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The National Heart, Lung, and Blood Institute (NHLBI):
June 16, 1948 – President Harry S Truman signed the National Heart Act, creating and establishing the National Heart Institute (NHI) in the Public Health Service (PHS) and the National Advisory Heart Council.
July 7, 1948 – Under section 4b of the Heart Act, Dr. Paul Dudley White was selected to be "Executive Director of the National Advisory Heart Council and Chief Medical Advisor to the National Heart Institute.”
August 1, 1948 – Surgeon General Leonard A. Scheele, by General Circular No. 36, Organization Order No. 14, established the NHI as one of the National Institutes of Health to assume responsibility for heart research, training, and administration asset forth in the National Heart Act. Intramural research projects in cardiovascular diseases (CVD) and gerontology, conducted elsewhere in NIH, were transferred to the NHI. The director of the NHI was designated to lead and coordinate the total heart program of the PHS.
August 29, 1948 – Surgeon General Scheele announced the names of the 16 members appointed to the first National Advisory Heart Council.
September 8, 1948 – The first meeting of the National Advisory Heart Council was held.
January 1949 – Cooperative research units were established at the University of California, University of Minnesota, Tulane University, and Massachusetts General Hospital, and jointly financed by them and NIH, pending completion of the NHI’s own research organization and availability of further research facilities.
July 1, 1949 – A comprehensive plan for the NHI’s intramural research program was initiated and organized on three general research levels, with three laboratory sections, five laboratory-clinical sections, and four clinical sections.
The Heart Disease Epidemiology Study at Framingham, MA, was transferred from the Bureau of State Services, PHS, to the NHI.
January 18-20, 1950 – The first National Conference on Cardiovascular Diseases, sponsored by the NHI and the American Heart Association, was held in Washington, D.C.
July 6, 1953 – The first patient was admitted to the Clinical Center for heart disease research.
July 1, 1957 – The first members of the NHI’s Board of Scientific Counselors began their terms. The Board was established in 1956 “to provide advice on matters of general policy, particularly from a long-range viewpoint, as they relate to the intramural research program.”
February 19, 1959 – A report to the Nation was presented by the American Heart Association and the NHI on “A Decade of Progress Against Cardiovascular Disease,” at Department of Commerce, Washington, D.C.
April 21, 1961 – The President’s Conference on Heart Disease and Cancer, whose participants on March 15 were requested by President John F. Kennedy to assist “in charting the Government’s further role in a National attack” on these diseases, convened at the White House and submitted its report.
November 22-24, 1964 – The Second National Conference on Cardiovascular Diseases was cosponsored by the NHI, American Heart Association, and Heart Disease Control Program of the PHS, to assess developments since the 1950 conference and to determine needs and opportunities for continued and accelerated progress against heart and blood vessel diseases.
December 9, 1964 – The President’s Commission on Heart Disease, Cancer and Stroke, appointed by President Lyndon B. Johnson, March 7, 1964, to “recommend steps that can be taken to reduce the burden and incidence of these diseases,” submitted its report.
October 16, 1968 – A Nobel Prize in Physiology or Medicine was awarded to Dr. Marshall W. Nirenberg, chief of NHI’s Laboratory of Biochemical Genetics, for discovering the key to deciphering the genetic code. Dr. Nirenberg was the first NIH Nobel laureate and the first Federal employee to receive a Nobel Prize.
October 26, 1968 – The NHI received the National Hemophilia Foundation’s Research and Scientific Achievement Award for its “medical leadership ... tremendous stimulation and support of research activities directly related to the study and treatment of hemophilia.”
November 14, 1968 – The 20th anniversary of the NHI was commemorated at the White House, with President Johnson and a notable array of prominent figures associated with the NHI participating.
August 12, 1969 – Major provisions of the NHI reorganization plan established five program branches in extramural programs (arteriosclerotic disease, cardiac disease, pulmonary disease, hypertension and kidney diseases, and thrombosis and hemorrhagic diseases); a Therapeutic Evaluations Branch and an Epidemiology Branch under the Associate Director for Clinical Applications; and three offices in the Office of the Director (heart information, program planning, and administrative management).
November 10, 1969 – The NHI was renamed the National Heart and Lung Institute (NHLI), reflecting expansion of functions.
February 18, 1971 – In his Health Message to the Congress, the President identified sickle cell anemia as a high-priority disease target and called for increased Federal expenditures. Subsequently, the Health, Education, and Welfare (HEW) Assistant Secretary for Health and Scientific Affairs, assigned the NIH and NHLI as the lead-agencies responsible for coordinating a National Sickle Cell Disease Program.
March 24, 1972 – President Nixon named Dr. John S. Millis to head a panel “to determine why heart disease is so prevalent and so menacing and what can be done about it.”
March 27-31, 1972 – The first meeting of U.S.-U.S.S.R. Joint Committee for Health Cooperation was held to develop and plan an approach to the health exchange program in several specific areas, including the cardiovascular field. The NHLI director was a member of the committee.
May 23, 1972 – A 5-year agreement for a Cooperative Health Program was signed by W. P. Rogers, U.S. Secretary of State, and B. V. Petrovsky, U.S.S.R. Minister of Health. The agreement calls for cooperative studies in pathogenesis of arteriosclerosis; management of ischemic heart disease; myocardial metabolism; congenital heart disease; sudden death; and blood transfusions, blood components, and prevention of hepatitis.
June 12, 1972 – HEW Secretary, Elliot Richardson, approved a nationwide program of hypertension information and education. The secretary appointed the Hypertension Information and Education Advisory Committee, chaired by the Director, NIH; and the Interagency Working Group, chaired by the Director, NHLI, to implement the national effort. A High Blood Pressure Information Center was established within the NHLI Office of Information to collect and disseminate public and professional information about the disease.
July 1972 – The NHLI launched the National High Blood Pressure Education Program (NHBPEP).
July 14, 1972 – HEW Secretary Richardson approved a reorganization of NHLI, elevating the Institute to Bureau status within the NIH, with seven division-level components: Office of Director, Division of Heart and Vascular Diseases, Division of Lung Diseases, Division of Blood Diseases and Resources, Division of Intramural Research, Division of Technological Applications, and Division of Extramural Affairs.
