Cardiovascular Drugs: From Nitroglycerin to Lipitor

Cardiovascular diseases are the leading cause of death worldwide and are projected to remain in the lead through 2025. Heart-related diseases include angina, arrhythmia, atrial fibrillation, congestive heart failure, hypertension, atherosclerosis, myocardial infarction (heart attack), and sudden cardiac death. More than 300,000 Americans suffer sudden heart attacks each year. In addition, one of the more important recently identified drug-induced cardiac events, which has occasionally resulted in drugs being withdrawn, is drug-induced torsade des pointes. This is a rare, fatal arrhythmia that has been associated with some drugs that prolong the QT interval of the electrocardiogram (ECG). Hypertension is America’s number one chronic disease. Fifty million Americans, one in six, suffer from high blood pressure. Similarly, high blood pressure affects about one-sixth of the world’s population (1 billion people) worldwide—mostly in the developed world. If uncontrolled, it can lead to heart attack, heart failure, stroke, and other potentially fatal events. Great strides have been made during the past 50 years in conquering cardiovascular diseases. Cardiopulmonary resuscitation (CPR) was developed by a group of researchers at the Johns Hopkins University in 1961. The 1960s also saw the emergence of beta-blockers. Calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors, and statins appeared in the 1980s and the 1990s. Angiotensin II receptor blockers (ARBs) also emerged in the 1990s. The heart, about the size of a person’s fist, beats about 2.8 billion times in a lifetime, pumping blood and oxygen through the body. Although its function was shrouded in mystery for centuries, mankind has come a long way in understanding how the heart works anatomically and physiologically, although we haven’t made much progress in understanding its “emotional” nature. Greek philosopher and anatomist Aristotle (384–322 B.C.) was the founder of biology. He was very interested in human and animal anatomy, especially the cardiovascular systems in higher animals. In his books he described, for the first time, the human blood system with an emphasis on the deeper-lying vessels. He incorrectly believed that the heart was the organ in which emotions were generated, whereas the function of the brain was to cool the blood. More than 500 years later, the German-born Roman physician Galen (130–200 A.D.) made two revolutionary discoveries about the cardiovascular system.