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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 - 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 PHS heart program.
September 8, 1948 - National Advisory Heart Council held its first meeting.
January 1949 - Cooperative research units were established at the University of California, University of Minnesota, Tulane University, and Massachusetts General Hospital. Pending completion of the NHI's own research organization and availability of further research facilities, the units were jointly financied by the NIH and the institutions.
July 1, 1949 - The NHI intramural research program was established and organized on three general research levels, consisting of three laboratory sections, five laboratory-clinical sections, and four clinical sections.
The Heart Disease Epidemiology Study at Framingham, Massachusetts, was transferred from the Bureau of State Services, PHS, to the NHI.
January 18-20, 1950 - NHI and the American Heart Association jointly sponsored the first National Conference on Cardiovascular Diseases.
July 6, 1953 - The Clinical Center admitted its first patient for heart disease research.
July 1, 1957 - The first members of the NHI 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 - The American Heart Association and the NHI presented a report to the Nation on "A Decade of Progress Against Cardiovascular Disease."
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, cosponsored by the NHI, American Heart Association, and the Heart Disease Control Program of the PHS, was held 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 the NHI 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 - A major 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, President Richard M. Nixon 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."
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 - 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 five-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 surveyed the problem of heart and blood vessel disorders and provided recommendations on how illness and death from these disorders may be reduced.
August 2, 1974 - The Secretary, HEW, approved regulations governing establishment, support, and operation of 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.
February 1978 - The NHLBI and the American Heart Association jointly celebrated their 30th anniversaries.
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 were 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 systematic, aggressive treatment of hypertension saves lives.
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.
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 demonstrated that mildly symptomatic patients with coronary artery disease can safely defer coronary artery bypass surgery until symptoms worsen.
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 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 has provided opportunities to examine the interrelationships of cardiovascular, respiratory, and blood diseases.
April 1985 - Phase I of the Thrombolysis in Myocardial Infarction (TIMI) Trial found that the new thrombolytic agent plasminogen activator (rt-PA) is approximately twice as effective as streptokinase (SK) in opening thrombosed coronary arteries.
November 1985 - The National Cholesterol Education Program (NCEP) was initiated.
June 1986 - Results of the Prophylactic Penicillin Trial demonstrated the efficacy of prophylactic penicillin in reducing morbidity and mortality associated with pneumococcal infections in children with sickle cell disease.
March 1989 - The NHLBI initiated the National Asthma Education Program (NAEP). The program was later renamed the National Asthma Education and Prevention Program (NAEPP).
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 was developed 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 - The Systolic Hypertension in the Elderly Program demonstrated that low-dose pharmacologic therapy of isolated systolic hypertension in those over age 60 significantly reduces stroke and myocardial infarction.
August 1991 - The Studies of Left Ventricular Dysfunction demonstrated 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.
January 30, 1995 - Results of the Multicenter Study of Hydroxyurea (MSH) 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 (BARI) 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 five years, a markedly lower death rate than similar patients treated with angioplasty.
May 21, 1996 - Framingham Heart Study investigators concluded that earlier and more aggressive treatment of hypertension is vital to preventing congestive heart failure. The Treatment of Mild Hypertension Study (TOMHS) demonstrated that lifestyle approaches, 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.
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 eliminate the need for antihypertensive medication in some older patients.
January 27, 1997 - Results from the Pathobiological Determinants of Atherosclerosis in Youth program showed that atherosclerosis develops before age 20 and 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.
April 14, 1997 - An NHLBI-supported study comparing two treatment strategies, an implantable cardiac defibrillator versus antiarrhythmic drug treatment demonstrated that implantable cardiac defibrillators are superior to drug therapy for improving overall survival for patients with life-threatening heart arrhythmias.
September 18, 1997 - Results of the Stroke Prevention Trial in Sickle Cell Anemia (STOP) showed that periodic red blood cell transfusions reduced the stroke rate by 90 percent among high-risk children with sickle cell anemia
October 1, 1997 - The NHLBI is given responsibility for the Women's Health Initiative (WHI), a study begun in 1991 to address women's health issues.