July 24, 1973 – The 5-volume National Heart, Blood Vessel, Lung and Blood Program was transmitted to Congress. The comprehensive, 5-year plan of attack against heart, blood vessel, lung and blood diseases, and research and management of blood resources was developed by the director, NHLI, with the advice of the National Heart and Lung Advisory Council, in accordance with the National Heart, Blood Vessel, Lung and Blood Act of 1972 (P.L. 92-423).
April 5, 1974 – The HEW Assistant Secretary for Health released the Report to the President by the President’s Advisory Panel on Heart Disease. It surveys the problem of heart and blood vessel disorders and provides recommendations on how illness and death from these disorders may be reduced.
August 2, 1974 – Regulations were approved governing establishment, support, and operation of the National Research and Demonstration Centers for heart, blood vessel, lung, and blood diseases.
June 25, 1976 – The NHLI was renamed the National Heart, Lung, and Blood Institute (NHLBI), reflecting an expansion in blood-related activities within the Institute.
July 1, 1976 – The NHBPEP released the first Joint National Committee Report on the Detection, Evaluation, and Treatment of High Blood Pressure.
October 28, 1977 – The U.S.-U.S.S.R. Cooperative Health Program was renewed for another 5 years with the signing of an agreement by Dr. Julius B. Richmond, HEW Assistant Secretary for Health, and Dr. Dmitri D. Venedictov, U.S.S.R. Deputy Minister of Health.
February 1978 – The NHLBI and the American Heart Association jointly celebrated their 30th anniversary.
September 1979 – The Task Force on Hypertension, established in September 1975 to assess the current state of hypertension research, completed its in-depth survey and recommendations for improved prevention, treatment, and control in 14 major areas. These recommendations are intended to guide the NHLBI in its future efforts.
November 1979 – The results of the Hypertension Detection and Follow-up Program (HDFP), a clinical trial begun in 1971, provided evidence that tens of thousands of lives are being saved through treatment of mild hypertension and that perhaps thousands more could be saved annually if all people with mild hypertension were under treatment.
November 21, 1980 – The Albert Lasker Special Public Health Award was presented to the Institute for the HDFP, “which stands alone among clinical studies in its profound potential benefit to millions of people.”
September 8, 1981 – A Working Group on Arteriosclerosis, convened in 1978 to assess present understanding, to highlight unresolved problems, and to emphasize opportunities for future research in arteriosclerosis, completed its report in two volumes.
October 2, 1981 – The Beta-Blocker Heart Attack Trial (BHAT) demonstrated benefits to those in the trial who received propranolol compared with the control group.
October 26, 1983 – The Coronary Artery Surgery Study (CASS) results were released. They demonstrated that mildly symptomatic patients with coronary artery disease can safely defer coronary artery bypass surgery until symptoms worsen. Results of this clinical trial will help patients and their physicians decide whether and when bypass surgery should be undertaken. They can base their decisions on firmer scientific footing.
January 12, 1984 – The Lipid Research Clinics Coronary Primary Prevention Trial established conclusively that reducing total blood cholesterol reduces the risk of coronary heart disease in men at increased risk because of raised cholesterol levels. Each 1 percent decrease in cholesterol can be expected to reduce heart attack risk by 2 percent.
April-September 1984 – The Tenth Report of the Director, NHLBI, commemorated the 10th anniversary of the passage of the National Heart, Blood Vessel, Lung, and Blood Act. The publication reviews 10 years of research progress and presents a 5-year research plan for the national program.
April 1984 – The Division of Epidemiology and Clinical Applications was created to provide the Institute with a focus on clinical trials; prevention, demonstration, and education programs; behavioral medicine; nutrition; epidemiology; and biometry. It also provides opportunities to examine the interrelationships of cardiovascular, respiratory, and blood diseases.
April 1985 – Results of Phase I of the Thrombolysis in Myocardial Infarction (TIMI) Trial comparing streptokinase (SK) with tissue plasminogen activator (rt-PA) were published. The new thrombolytic agent rt-PA is approximately twice as effective as SK in opening thrombosed coronary arteries.
October 1985 – The NHLBI Smoking Education Program was initiated.
November 1985 – The National Cholesterol Education Program (NCEP) was inaugurated.
June 1986 – Results of the Prophylactic Penicillin Trial were released. They demonstrate the efficacy of prophylactic penicillin in reducing morbidity and mortality associated with pneumococcal infections in children with sickle cell disease.
October 1986-September 1987 – The NHLBI celebrated its 40th anniversary and the NIH centennial with a year-long series of events. Activities included symposia and conferences, commemorative publications and exhibits, and a reunion of former NHLBI directors.
October 1987 – The NHLBI established the National Blood Resource Education Program.
March 1989 – The NHLBI initiated the National Asthma Education Program (NAEP).
September 1990 – Scientists from the NHLBI and the National Cancer Institute began the first gene therapy trial in a human patient, a 4-year-old girl with an inherited immune dysfunction.
January 1991 – The NHLBI Obesity Education Initiative began to educate the public and health professionals about obesity as an independent risk factor for CVD and its relationship to other risk factors such as high blood pressure and high blood cholesterol.
February 1991 – An expert panel of the NAEP released Guidelines for Diagnosis and Management of Asthma to educate physicians and other health care providers in asthma management.
June 11, 1991 – The National Heart Attack Alert Program was established.
July 1991 – Results of the Systolic Hypertension in the Elderly Program were released, demonstrating that low-dose pharmacologic therapy of isolated systolic hypertension in those over age 60 significantly reduces stroke and myocardial infarction.
August 1991 – Results of the Studies of Left Ventricular Dysfunction were released, demonstrating that use of enalapril – an angiotensin converting enzyme inhibitor – causes significant reduction in mortality and hospitalization for congestive heart failure in patients with symptomatic heart failure.
October 30, 1992 – A celebration of the 20th anniversary of the NHBPEP was held in conjunction with the NHBPEP coordinating committee meeting. The fifth Joint National Committee Report on the Detection, Evaluation, and Treatment of High Blood Pressure and the first NHBPEP Working Group Report on the Primary Prevention of Hypertension were released.
