CVD Epidemiology Spreads Around the World

Cardiovascular Disease (CVD) epidemiology and prevention investigations rapidly spread, or arose, beyond the three centers where thinking and formal research and training first developed in Minnesota, Boston-Framingham, and London.

Minnesota’s priority is manifest in Ancel Keys’s study of the “mode of life” and biological markers among middle-aged Minnesota men begun in 1947 and from his peripatetic observations in Naples, Madrid, Cape Town and Japan in the early ‘50s.

The Framingham Study made up an early and independent universe, organized by visionaries in the US Public Health Service. It attracted visitors and presented its findings early and widely in world conferences and in the literature.

The MRC Social Medicine Unit in London, headed by Jeremy Morris, brought to bear social medicine and public health views and statistical skills, juxtaposed with the scholarly influence of Bradford Hill in the London School of Hygiene and Tropical Medicine. It had wide contacts in North America and on the continent.

Scandinavians independently explored cohort observations and prevention trials from the early 1950s.

Starting in the mid-1950s, WHO facilitated the spread of epidemiologic approaches by convening expert committees to ponder causes of CVD and study methods and design, and to set up collaborative programs. Multiple foci of interest and early research tentatives arose elsewhere in Europe and Asia, some independent of, but many within the sphere of influence of one or another of the pioneer groups.

Ancel Keys and Paul White were central to the insertion of CVD epidemiology and prevention concepts into mainstream cardiology internationally, dramatically illustrated by the Symposium they promoted and chaired at the Second World Congress of Cardiology in Washington, DC in fall 1954.

The early academic impact of CVD epidemiology came with publication of the first follow-up risk factor analyses from U.S. cohort studies, published in a supplement to the American Journal of Public Health in fall 1957. (American Journal of Public Health, 1957, 47) (Henry Blackburn)