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 - A large clinical trial of mechanical ventilator use for intensive care patients with acute respiratory distress syndrome (ARDS) 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 - The Early Revascularization for Cardiogenic Shock study showed improved survival, at 6 months, 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 Dietary Approaches to Stop Hypertension (DASH) Sodium Trial 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 diagnosis, management, and prevention of chronic obstructive pulmonary disease (COPD).
April 2001 - NHLBI-supported investigators identified genes that regulate human cholesterol levels.
May 2001 - The NHLBI released the NCEP's new Adult Treatment Panel III (ATP III) guidelines for the detection, evaluation, and treatment of high blood cholesterol in adults.
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 (NETT) identified characteristics of patients at high risk for death following lung volume reduction surgery.
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.
June 2002 - The NAEPP issued an update of selected topics in the Guidelines for the Diagnosis and Management of Asthma .
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.
December 4, 2002 - Results of the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) Trial indicated that a strategy involving rate control rather than rhythm control may be the preferred treatment for patients with atrial fibrillation. The rate control strategy involves the use of less expensive drugs and fewer hospitalizations.
December 17, 2002 - Results from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT), the largest hypertension clinical trial ever conducted, showed that less expensive traditional diuretics are at least as good as newer medicines (calcium channel blockers and ACE inhibitors) to treat high blood pressure and to prevent some forms of heart disease. These findings were in addition to ALLHAT results from 2000, when researchers reported that an alpha-adrenergic blocker was less effective than the diuretic in reducing risk of some forms of CVD.
January 23, 2003 - An NHLBI-supported study demonstrated that magnetic resonance imaging (MRI) can be used to detect heart attacks faster and more accurately than traditional methods in patients who arrive at the emergency room with chest pain.
February 24, 2003 - The Prevention of Recurrent Venous Thromboembolism (PREVENT) trial was stopped because treatment with low-dose warfarin to prevent recurrence of the blood clotting disorders deep vein thrombosis and pulmonary embolism was found to benefit the patients.
May 14, 2003 - The Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VII) was released.
May 22, 2003 - The National Emphysema Treatment Trial (NETT) found that lung volume reduction surgery benefits emphysema patients who have certain clinical characteristics. The findings will help determine the Medicare coverage policy for the surgery.
July 2003 - The NHLBI and Gen-Probe Corporation develop a test to screen donated blood for the West Nile virus.
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. Responsiblity for the Registry later was transfered to the Health Resources and Services Administration.
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.
Dr. Lenfant was appointed NHLBI director on July 6, 1982. He received his B.S. degree in 1948 from the University of Rennes, France, and his M.D. in 1956 from the University of Paris.
Upon completing his medical studies, he assumed the position of director of the Laboratory of Experimental Surgery, Centre Marie Lannelongue, in Paris. While there he directed research into extracorporeal oxygenation of blood and use of deep hypothermia in cardiac surgery.
In 1957 Dr. Lenfant was appointed postdoctoral fellow at the University of Buffalo, and the following year continued that appointment at Columbia University in New York. His postdoctoral interests were directed to respiratory and circulatory physiology.
Returning to France, he assumed a teaching position as assistant professor of physiology at the University of Lille. He soon returned to the United States, however, where he was appointed to a joint position in the departments of medicine and of physiology and biophysics at the University of Washington, Seattle. He rose to the rank of professor in both departments. He published extensively on dynamics of blood-gas exchange in humans and various other species under normal conditions and under conditions of altitude and pressure. Respiratory adaptation to hypoxia, anemia, alkalosis and acidosis also were investigated.
In 1970 Dr. Lenfant was appointed the first associate director for lung programs of the then NHLI, and also assumed the position of acting associate director for collaborative research and development programs. This program evolved into the Division of Lung Diseases, formed in 1972, with Dr. Lenfant as its director. For his accomplishments he was awarded the HEW Superior Service Honor Award in 1974. The Division of Lung Diseases continued to grow and to coordinate a strong and diverse program of research into the prevention, diagnosis and treatment of lung diseases.
He became NIH associate director for international research and director of the Fogarty International Center in 1981, positions he held until his appointment as director of NHLBI. In 1983 he was elected member of the Institute of Medicine, NAS. He was named Distinguished Executive of the Senior Executive Service in 1991 and Federal Executive of the Year for 1992 by the Institute Alumni Association.