June 15, 1993 – The Second Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults was released.
January 30, 1995 – Results of the Multicenter Study of Hydroxyurea were released through a clinical alert. They demonstrated that hydroxyurea reduced the number of painful episodes by 50 percent in severely affected adults with sickle cell disease. This is the first effective treatment for adult patients with the disorder.
September 21, 1995 – Results of the Bypass Angioplasty Revascularization Investigation were released through a clinical alert. They demonstrated that patients on drug treatment for diabetes who had blockages in two or more coronary arteries and were treated with coronary artery bypass surgery (CABG) had, at 5 years, a markedly lower death rate than similar patients treated with angioplasty. The clinical alert recommends CABG over standard angioplasty for patients on drug therapy for diabetes who have multiple coronary blockages and are first-time candidates for either procedure.
November 5-6, 1995 – A Conference on Socioeconomic Status (SES) and Cardiovascular Health and Disease was held to determine future opportunities and needs for research on SES factors and their relationships with cardiovascular health and disease.
December 4-5, 1995 – A celebration of the 10th anniversary of the NCEP was held in conjunction with the NCEP Coordinating Committee meeting. Results of the 1995 Cholesterol Awareness Surveys of physicians and the public were released.
May 21, 1996 – The NHLBI announced results from the Framingham Heart Study that concluded earlier and more aggressive treatment of hypertension is vital to preventing congestive heart failure. Lifestyle changes, such as weight loss, a healthy eating plan, and physical activity, are crucial for reducing blood lipids in those treated for Stage I hypertension.
September 1996 – Findings from the Asthma Clinical Research Network indicated that taking an inhaled beta-agonist at regularly scheduled times is safe for people with asthma but provides no greater benefit than taking the medication only when asthma symptoms occur. Recommendation to physicians who treat patients with mild asthma is to prescribe inhaled beta-agonists only on an as-needed basis.
November 13, 1996 – The NHLBI released findings from two studies that show lifestyle changes, such as modifying one’s diet and losing weight, substantially reduce blood pressure in adults and can keep older patients off antihypertensive medication.
January 27 1997 – Results from the Pathobiological Determinants of Atherosclerosis in Youth program were published. They showed that atherosclerosis develops before age 20, that high density lipoprotein cholesterol, low density lipoprotein cholesterol, and cigarette smoking affect progression of atherosclerosis equally in women and men regardless of race.
February 24, 1997 – The NAEPP released the Expert Panel Report 2, Guidelines for the Diagnosis and Management of Asthma to the public in conjunction with a meeting of the American Academy of Allergy, Asthma, and Immunology in San Francisco.
April 14, 1997 – The NHLBI stopped early an arrhythmia study comparing two treatment strategies, an implantable cardiac defibrillator versus antiarrhythmic drug treatment, for patients with life-threatening heart arrhythmias. Results demonstrated that implantable cardiac defibrillators are superior to drug therapy for improving overall survival.
September 18, 1997 – Results of the Stroke Prevention Trial in Sickle Cell Anemia (STOP) were released through a clinical alert. They showed that periodic red blood cell transfusions reduce by 90 percent the rate of stroke found in high-risk children with sickle cell anemia
October 1997-September 1998 – The NHLBI celebrated 50 years with a year-long series of events. Activities included scientific symposia and conferences and commemorative publications and exhibits.
November 6, 1997 – The NHBPEP released The Sixth Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-VI).
February 12, 1998 – The Task Force on Behavioral Research in Cardiovascular, Lung, and Blood Health and Disease, established in November 1995 to develop a comprehensive plan for NHLBI support of research on health and behavior in cardiovascular, lung, and blood diseases and sleep disorders, presented its recommendations.
June 17, 1998 – The NHLBI, in cooperation with the National Institute of Diabetes and Digestive and Kidney Diseases, released the Clinical Guidelines on the Identification, Treatment, and Evaluation of Overweight and Obesity in Adults: Evidence Report.
March 15, 1999 – The NHLBI announced that a large clinical trial of mechanical ventilator use for intensive care patients with acute respiratory distress syndrome (ARDS) has been stopped early. Results demonstrated that approximately 25 percent fewer deaths occurred among intensive care patients with ARDS receiving small, rather than large, breaths of air from a mechanical ventilator.
August 1999 – Results of the Early Revascularization for Cardiogenic Shock were released. They showed, at 6 months, improved survival in patients treated with balloon angioplasty or coronary bypass surgery compared with patients who received intensive medical care to stabilize their condition.
September 2000 – NHLBI-supported investigators identified a gene for primary pulmonary hypertension.
January 2001 – Results of the DASH Sodium Trial were released. They showed that dietary sodium reduction substantially lowers blood pressure in persons with high blood pressure; the greatest effect was seen when sodium reduction was combined with the DASH diet.
February 1, 2001 – The NHLBI, along with the DHHS Office of Disease Prevention and Health Promotion, the Office of the Surgeon General, the Centers for Disease Control and Prevention, the National Institute of Neurological Disorders and Stroke, and the American Heart Association, signed a memorandum of understanding to focus and coordinate their efforts to meet the Healthy People 2010 objectives on cardiovascular health.
April 2001 – The NHLBI released the International Guidelines for chronic obstructive pulmonary disease (COPD).
April 2001 – NHLBI-supported investigators identified genes that regulate human cholesterol levels.
June 2001 – NHLBI-supported investigators found that human heart muscle cells regenerate after a heart attack.
July 2001 – A self-contained artificial heart was implanted in a patient for the first time.
August 2001 – Early results from the National Emphysema Treatment Trial identified characteristics of patients at high risk for death following lung volume reduction surgery.
August 2001 – Scientists from the NHLBI-funded SCOR program at Yale University identified two genes responsible for pseudohypoaldosteronism type II, a rare Mendelian form of high blood pressure. These genes encode for protein kinases involved in a previously unknown pathway, and may provide potential new targets for therapy.
September 10, 2001 – The NHLBI, along with the American Heart Association and other partners, launched a national "Act in Time to Heart Attack Signs" campaign to increase awareness of the signs of heart attack and the need for a fast response.
