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In the years after World War II, heart attacks killed thousands of middle-aged Americans, many of them soldiers who had returned from conflict. Since then, NIH research has fueled major progress. Beginning with the landmark Framingham Heart Study in the 1940s, key risk factors were identified for cardiovascular disease, including smoking, cholesterol, high blood pressure, and diabetes. Research studies funded by NIH then tested interventions to reduce those risks, showing they could work. These included cholesterol- and blood pressurelowering drugs and lifestyle modifications such as physical activity, a healthy diet, and quitting smoking. Since 1969, heart disease deaths have dropped nearly 70 percent.

But stroke still strikes an American once every 40 seconds and can have catastrophic consequences for a person’s ability to function. In the mid-90s, NIH research led to approval of the drug tissue-type plasminogen activator (tPA), which dissolves stroke-causing clots if given soon after symptoms appear. More recent studies showed that inserting balloon catheters to remove brain clots can prevent further damage in people suffering major strokes. NIH’s Know Stroke awareness campaign has helped thousands learn to recognize stroke as a medical emergency and seek immediate help.

Yet, with heart disease and stroke still the leading causes of death for both U.S. men and women, more research is needed. NIH-funded scientists currently are looking to the power of precision medicine to better understand and manage these disorders. These efforts will combine molecular data with that from behavioral, imaging, environmental, and clinical studies to predict, prevent, diagnose, and treat illness based on a person’s unique genes, lifestyle, and molecular signatures.

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