Dr. Lenfant has received numerous honors and awards, including the Surgeon General's Exemplary Award in 1993, the American Academy of Allergy and Immunology's Special Recognition Award in 1994 and in 1998, the French Committee for Research on Atherosclerosis and Cholesterol's International Prize in 1997, the National Sleep Foundation's Person of the Year in 1998, the American Society of Hematology's Outstanding Service Award in 1999, the Society of Behavioral Medicine's Distinguished Achievement Award in 2000, the LAM Foundation's Founder's Distinguished Award in 2000, the Association for Laboratory Automation's Beckman Coulter Award in 2001, the American Heart Association's Gold Heart Award in 2002, and the European Lung Foundation's Award for Services to Human Health in 2002.
He holds honorary degrees from the universities in Taipei, Taiwan; Lima, Peru; Medona, Italy; Montpellier, France; and from the University of New York at Buffalo, Wake Forest University, and the Medical College of Ohio.
His memberships include the Soviet Union's Academy of Medical Sciences and the National French Academy of Medicine. He is a fellow of the Royal College of Physicians (London), an honorary member of the Royal Society of Medicine, an honorary member of Alpha Omega Alpha Honor Medical Society, and an honorary fellow in the Polish Society of Hypertension.
Dr. Lenfant is a member of a number of professional groups including the American and French Physiological Societies, the American Society for Clinical Research, the American Society for Clinical Investigation, the Association of American Physicians, and the Society for Experimental Medicine and Biology. He has served on the editorial board of American Journal of Physiology; Journal of Applied Physiology; Respiratory Physiology; American Review of Respiratory Disease; Proceedings of the Society for Experimental Biology and Medicine; Undersea Biomedical Research; Respiration, Environmental and Exercise Physiology; Continuing Education for Family Physicians; Revue Francaise des Maladies Respiratories; and American Journal of Medicine. He is the chief editor of a series of monographs, Lung Biology in Health and Disease, that includes 167 volumes. He has published 228 papers in his areas of research interest.
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. A more detailed description of NHLBI activities is in the NHLBI Factbook.
Division of Heart and Vascular Diseases
The DHVD plans and directs a coordinated research program on 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 supports clinical and fundamental studies in cardiac diseases, from embryonic life through adulthood. Specific areas 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 supports investigations in atherosclerosis, hypertension, vascular biology, and gene therapy for prevention and treatment of vascular diseases. Other areas are the etiology, pathogenesis, and treatment of 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 basic and clinical gene therapy.
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 clinical trials in disease mechanisms, management, and treatment. 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, and exercise also are pursued. 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, support of human and model organism genomic resources, and development of 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, directs, and evaluates research on the causes, prevention, diagnosis, and treatment of cardiovascular, lung, and blood disease. It supports epidemiologic studies, clinical trials, demonstration and education research, disease prevention and health promotion research, and basic and applied research in behavioral medicine. In addition, it provides training and career development in cardiovascular, lung, and blood diseases and sleep disorder research for individuals at all stages of their professional training.
The Division is organized 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 and disease prevention, community interventions, health education research, nutrition research, and behavioral medicine. It supports large-scale, multicenter studies in hypertension, 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 hyperlipidemia, obesity, and other risk factors in children and adolescents; interventions to improve delivery of care using evidence-based guidelines; 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 using field studies and clinical epidemiology, genetic epidemiology, and analytical resources. It focuses on development and progression of CVD risk factors in children and young adults; development and progression of atherosclerosis measured non-invasively 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. It develops new statistical solutions to problems for which techniques are not yet available. Designing efficient trials and monitoring data collection are important functions of the Office. Research includes new methods for permitting extension or early suspension of ongoing randomized clinical trials, methods for analyzing complex survival data, trials with multiple endpoints, and trials involving multiple treatments.
Division of Lung Diseases
The DLD plans and directs a coordinated research program on the causes and progression 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:
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. Research programs include delineation of the genetic and metabolic defects underlying pulmonary complications associated with cystic fibrosis and 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.
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 supports 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 a clinical network for treatment of acute respiratory distress syndrome, an epidemiologic study of sarcoidosis; activities to address pathobiology of tuberculosis (TB) and Pneumocystis carinii and basic cell biology of pulmonary manifestations of AIDS; and a program to develop lung specific drug delivery systems for enhanced TB treatment.