April 10, 2002 – The World Hypertension League (WHL) and the NHLBI held an international symposium; subsequently they prepared an action plan at the WHL Council Conference to control hypertension and obesity.
July 9, 2002 – The NHLBI stopped early the trial of estrogen plus progestin component of the WHI due to increased breast cancer risk and lack of overall benefits. The multicenter trial also found increases in coronary heart disease, stroke, and pulmonary embolism in participants on estrogen plus progestin compared to women taking placebo pills.
June 16, 1948 – The National Heart Act (P.L. 80-655) authorized NHI. The act's purpose was "To improve the health of the people of the United States through the conduct of researches, investigations, experiments, and demonstrations relating to the cause, prevention, and method of diagnosis and treatment of diseases of the heart and circulation; assist and foster such researches and other activities by public and private agencies, and promote the coordination of all such researches and activities and the useful application of their results; provide training in matters relating to heart diseases, including refresher courses for physicians; and develop, and assist States and other agencies in use of the most effective methods of prevention, diagnosis, and treatment of heart diseases."
December 30, 1963 – House Joint Resolution 848 (P.L. 88-254) was approved, that authorized and requested the President to issue an annual proclamation designating February as American Heart Month, inviting governors of states and territories to issue similar proclamations.
May 16, 1972 – The National Sickle Cell Anemia Control Act (P.L. 92-294) established a national program for diagnosis, control, and treatment of and research in sickle cell anemia. The act did not mention NHLI but had special pertinence because NHLI was designated to coordinate the National Sickle Cell Disease Program.
September 19, 1972 – The National Heart, Blood Vessel, Lung, and Blood Act of 1972 (P.L. 92-423) enlarged institute authority to advance the national attack on heart, blood vessel, lung, and blood diseases. The act provided for expanded, intensified, and coordinated institute activities in accordance with a comprehensive, specified National Heart, Blood Vessel, Lung, and Blood Disease Program to be planned by the director and the Advisory Council.
Other provisions include establishment of prevention and control programs; development of 15 new centers for basic and clinical research, training, demonstration, and prevention programs for heart, blood vessel, and blood diseases; and development of 15 such centers for chronic lung diseases.
June 25, 1976 – Title I of the Health Research and Health Services Amendments of 1976 (P.L. 94-278) redesignated NHLI as NHLBI to advance the national attack on heart, blood vessel, lung, and blood diseases, and to conduct research in use of blood and blood products and in management of blood resources. The NHLBI director and the institute Advisory Council continue to plan the national program under the basic P.L. 92-423 provisions with some refinements.
August 1, 1977 – The Biomedical Research Extension Act of 1977 (P.L. 95-83) reauthorized NHLBI, with continued emphasis on both the national program and related prevention and dissemination activities.
December 17, 1980 – The Health Programs Extension Act of 1980 (P.L. 96-538) reauthorized NHLBI, with continued emphasis on both the national program and related prevention programs.
January 4, 1983 – The Oprhan Drug Act (P.L. 97-414 ) amended the Public Health Service Act to mandate development and support of not less than 10 comprehensive centers for sickle cell disease.
November 20, 1985 – The Health Research Extension Act (P.L. 99-158) reauthorized the NHLBI, provided for the establishment of information dissemination and education programs, and provided for an Associate Director for Prevention.
September 20, and November 4, 1988 – The National Bone Marrow Donor Registry (P.L. 100-436, P.L. 100-607) was established. With enactment of these authorization and appropriation measures, NHLBI was given the task of developing an implementation plan for the voluntary bone marrow registry.
November 4, 1988 – The Health Omnibus Extension Act of 1988 (P.L. 100-607) reauthorized NHLBI.
June 10, 1993 – The NIH Revitalization Act of 1993 (P.L. 103-43) established a National Center on Sleep Disorders Research within NHLBI.
October 31, 1998 – Section 104 of the Women's Health Research and Prevention Amendments (P.L.105-340) instructed the NHLBI director to expand and intensify research and related activities of the institute with respect to heart attack, stroke, and other CVDs in women and to collaborate with other NIH institutes.
October 17, 2002 – The Children's Health Act (P.L. 106-310) mandated that the Director, NHLBI, through the Coordinating Committee of the National Asthma Education and Prevention Program, develop a federal plan for responding to asthma and recommended ways to strengthen coordination of federal asthma-related activities.
The NHLBI’s research programs are implemented through five extramural units: the Division of Heart and Vascular Diseases (DHVD), the Division of Epidemiology and Clinical Applications (DECA), the Division of Lung Diseases (DLD), the Division of Blood Diseases and Resources (DBDR), and the National Center on Sleep Disorders Research (NCSDR), and one intramural unit, the Division of Intramural Research (DIR). The NHLBI also has primary responsibility for the Women’s Health Initiative. Research grants, program project grants, specialized center grants, cooperative agreements, research contracts, research career development awards, and institutional and individual national research service awards are used to support research and research training. Specific programs foster career development for minority students and scientists. Included are minority institutional research training awards, minority school faculty development award, research development award for minority faculty, and short-term training for minority students program.
Division of Heart and Vascular Diseases
The DHVD plans and directs an integrated and coordinated research program, with emphasis on advancing knowledge of the causes of heart and vascular diseases and on their prevention, diagnosis, and treatment. Multidisciplinary programs are supported to advance basic knowledge of disease and to generate the most effective methods of clinical management and prevention. Clinical trials are an important part of the research program; they provide an opportunity to test and apply promising preventive or therapeutic measures.
The Division has three major programs: the Heart Research Program, the Vascular Biology Research Program, and the Clinical and Molecular Medicine Program, in addition to a Research Training and Special Programs Group
The Heart Research Program supports clinical and fundamental studies in cardiac diseases, from embryonic life through adulthood. Specific areas of interest include heart arrhythmias and electrical abnormalities, cardiomyopathies, cardiac development, pediatric heart disease, heart failure and cardiogenic shock, ischemic heart disease, inflammation and infectious disorders of the heart, exercise physiology, heart transplantation, and myocardial preservation. Other areas focus on normal and abnormal cardiac development, diabetic cardiomyopathy, gene-nutrient interactions in the pathogenesis of congenital heart defects, pathogenesis of heart failure, electrical remodeling, and various aspects of HIV infection as it relates to the heart. Specialized Centers of Research support studies on heart disease in blacks; ischemic heart disease, sudden cardiac death, and heart failure; and pediatric heart disease.
