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Research in vascular disease

1989; Elsevier BV; Volume: 9; Issue: 2 Linguagem: Inglês

10.1016/0741-5214(89)90069-4

1097-6809

John T. Watson,

Lipoproteins and Cardiovascular Health

Vascular diseases have a major impact on the health of people throughout the world. Although heart disease has a widespread research base, vascular diseases have received relatively little attention. The vascular research community is small and somewhat unorganized. These facts are surprising given the estimates of 10 million patients with symptomatic coronary, cerebrovascular, or peripheral atherosclerosis; 6 million diagnosed cases of diabetes mellitus; and that the number of annual cardiovascular surgical and angioplastic procedures is approximately equally divided between coronary and peripheral arteries. In fiscal year 1987 the Division of Heart and Vascular Diseases supported nearly $14 million in research projects with peripheral vascular disease as the primary or secondary research focus. This represents less than 4% of the total extramural budget of the Division and an even smaller percentage of the total National Heart, Lung, and Blood Institute (NHLBI) budget. Work is required in all areas of diagnosis, treatment, and prevention of vascular disease. For example, the overall objective of the NHLBI instrumentation program has been the diagnostic imaging of lesions in coronary arteries of 2 mm diameter requiring less invasive methods than conventional intraarterial angiography. Although this goal has not been achieved, the advances in the field have had a direct effect on diagnosing peripheral vascular disease. It is interesting that only carotid artery disease has been a major research focus for diagnostic technology and the other peripheral vascular beds have been left underserved. Many other examples could be given for treatment research, identification of risk factors, and education. Recently the NHLBI has initiated three programs relevant to vascular research that should begin to bear fruit over the next several years. Applications for grants are being sought for vascular healing and cell matrix research and specialized centers for research in coronary and vascular disease. The Vascular Healing Program will support multidisciplinary research of relevance to the clinical problems of functional failure and thromboembolic complications of biologic or prosthetic cardiovascular implants. The objectives are to define the relative contributions of biologic mediators, rheologic factors, physical properties, and chemical composition of vascular prostheses to pseudointimal hyperplasia and thrombosis. The Cell-Matrix Program will focus on interactions in hypertension and vascular repair. The objective of this call for grant applications is to encourage investigation of the molecular processes involved in the interaction between cells and the extracellular matrix, particularly vascular injury induced by surgery or angioplasty and its repair. A request for application for grants to support specialized centers of research (SCOR) in coronary and vascular disease has been released. A special feature of a SCOR is that it must include clinical studies, as well as fundamental research related to the disease focus. The projects of the SCOR may seek answers to questions of etiology and pathogenesis of vascular disease and to diagnosis, treatment, and prevention. The blood vessels are composed of similar structural components that include the endothelium, smooth muscle, and extracellular matrix. Findings that relate to one vascular bed may indeed relate in part or totally to another. The broadening of concepts that have been applied to the heart, and other fields, such as approaches that use expertise in immunology, cellular and molecular biology and genetics, to collaborative vascular research, suggests an exciting future. The forerunner of this workshop was held in August 1986.1Strandness DE Didisheim P Clowes AW Watson JT Vascular diseases: current research and clinical applications. Grune & Stratton, New York1987Google Scholar The purpose of the 1986 Workshop was to define the present state of knowledge and to identify needs and promising directions for the future. The initiatives for new grant programs noted earlier resulted in part from the discussion held at the first workshop. In 1986 it was further recommended that a forum be provided in the future to further foster a topical interchange between experts with a variety of backgrounds but sharing a common interest in problems involving the vascular system. The current 1988 Workshop is the next step in nurturing and fostering fundamental research into the basic mechanisms of vascular disease and its ultimate prevention.