The International Society of Cardiology (ISC) and CVD Epidemiology
Just as the American Heart Association was once a strictly professional society of North American cardiologists, so too was the International Society of Cardiology (ISC), founded in the late 1940s, a club for academic cardiologists and senior consultants. Its primary function was to organize a grandiloquent quadrennial World Congress of Cardiology where peer specialists and the academic elite might strut their stuff. Topics of epidemiology and prevention of CVD were nowhere to be found on the agenda of the first congress, held in Paris in 1950, but by the time of the second congress in Washington in 1954, Paul Dudley White and Ancel Keys had claimed an important place for these subjects on the program. With the additional support of James Watt, newly appointed NHI director and the nation’s host to the World Congress, White and Keys led the first-ever plenary symposium on CVD epidemiology. The historic discussion was subsequently published as a “little green book” that was not widely circulated (Keys and White 1956).
As co-chairs of the ISC Research Committee during the 1950s and early ‘60s, White and Keys guided the organization, which was by then a consortium of regional professional societies to encourage research and formal training in CVD epidemiology among young cardiologists. The two men co-opted other leaders of international cardiology into conferences convened in exotic places such as Mexico City (1962), the Dalmatian coast (1963 and 1968), and Venice (1965) to discuss the design, methods, and overall needs of population research and training for CVD.
During this period, the committee proposed collaborative researches and focused on the development of field methods, formally requesting that WHO prepare a manual on such methods. The resulting book, Cardiovascular Survey Methods, was begun in 1964 and finally published in 1968, and reached an international audience (Rose and Blackburn 1968). In 1966, along with other international leaders at the World Congress in New Delhi, the Research Committee helped mold the ISC into scientific councils for cardiovascular specialties, a la American Heart Association. The council of greatest interest to CVD epidemiology, the ISC Scientific Council on Epidemiology and Prevention, was born there amidst fanfare [see below]. Its cardinal function became the popular International Ten-day Seminars in CVD Epidemiology, launched in 1968 and meeting annually since (Labarthe et al. 1998).
The ISC Scientific Council on Epidemiology and Prevention is born in New Delhi
A huge, brightly colored tent, festooned with flowing banners and lit by flaming tapers, covered a large area adjacent to the Hotel Ashoka and housed the opening reception and banquet of the World Congress of Cardiology in New Delhi in fall 1966. Steaming tables of saffron rice and roast chicken, endless varieties of legumes and vegetables, and groaning boards of sweets tempted the delegates gathered in the exotic setting. The main organizational business of the congress would include formation of the International Society’s eight new scientific councils, including the Council on Epidemiology and Prevention. After twelve years of planning and politicking by White, Keys, and colleagues, the new council was formally charged with the development of standard field methods and criteria, of training programs for researchers, of collaborative population studies and prevention trials, and of public-policy recommendations for CVD prevention.
Thus, the festive opening of the congress was full of promise for the preventionists. Unhappily, in the days immediately following the grand reception, many delegates found themselves ill-adapted to the exotic cuisine and their organizational tasks had to be borne by those few who remained upright and vigorous.
The minutes of the organizational meeting in New Delhi included two ideas forming the framework of the new Council’s intent. The first was “recognition that a key strategy in the control of epidemic cardiovascular disease–particularly coronary heart disease–was primary prevention.” A second was based on the observation that incidence of these diseases varied greatly among the world’s populations, and that “study of the factors related to these differences–that is, epidemiological investigations–could help form the necessary scientific foundation for prevention” (International Society of Cardiology 1966).
After incorporation, the new council’s main undertaking was training young investigators in epidemiology, for which it planned the annual International Ten-Day Seminars on Cardiovascular Epidemiology and Prevention, the first of which was held in Makarska, Yugoslavia in 1968.
International Cardiology Foundation (ICF) and International Society and Foundation of Cardiology (ISFC)
In 1969, through the initiative of Paul White and Louis Katz, the International Cardiology Foundation (ICF) was formed and registered in Geneva to raise funds for the scientific and medical programs of the ISC. As sometimes happens among connected organizations with differing roles and goals, tensions developed between the academic leadership of the ISC and the lay leadership of the Foundation. In 1978, after some years of difficult deliberations, peaceable relations were brought about–again, thanks largely to the diplomatic efforts of Paul White–at the Eighth World Congress of Cardiology in Tokyo, when the two groups merged into a single body. The new organization was called the International Society and Foundation of Cardiology (ISFC), and all the regional and national cardiological societies–Asian-Pacific, Inter-American, North American, and European –became members.
From the 1970s, the ISFC Council on Epidemiology became increasingly involved in policy, with members preparing reports on medical and public health strategies of prevention and control of CVD that provided for studies and programs for both primary and secondary prevention. The Council also played a central role in setting up collaborative researches including the European Multiple Risk Factor Trial in Industry and the MONICA Project of surveillance.
These activities of the ISC in its several configurations were central to the evolution of CVD epidemiology internationally and to the dissemination of concepts and methods of CVD prevention. The International Council on Epidemiology and Prevention became a critical force in CVD prevention research beyond, different from, and independent of academic epidemiology.
In 1998, the ISFC reorganized yet again into the World Heart Federation (WHF), with new officers and constitution and a new focus on influencing government policies. Within the next decade, the WHF dissolved the scientific councils of the ISFC and their professional programs and training seminars. The old councils were cut loose to continue as autonomous organizations. The Council, renamed the International Council of Cardiovascular Epidemiology and Prevention, happily found sources of support for its conferences and for its popular Ten-day Seminars.
In 2001 in Osaka, the International Conference on Preventive Cardiology merged with the World Congress of Cardiology into the WHF International Heart Health Conference, which then promoted a series of authoritative statements to guide governments and non-governmental agencies in promoting cardiovascular health (Farquhar et al 1992). (Henry Blackburn)
Chairs of the International Society of Cardiology Scientific Council on Epidemiology and Prevention and their years of service: Ancel Keys, 1966-70; Jeremy Morris, 1970-74; Jeremiah Stamler, 1974-78; Geoffrey Rose, 1978-82; Kalevi Pyorala, 1982-86; Henry Blackburn, 1986-90; Lars Wilhelmsen, 1990-94; Darwin Labarthe, 1994-98; Dag Thelle, 1998-02; Srinath Reddy, 2002-07; Kay Tee Khaw, 2007-present. The first International Conference on Preventive Cardiology was organized in 1985 in Moscow by Russian cardiologist Evgueni Chazov during the time of the Cold War. Chazov and cardiologist Bernard Lown of Boston were co-founders of International Physicians for the Prevention of Nuclear War, which received the Nobel Peace Prize in 1985.
Farquhar, J. W., and D. R. MacLean. 1992. The Victoria Declaration on Heart Health. Victoria, Canada: Health and Welfare Canada.
International Society of Cardiology. 1966. Minutes of the New Delhi meeting. Geneva: ISC Archives.
International Society and Foundation of Cardiology. 1987. Statement of the Scientific Council on Epidemiology and Prevention. Geneva: ISC Archives.
Keys, A., and P.D. White (Eds.) 1956. Cardiovascular epidemiology. Selected papers from the Second World Congress of Cardiology and Twenty-seventh Annual Scientific Sessions of the American Heart Association. New York. Hoeber-Harper.
Labarthe, D., K. T. Khaw, D. Thelle, and N. Poulter. 1998. The Ten Day International Teaching Seminar on Cardiovascular Epidemiology and Prevention: a 30-year perspective. CVD Prevention 1:156-66.
Rose, G., and H. Blackburn. 1968. Cardiovascular survey methods. WHO technical report series no. 56. Geneva: World Health Organization.