The Vascular Biology Research Program oversees investigations in atherosclerosis, hypertension, basic vascular biology, and gene therapy for prevention and/or treatment of vascular diseases. Other targeted areas are the etiology, pathogenesis, and treatment of excess cardiovascular disease (CVD) in diabetes mellitus and cardiovascular complications of HIV/AIDS. Specific programs include Specialized Centers of Research on molecular medicine and atherosclerosis, molecular genetics of hypertension, and gene transfer principles for heart, lung, and blood diseases.
The Clinical and Molecular Medicine Program supports clinical, basic, and engineering research on CVD and health. Its scope includes genetic, genomic, and proteomic research; bioengineering; informatics and simulation; and cardiovascular clinical trials. Although the primary focus is on studies involving patients with CVD, rather than the general population, other areas, such as the role of lipid interventions, nutrition, exercise, and hormone replacement therapy in the prevention of heart disease, are also pursued. Selected programs include development of new medical and surgical procedures for acute and chronic ischemic heart disease; quantitative measurement of atherosclerosis; diagnosis and management of arrhythmias; and restenosis after revascularization procedures. Bioengineering projects include innovative ventricular assist systems, implantable total artificial hearts, genetically enhanced cardiovascular implants, magnetic resonance angiography, mathematical models and simulation, imaging, biomaterials, tissue engineering, and other therapeutic devices. Genomic applications include the development of research tools such as genetically altered animals; human and model organism genomic resources; as well as functional genomics and bioinformatics to understand heart, lung, and blood diseases.
The Research Training and Special Programs Group is responsible for planning, conducting, analyzing, and directing a program for developing highly specialized human resources related to research and career development in cardiovascular diseases. Research training and career development programs are available for all stages in the professional development of the investigator, from pre- and postdoctoral levels to the senior investigator level.
Division of Epidemiology and Clinical Applications
The DECA plans and directs programs in epidemiologic studies, basic and applied behavioral research, demonstration and education research, and projects for disease prevention and health promotion, including large scale clinical trials. It identifies research opportunities; stimulates and conducts research on causes, prevention, diagnosis, and treatment of disease; and assesses the need for technologic development in acquisition and application of research findings in these areas. It evaluates and uses basic and clinical research findings in defined populations (such as occupational groups, school children, health professionals, and minorities) and community settings, with an emphasis on studies of primary and secondary prevention in nonhospitalized patients or populations. It supports research that provides multidisciplinary approaches to heart and blood vessel, lung, and blood diseases, with a primary focus on CVD.
The Division is divided into two programs, the Clinical Applications and Prevention Program and the Epidemiology and Biometry Program, and the Office of Biostatistics Research.
The Clinical Applications and Prevention Program oversees research in prevention of heart and vascular, pulmonary, and blood diseases through activities such as clinical trials, health promotion-disease prevention, community interventions, health education research, nutrition research, and behavioral medicine. It supports large-scale, multicenter studies in hypertension, cardiac arrhythmias, heart failure, hyperlipidemia, and platelet aggregation. The prevention and education programs support research to test effectiveness and demonstrate capability of preventive interventions that are designed to reduce cardiovascular risk factors. Ongoing programs include studies of prevention and treatment of hypertension; hyperlipidemia, obesity, and other risk factors in children and adolescents; response of patients and medical care systems to symptoms of CVD in blacks; and community-wide prevention programs. The behavioral medicine programs encourage basic and clinical collaborations between biomedical and behavior scientists.
The Epidemiology and Biometry Program supports and conducts epidemiological studies of heart and vascular, lung, and blood diseases in defined populations in the United States and internationally. It focuses on development and progression of CVD risk factors in children and young adults; development and progression of atherosclerosis measured non-invasively or at autopsy in middle-aged or older adults; and development and progression of overt cardiovascular and pulmonary disease in older adults. Also emphasized are genetic and environmental influences on CVD and its risk factors; trends in incidence, prevalence, and mortality from CVD, stroke, peripheral vascular disease, congestive heart failure and cardiomyopathy; and relationships between insulin, insulin resistance, and overt diabetes and CVD and its risk factors. Other programs investigate incidence of and mortality from cardiovascular, lung, and blood diseases. Research strategies apply family, longitudinal, demographic information and vital statistics to study natural history, etiology, and epidemiology of those diseases.
The Office of Biostatistics Research (OBR) provides statistical expertise to members of all Divisions of NHLBI and performs diverse functions in planning, design, implementation, and analysis of NHLBI-sponsored studies. In these activities, the OBR has primary responsibility for providing objective, statistically sound, and medically relevant solutions to problems. It is concerned with designing efficient studies and monitoring data while studies are ongoing. Recent research interests include new methods for permitting extensions or early stopping of randomized clinical trials and methods for complex survival data, trials with multiple endpoints, and trials including multiple treatments.
Division of Lung Diseases
The DLD plans and directs a coordinated research program on the causes of lung diseases and on their prevention, diagnosis, and treatment. Its activities focus on understanding the structure and function of the respiratory system, increasing fundamental knowledge of mechanisms associated with specific pulmonary disorders, and applying new findings to evolving treatment strategies for patients.
The Division is divided into two programs: Airway Biology and Disease and Lung Biology and Disease.
The Airway Biology and Disease Program focuses on basic and clinical research, education, and training related to chronic obstructive pulmonary diseases, asthma, cystic fibrosis, control of breathing, bronchiolitis (bronchopneumonia), respiratory neurobiology, sleep, and other adult airway diseases. Targeted research programs include delineation of the genetic and metabolic defects underlying pulmonary complications associated with cystic fibrosis, ion channels in pulmonary cells, alpha-1-proteinase inhibitor deficiency, pathogenesis of smoking- and environmentally related airway diseases, genetics and treatment of asthma, gene therapy, and neurochemicals in control of breathing. Specialized Centers of Research support clinical and basic research on chronic diseases of the airways, asthma, cystic fibrosis, and cardiopulmonary disorders during sleep.
