’s 610,000 people per year. About 735,000 people in the United States have a heart attack each year.

Heart disease is considered one of the top preventable causes of death in the United States. Some genetic factors can contribute, but the disease is largely attributed to poor lifestyle habits.

Among these are poor diet, lack of regular exercise, tobacco smoking, alcohol or drug abuse, and high stress. These are issues that remain prevalent in American culture, so it’s no wonder that heart disease is of great concern.

Has this disease always plagued the human race or is our modern lifestyle to blame? A look back at the history of heart disease may surprise you.

At the 2009 American Heart Association meeting in Florida, researchers presented study results showing that Egyptian mummies, some 3,500 years old, had evidence of cardiovascular disease — specifically atherosclerosis (which narrows the arteries) in different arteries of the body.

Pharaoh Merenptah, who died in the year 1203 BCE, was plagued by atherosclerosis. Of the other mummies studied, 9 of the 16 also had probable-to-definite evidence of the disease.

How could this be possible? Researchers theorized that diet could be involved. High-status Egyptians may have eaten a lot of fatty meats from cattle, ducks, and geese.

Beyond that, the study brought up some interesting questions and has prompted scientists to continue their work to fully understand the condition.

The findings suggest that we may have to look beyond modern risk factors to fully understand the disease,” said co-principal investigator on the study, clinical professor of cardiology Dr. Gregory Thomas.

To say exactly when civilization first became aware of coronary artery disease (arterial narrowing) is difficult. However, it’s known that Leonardo da Vinci (1452–1519) investigated coronary arteries.

William Harvey (1578–1657), physician to King Charles I, is credited with discovering that blood moves around the body in a circulatory manner from the heart.

Friedrich Hoffmann (1660–1742), chief professor of medicine at the University of Halle, noted later that coronary heart disease started in the “reduced passage of the blood within the coronary arteries,” according to the book “Drug Discovery: Practices, Processes, and Perspectives.

Angina — tightness in the chest that’s often an indicator of ischemic heart disease — puzzled many physicians in the 18th and 19th centuries.

First described in 1768 by William Heberden, it was believed by many to have something to do with blood circulating in the coronary arteries, though others thought it was a harmless condition, according to the Canadian Journal of Cardiology.

William Osler (1849–1919), physician in chief and professor of clinical medicine at Johns Hopkins Hospital, worked extensively on angina and was one of the first to indicate that it was a syndrome rather than a disease in itself.

Later, in 1912, the American cardiologist James B. Herrick (1861­–1954) concluded that the slow, gradual narrowing of the coronary arteries could be a cause of angina, according to the University of Minnesota.

The 1900s mark a period of increased interest, study, and understanding of heart disease. In 1915, a group of physicians and social workers formed an organization called the Association for the Prevention and Relief of Heart Disease in New York City.

In 1924, multiple heart association groups became the American Heart Association. These doctors were concerned about the disease because they knew little about it. The patients they typically saw with it had little hope for treatment or a fulfilling life.

Just a few years later, doctors began to experiment with exploring the coronary arteries with catheters. This would later become left heart catheterization (with coronary angiogram).

Today, these procedures are commonly used to evaluate or confirm the presence of coronary artery disease and to determine the need for further treatment.

Both Portuguese physician Egas Moniz (1874–1955) and German physician Werner Forssmann (1904–1979) are credited as pioneers in this field, according to the American Journal of Cardiology.

In 1958, F. Mason Sones (1918–1985), a pediatric cardiologist at the Cleveland Clinic, developed the technique for producing high-quality diagnostic images of the coronary arteries. The new test made an accurate diagnosis of coronary artery disease possible for the first time.

In 1948, researchers under the direction of the National Heart Institute (now called the National Heart, Lung, and Blood Institute) initiated the Framingham Heart Study, the first major study to help us understand heart disease, according to an article in the Lancet journal.

In 1949, the term “arteriosclerosis” (known as “atherosclerosis” today) was added to the International Classification of Diseases (a diagnostic tool), which caused a sharp increase in reported deaths from heart disease.

In the early 1950s, University of California researcher John Gofman (1918–2007) and his associates identified today’s two well-known cholesterol types: low-density lipoprotein (LDL) and high-density lipoprotein (HDL), according to the University of Minnesota. He discovered that men who developed atherosclerosis commonly had elevated levels of LDL and low levels of HDL.

Also in the 1950s, American scientist Ancel Keys (1904–2004) discovered in his travels that heart disease was rare in some Mediterranean populations where people consumed a lower-fat diet. He also noted that the Japanese had low-fat diets and low rates of heart disease as well, leading him to theorize that saturated fat was a cause of heart disease.

These and other developments, including results from the Framingham Heart Study, led to the first attempts at urging Americans to change their diets for better heart health.

It was in the 1960s and 1970s that treatments like bypass surgery and percutaneous balloon angioplasty were first used to help treat heart disease, according to the Society for Cardiovascular Angiography and Interventions.

In the 1980s, the use of stents to help prop open a narrowed artery came into play. As a result of these treatment advances, a diagnosis of heart disease today is not necessarily a death sentence.

Also, in 2014, the Scripps Research Institute reported a new blood test that may be able to predict who is at high risk for the occurrence of a heart attack.

Physicians are also looking to change some misconceptions about low-fat diets. The link between saturated fats, trans fats, and heart disease continues to be controversial; however, we now know that some fat is actually good for your heart.

Unsaturated fats help reduce undesired cholesterol levels while promoting overall heart health. Look for monounsaturated or polyunsaturated fats as well as omega-3 fatty acid sources. Good sources of monosaturated fat include olive oil, sesame oil, and peanut oil. Good sources of polyunsaturated fats and omega-3 fatty acid include fish, walnuts, and brazil nuts.

Today, we know more about how to treat coronary artery disease (atherosclerotic, narrowed coronary arteries) to lengthen and improve quality of life. We also know more about how to reduce our risk of heart disease in the first place.

We don’t yet know it all. And we’re still a long way from completely erasing heart disease from human history.