I recently celebrated the 40th anniversary of my graduation from medical school at a class reunion in Boston. While reminiscing with my former classmates about the joys and tribulations of living as a student during the 1960s, a discussion arose regarding what was available to us then in the area of pharmacotherapeutics compared with what is now available for practicing physicians. In regard to treatments for cardiovascular disease, my area of internal medicine subspecialty, we had nitrates for angina pectoris; digitalis preparations and furosemide for heart failure; hydrochlorothiazide, reserpine, guanethidine, hydralazine, and alpha-methyldopa for hypertension; quinidine, lidocaine, and procainamide for arrhythmias; and bile acid resins for hypercholesterolemia. Since 1969, with the advances in basic research supported by the National Institutes of Health (NIH) and the development of new drugs by the pharmaceutical industry, we now have available for clinical use the beta-adrenergic blockers and calcium-entry blockers for the treatment of angina pectoris; angiotensin-converting enzyme inhibitors and angiotensin receptor blockers for heart failure; new drugs for systemic and pulmonary hypertension; thrombolytics for myocardial infarction; statins for hypercholesterolemia; and new antiplatelet drugs. These newer therapies have favorably affected both the prevention and treatment of cardiovascular disease.
As examples, over the past 40 years, major reductions have occurred in the numbers of acute myocardial infarctions, in part related to innovative drug therapies for cholesterol elevations, hypertension, and smoking addiction.
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– William H. Frishman, MD
This article was originally published in the October 2009 issue of The American Journal of Medicine.