In 2001 the first international guidelines for the diagnosis, management, and prevention of chronic obstructive lung disease were issued by an international team of scientists from the Global Initiative for Chronic Obstructive Lung Disease (GOLD) created by the NHLBI and the World Health Organization. The GOLD Workshop Report, which provides evidence-based recommendations for clinical management of COPD, is the first step in an international effort to boost awareness of COPD and improve the way it is treated.
The Lung Biology and Disease Program oversees research, education, and training programs in lung cell and vascular biology; lung growth and development and pediatric lung disease; acute lung injury and critical care medicine; interstitial lung diseases, including pulmonary fibrosis; and AIDS and tuberculosis. Representative projects include clinical network for treatment of acute respiratory distress syndrome, epidemiologic study of sarcoidosis, and investigation of lung injury following bone marrow transplantation. Additional projects target clinical study of the cardiopulmonary complications of HIV infection in infants and children; programs to address pathobiology of tuberculosis (TB) and Pneumocystis carinii and basic cell biology of pulmonary manifestations of AIDS; program to develop lung specific drug delivery systems for enhanced TB treatment; and program to design behavioral interventions for control of TB.
Division of Blood Diseases and Resources
The DBDR plans and directs a coordinated program in hematology, hematologic diseases (except malignancies of the blood), and immunologic and other disorders of white blood cells, transfusion medicine, blood resources, and marrow and stem cell transplantation. It supports research into the causes, prevention, diagnosis, and treatment of diseases of the blood, as well as research on the use of blood and blood components in the treatment and prevention of diseases. Management of the nation’s blood resources and transplantable tissue is also within its purview.
The Division is divided into two programs: Blood Diseases and Blood Resources. The Blood Diseases Program supports research and training in disorders of the red cell, hematopoiesis (formation and development of blood cells), thalassemia, and sickle cell disease (SCD). Specifically, in the area of SCD and thalassemia, research is focused on pathophysiology, genetics, regulation of hemoglobin synthesis, iron chelation, development of pharmacologic agents that increase fetal hemoglobin production, gene therapy, animal models, disease management, and therapy. In addition, basic research in SCD includes membrane function, red cell rheology (science of the deformation and flow of blood through the heart and blood vessel), and adherence of red cells to the vascular endothelium; clinical studies include the natural history of the disorder, stroke prevention, long-term effects of hydroxyurea therapy, and determination of the optimal hydroxyurea dose in the pediatric population. A multidisciplinary program of basic, clinical, and applied research is supported through the Comprehensive Sickle Cell Centers. Cellular hematology research is carried out in three subprograms: red blood cell membrane and enzyme systems, hematopoiesis and stem cell biology, and Cooley’s anemia and other hemoglobin variants. It is directed at reducing morbidity and mortality caused by disorders of the hematopoietic system and preventing their occurrence. Multidisciplinary research on stem cells is supported in Specialized Centers of Research.
The Blood Resources Program supports research and training in bone marrow transplantation, thrombosis and hemostasis (interruption of blood flow), and transfusion medicine. Areas of interest involve research on unrelated-donor marrow transplantation and pathogenesis, prevention, diagnosis, and treatment of major complications of transplantation. Transplantation studies of stem cells from marrow and peripheral and cord blood are emphasized. Other areas focus on thromboembolism (obstruction of a blood vessel with thrombotic material), platelet disorders, megakaryocytes (giant blood marrow cells), and hemorrhagic disorders. Blood component and blood derivative therapy, blood therapy safety, immunohematology (study of antigen-antibody reactions related to the pathogenesis and clinical manifestation of blood disorders), development of blood substitutes, and blood resource management are also under the program’s purview. Basic and applied research to develop and test methods to reduce the risk of HIV infection by transfusion of blood, blood components, and blood derivatives is emphasized. Specialized Centers of Research support a multidisciplinary approach to thrombosis and hemostasis and transfusion medicine.
National Center on Sleep Disorders Research
The NCSDR plans, directs, and supports a program of basic, clinical, and applied research; health education; and prevention-related research in sleep and sleep disorders. It maintains surveillance over developments in its program areas; assesses the national need for research on causes, diagnosis, treatment, and prevention of sleep disorders; and coordinates sleep research activities across the Federal Government. Research activities include cellular, molecular, and genetic basis of sleep and its disorders; epidemiology of sleep and sleepiness in health and disease; effects of sleep loss on the waking function of the brain, other systems, and behavior; and pathophysiology and optimal management of common sleep disorders. Development of programs to train investigators to become sleep researchers is also a priority.
The NCSDR works closely with the NHLBI Office of Prevention, Education, and Control (OPEC) on sleep disorder education for physicians and the community. Reaching the young with information about sleep and sleep disorders is a major priority. In 2001 the Center implemented a five-year education initiative targeting young children - and their parents, teachers, and health care providers - with the message that adequate nighttime sleep - at least nine hours each night - is important to their health, performance, and safety. Garfield the Cat was chosen as the campaign's "Star Sleeper" and is being used to promote the importance of adopting healthy sleep habits.
Women’s Health Initiative
The WHI is a 15-year project consisting of three major components: a randomized controlled clinical trial of promising but unproven approaches to prevention, an observation study to identify predictors of disease, and a study of community approaches to developing healthful behaviors. The clinical trial and the observational study, consisting of more than 167,000 women, 50 to 79 years of age, will seek to answer questions on benefits and risks of hormone replacement therapy and changes in dietary patterns and calcium/vitamin D supplements in disease prevention. The program was originally established by NIH in 1991 to address the most common causes of death, disability, and impaired quality of life. On October 1, 1997, management of the WHI was transferred to the NHLBI.
NHLBI FY 2002 Research Initiatives
In FY 2002, the NHLBI initiated programs to:
Office of Prevention, Education, and Control
The OPEC, located in the NHLBI Office of the Director, is the institute’s technology transfer arm, relaying results of heart, lung, and blood research to health care professionals, their patients, and the public. Its function is to disseminate and translate up-to-date research findings that will help practitioners be more effective, and provide scientific knowledge to patients and the public that will enable them to make “healthy decisions.”