Division of Blood Diseases and Resources
The DBDR plans and directs a coordinated research program on the causes and prevention of blood diseases and disorders. Areas of interest encompass a broad spectrun of research from stem cell biology to medical management of blood diseases, with a focus on non-malignant and pre-malignant processes. The Division also has a major responsibility to improve the adequacy and safety of the Nation's blood supply. It has recently taken a leading role in developing cell-based therapies, combining the expertise of transfusion medicine and stem cell technology with the exploration of repair and regeneration of human tissues and biological systems.
The Division is organized into two major programs:
The Blood Diseases Program supports research and training in nonmalignant disorders of red blood cells and disorders of hemostasis and thrombosis. A major goal is to find additional platelet inhibitors, anticoagulants, and fibrinolytic agents that will improve specificity and reduce side effect when used in treatment of thrombotic and thromboembolic disorders. It also includes a comprehensive program focusing on reducing morbidity and mortality caused by disorders of the hematopoietic system and preventing their occurrence. Diseases include sickle cell disease (SCD), thalassemia, Fanconi anemia, and Diamond Blackfan anemia.
The NHLBI supports 10 Comprehensive Sickle Cell Centers, which collectively form a SCD clinical research network, and which individually conduct basic and clinical research, as well as provide state-of-the-art patient care, educational activities for patients and health professionals, community outreach, and genetic counseling services.
Finding an effective treatment for hemophilia is another priority. Bleeding disorders associated with defects in coagulation proteins or abnormal platelet function, such as the immune thrombocytopenias, are also being studied. Other emerging areas being supported are gene transfer, clinical proteomics, inflammation and thrombosis, coagulation activation, autoimmune disease, and thrombotic complications of obesity, diabetes and cancer.
The Blood Resources Program plans and directs research and training in transfusion medicine, stem cell biology and disease, and clinical cellular medicine. Areas of interest in include transmission of disease through transfusion, development of methods to detect and inactivate viruses in donated blood, improvement of blood donor screening procedures, and identification of emerging diseases that may be transmitted by blood transfusions. It supports basic and clinical investigations related to transfusion immunobiology, focusing on graft versus host disease, graft versus leukemia effect, and dendritic cell therapies. The Program also developed two clinical research networks to promote efficient comparison of innovative treatment strategies-one for patients undergoing blood or marrow transplantation and the other for patients with hemostatic disorders such as idiopathic thrombocytopenia and thrombotic thrombocytopenic purpura. Specialized Centers of Research support collaborative studies on hematopoietic stem cell biology and transfusion biology and 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 sleepiness; and coordinates sleep research activities across the Federal Government and with professional, voluntary, and private organizations. Research topics 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.
In 2003, the NCSDR released the revised National Sleep Disorders Research Plan. The Plan summarizes advances in knowledge since the first plan was released in 1996, identifies gaps in our knowledge base, and recommends research priorities.
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 2003 Research Initiatives
In FY 2003, the NHLBI initiated programs to:
Office of Prevention, Education, and Control
The OPEC, located in the NHLBI Office of the Director, relays results of heart, lung, and blood research to health care professionals, their patients, and the public. It disseminates and translates up-to-date research findings that will help practitioners be more effective and provides scientific knowledge to patients and the public that will enable them to make "healthy decisions."
The institute has six areas of educational emphasis; 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 CVD.
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, 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 2003, the NHBPEP released the Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VII) . The new guidelines streamline the steps by which doctors diagnose and treat patients, recommend the use of diuretics as part of the drug treatment plan for high blood pressure in most patients, and include a new "prehypertension" level at which people need to reduce their risk of high blood pressure by making lifestyle changes.
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. 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 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 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. In 2003, the campaign unveiled the Red Dress Project. This groundbreaking project, supported by Mercedes-Benz USA and 7th on Sixth (the producers of Mercedes-Benz Fashion Week), launched a red dress icon to raise awareness of women's risk of heart disease, give a sense of hope that women can reduce their risk and empower them to do so, and provide a clear call to action coupled with a sense of urgency.
The Division of Intramural Research (DIR) plans and directs laboratory and clinical research in heart, blood vessel, lung, and blood 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 four 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 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 21, 2005 .|
National Institutes of Health (NIH)