The Heart Failure Paradox: An Epidemic of Scientific Success
Presidential Address at the American Heart Association 2013 Scientific Sessions
Good afternoon, and welcome to the American Heart Association’s (AHA) Scientific Sessions. I am so excited to be here with you in Dallas.
Texas is a huge state and famous throughout the world for so many things: hospitality and graciousness, oil, cowboys, the Alamo, and of course, the television show Dallas. But I always think of Texas as home to the AHA. So I welcome you with the big heart of Texas and thank you for being here. I am truly honored to address you: healthcare professionals, scientists, educators, students, AHA volunteers, and colleagues from around the world.
Today, I’m going to explore the remarkable yet troubling history of heart failure. The state of this common cardiovascular syndrome is remarkable in many ways, particularly because it illustrates our progress in so many areas of science and medicine. Yet it is also troubling, because in just a few short decades, heart failure has developed into a full-blown epidemic, with 23 million people suffering from the disease worldwide.1–3
Heart failure is, very strangely, an epidemic of scientific success. Mortality from cardiovascular disease in general has been decreasing thanks to scientific breakthroughs, so people are living longer. People who have had heart attacks are also benefitting, thanks to science and programs to deliver that science, such as Mission: Lifeline.4,5 But elderly people and heart attack survivors are both more susceptible to heart failure. And all of these older people (and all of us, by the way) live in a world of growing obesity and diabetes rates that fuel the heart failure epidemic.6,7
I could share hundreds of stories about my patients over the past 30 years who exemplify …