The institute has targeted six areas for educational emphasis. They include: high blood pressure; cholesterol; asthma; heart attack alert; sleep disorders; and obesity. Three – high blood pressure, cholesterol, and obesity – address major modifiable risk factors for CVDs.
The National High Blood Pressure Education Program (NHBPEP) was established in 1972 to reduce death and disability associated with high blood pressure through professional, patient, and public education. Its mission is to translate and disseminate research findings and scientific consensus to improve medical care outcomes and the public’s health. In collaboration with a coordinating committee consisting of national medical, public health, and voluntary organizations and other Federal agencies, the NHBPEP strives to increase public awareness about high blood pressure and promote activities to encourage detection of the disease especially among underserved groups and encourage hypertensive patients to seek medical care and follow their doctor’s advice.
In 2002, the NHLBI began to develop a major new strategy to raise the importance of high blood pressure on the national public health agenda. With the Setting Priorities for Retirement Years (SPRY) Foundation, the NHLBI launched a 2-year pilot project to raise awareness and knowledge about high and high normal blood pressure, risk factors and treatment, prevention strategies among Americans of all ages.
The National Cholesterol Education Program (NCEP) was initiated in 1985 to educate health professionals and the public about high blood cholesterol as a risk factor for coronary heart disease (CHD) and about benefits of lowering cholesterol levels to reduce illness and death from CHD. Program success can be seen by the fact that, from 1983 to 1995, the percentage of the public who had their cholesterol checked rose from 35 to 75 percent - showing that 70 to 80 million more Americans were aware of their cholesterol level in 1995 than in 1983. Additionally, in 1995, physicians reported initiating diet and drug treatment at much lower cholesterol levels than in 1983.
In 2002, the NCEP disseminated the new Clinical Guidelines on Cholesterol Management in Adults (ATP III), developed a Web-based kit of materials derived from the Guidelines, and distributed ATP III Opinion Leader kits to encourage influential members of the medical community to use the Guidelines and communicate their importance to professional colleagues. The NCEP is also developing a new patient booklet on therapeutic lifestyle changes based on recommendations in the Guidelines.
The National Asthma Education and Prevention Program (NAEPP) was initiated in 1989 to raise awareness of asthma as a serious, chronic disease and to promote more effective management of asthma through professional, patient, and public education. Dissemination of national guidelines on diagnosis and management of asthma is a priority. To facilitate its outreach efforts, the NAEPP developed the Asthma Management Model System that can be accessed from the NHLBI home page. The Model System consists of three main components: “research” that links to and integrates a variety of databases and other resources; “education” that provides immediate access to clinical practice guidelines and professional and patient education materials; and “communication” that allows users to e-mail the Webmaster, register for updates, and connect with online discussion groups.
The NAEPP has created partnerships with local asthma coalitions to stimulate grassroots asthma control programs, particularly in underserved, high-risk communities that are disproportionately affected by asthma. These programs are directed to health care providers, patients, and their families and encourage them to follow the NAEPP Expert Panel Report 2: Guidelines for the Diagnosis and Management of Asthma.
In 2002, the NAEPP, in partnership with the Department of Education, revised the NIH publication, Managing Asthma: A Guide for Schools. The updated guide contains action steps for principals, school nurses, teachers, guidance counselors, and maintenance staff. Other new publications include: Making A Difference in the Management of Asthma: A Guide for Respiratory Therapists, developed in partnership with the American Association of Respiratory Care; and Key Clinical Activities for Quality Asthma Care, developed in partnership with the Centers for Disease Control and Prevention (CDC) for employee health benefits managers and other health care planners.
The National Heart Attack Alert Program (NHAAP) was initiated in 1991 to reduce morbidity and mortality from acute myocardial infarction and sudden cardiac arrest through education of health care professionals, patients, and the public about the importance of rapid identification and treatment of individuals with heart attack symptoms. In 1997, the program broadened its scope to include early identification and treatment of individuals with acute coronary syndromes encompassing unstable angina as well as acute heart attack. The program develops educational materials on symptom recognition and appropriate reactions and collaborates with health care organizations and state and Federal agencies.
In 2001 the NHAAP, in partnership with the American Heart Association, the American Red Cross, and the National Council on Aging, launched a major campaign to urge physicians and health care providers to educate their patients about heart attack risk, warning signs, and steps to increase survival. As part of the campaign to increase awareness of the need to act fast when someone may be having a heart attack, the NHLBI established a Web page, "Act in Time to Heart Attack Signs" (http://www.nhlbi.nih.gov/actintime/), with educational material for heath professionals, patients, and the public.
The NHLBI Obesity Education Initiative (OEI) was initiated in 1991 to inform health care professionals and the public on the health risks associated with overweight and obesity. Obesity is not only an independent risk factor for CVD, but also a contributor to high blood pressure and high blood cholesterol and is related to sleep apnea. The goal of the OEI is to encourage individuals to adopt heart-healthy eating patterns and physical activity habits to reduce the prevalence of overweight and obesity and their related CHD risk factors along with sleep apnea, and thereby reduce morbidity and mortality from CHD.
In FY 2002, the NHLBI Hearts N' Parks project in 50 high-risk communities continued to gain momentum. The goal is to reduce obesity and risk of coronary heart disease by creating model community-based programs to increase the number of children, adults, and seniors practicing heart-healthy behaviors in order to reduce obesity, improve nutritional status, and increase physical activity. In addition, the NHLBI served on the Steering Committee for the Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity.
The NHLBI Ad Hoc Committee on Minority Populations was established in 1975 to facilitate communication between minority communities and the NHBPEP. As the institute developed new programs, the role of the committee was expanded. Today, it provides direct input to the NHLBI regarding development and implementation of all outreach and education projects specifically designed to improve the health status of minority populations.
The NHLBI initiated several cardiovascular health outreach and education activities to address the overall Healthy People (HP) 2010 goals of eliminating health disparities and increasing the quality and years of healthy life for all Americans. Included among the activities are the Baltimore City Cardiovascular Health Partnership to promote cardiovascular health in African American communities, the Salud para su Corazón (Health for Your Heart) project to promote heart health in Latino communities, and the Strengthen the Heartbeat of American Indian and Alaska Native Communities to increase knowledge and promote heart health among three targeted tribal communities (the Ponca Tribe of Oklahoma, the Bristol Bay Area Corporation in Western Alaska, and the Laguna Pueblo in New Mexico). The NHLBI has also initiated a program of Enhanced Dissemination and Utilization Centers (EDUCs) dedicated to the elimination of cardiovascular health disparities in underserved populations. The EDUCs form the foundation of what is intended to become a nationwide network of performance partners that will use the Institute's science-based information to develop educational strategies to improve the health behaviors and health status of individuals in high-risk communities. The EDUCs are a key part of NHLBI's response to the Healthy People (HP) 2010 Objectives for the Nation.
The NHLBI Women's Heart Health Education Initiative was established in 2001 to expand, intensify, and coordinate cardiovascular disease education for women. In 2002, the NHLBI launched The Heart Truth – a campaign directed at women 40 to 60 years old and at health professionals – to increase awareness about heart disease in women, improve detection and treatment of risk factors by health professionals, and motivate national and community organizations to become involve in heart health education. Special attention is given to minority women who are at increased risk for developing heart disease.
The Division of Intramural Research (DIR) plans and directs laboratory and clinical research in heart, blood vessel, lung, blood, and kidney diseases. In addition, it supports the development of technology related to cardiovascular and pulmonary diseases.
The Division has two major programs: the Clinical Research Program and the Laboratory Research Program.
The Clinical Research Program plans and directs clinical research in heart, vascular, pulmonary, and blood diseases. It encourages implementation of new technology and application of new techniques and treatments through clinical trials. The Program oversees five branches and one laboratory.
The Cardiovascular Branch develops new diagnostic and therapeutic modalities for treatment of cardiovascular diseases. It focuses on mechanistic studies and novel clinical protocols.
The Cardiothoracic Surgery Branch conducts clinical research in patients undergoing cardiac surgery for coronary artery disease, valvular disease, and other cardiac abnormalities. It studies the development and use of surgical robotics and the application of stem cell biology to myocardial regeneration.
The Hematology Branch investigates normal and abnormal hematopoiesis in patients and in cellular, molecular, and immunologic laboratory research. It focuses on bone marrow failure, viral infections of hematopoietic cells, gene therapy of hematologic and malignant diseases, bone marrow transplantation, and mechanisms of immunologically mediated syndromes like graft-versus-host disease and autoimmune diseases.
The Molecular Disease Branch conducts research into the genetic disorders of lipoprotein and cholesterol metabolism with special emphasis on the diagnosis, genetic analysis, and treatment of patients with genetic dyslipoproteinemias and atherosclerosis.
The Pulmonary Critical Care Medicine Branch conducts research related to the lung and the cardiovascular system to define, at a molecular level, normal function and disease. It focuses on integration of biochemical, molecular biological, and immunological events in order to understand intra- and intercellular communication and organ function.
The Laboratory of Animal Medicine and Surgery provides laboratory animal care, facilities, and services for all phases of animal experimentation as required by the intramural research programs, including surgery, clinical medical care, animal resources, and diagnostic services.
The Laboratory Research Program plans, coordinates, and manages research in cellular and molecular biology, cell signaling, genetic studies, biophysics and biochemistry, and other applied sciences. The Program oversees 11 laboratories.
The Laboratory of Biochemical Genetics conducts research in molecular and cellular biology directed towards understanding the mechanisms regulating gene expression, signal transduction, and assembly of the nervous system.
The Laboratory of Biochemistry conducts biochemical and molecular biological research on cellular regulation of enzyme action and metabolism, oxygen free radical-mediated protein damage in aging and diseases, mechanisms of intermediary metabolism, biochemical functions of selenium and vitamin B12, and biophysical and biochemical properties of proteins.
The Laboratory of Biophysical Chemistry conducts research on the structure and function of naturally occurring compounds employing modern instrumental, chemical, and biological methods.
The Laboratory of Cardiac Energetics conducts research on the physiology of the heart and kidney in animals and man. It studies the specific mechanisms of energy transduction in vivo and in vitro and develops non-invasive techniques using nuclear magnetic resonance and optical spectroscopy to investigate organ and cellular physiology.
The Laboratory of Cell Biology conducts research at the molecular, structural, and regulatory level of the functions of integrated membrane and cytoskeletal systems involved in cell motility, endocytosis and exocytosis, and energy transduction.
The Laboratory of Cell Signaling is primarily concerned with understanding the transmembrane signaling cascades associated with hydrolysis of phosphatidylinositol 4,5 bisphosphate by phospholipase C. It seeks to elucidate the role of hydrogen peroxide in cell signaling.
The Laboratory of Developmental Biology investigates the etiology of congenital cardiovascular anomalies and the potential role of developmental perturbations on adult cardiovascular dysfunction and disease. It seeks to elucidate the cellular and molecular mechanisms regulating mammalian cardiovascular morphogenesis and development. The Laboratory plans an integrated approach using vertebrate animal models to identify novel genes and cell signaling pathways essential for cardiovascular development and function.
The Laboratory of Kidney and Electrolyte Metabolism studies kidney function in health and disease. It investigates renal transport and osmotic regulation at molecular and cellular levels and determines how these processes are integrated to account for normal and abnormal renal function.
The Laboratory of Molecular Cardiology conducts research on the regulation of contractile proteins in smooth muscle and non-muscle cells (such as platelets and macrophages) by calcium, calmodulin and cyclic nucleotides. It investigates the genetic basis for cardiac muscle development and diseases and studies the regulation of differentiation of cardiac, skeletal and smooth muscle cells.
The Laboratory of Molecular Immunology investigates the intracellular process involved in the activation of lymphocytes and mast cells by antigens and growth factors. It focuses on how membrane triggering activates and regulates appropriate target genes. Included are studies associated with mechanisms by which drugs and other foreign compounds interact with endogenous cellular proteins to form neoantigens and cause allergic/autoimmune reactions.
|This page was last reviewed on June 22, 2005 .|
National Institutes of Health (NIH)