ABSTRACT:After World War II, industrialized countries found themselves faced with a new epidemic of chronic disease. Stroke had long been a common cause of death, however a much more virulent form of vascular disease involving the coronary arteries was now recognized as a major public health challenge. By the late 1950s, cardiovascular diseases (CVD) accounted for almost two-thirds of deaths in the US. Within 10 years, the key causal factors underlying CVD had been fully defined, and by the mid-1960s, prevention trials, policy changes, and subsequent population-wide risk factor improvement and targeted high-risk medical therapy led to a rapid and sustained decline in both coronary heart disease (CHD) and stroke. By the turn of the century, CVD had declined over 80%, transforming health for adults and providing the main driver of lengthening life expectancy. This transformative process has now reached every country in the world. Epidemiologic, nutritional and clinical research, along with changes in social norms, public health education, smoke-free indoor air regulations, drug development, and clinical trials have led to the astounding success of the CVD control movement. The broad pattern pursued in the control of CVD provides a template for similar control efforts aimed at cancer, diabetes, renal disease, and other common chronic diseases.

中文翻译：

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20世纪控制心血管疾病：迎接慢性退行性疾病的挑战

摘要：二战后，工业化国家面临新的慢性病流行。中风长期以来一直是导致死亡的常见原因，但现在人们认为一种危害更大的冠状动脉血管疾病是一项重大的公共卫生挑战。到 1950 年代后期，心血管疾病 (CVD) 几乎占美国死亡人数的三分之二。在 10 年内，心血管疾病的关键致病因素已经完全确定，到 1960 年代中期，预防试验、政策变化以及随后的全人群风险因素改善和有针对性的高危药物治疗导致心血管疾病的快速持续下降在冠心病（CHD）和中风中。到世纪之交，CVD 下降了 80% 以上，改变成年人的健康并提供延长预期寿命的主要驱动力。现在，这一变革进程已遍及世界上每个国家。流行病学、营养和临床研究，以及社会规范、公共卫生教育、无烟室内空气法规、药物开发和临床试验的变化，导致 CVD 控制运动取得了惊人的成功。在 CVD 控制中追求的广泛模式为针对癌症、糖尿病、肾病和其他常见慢性病的类似控制工作提供了模板。和临床试验使 CVD 控制运动取得了惊人的成功。在 CVD 控制中追求的广泛模式为针对癌症、糖尿病、肾病和其他常见慢性病的类似控制工作提供了模板。和临床试验使 CVD 控制运动取得了惊人的成功。在 CVD 控制中追求的广泛模式为针对癌症、糖尿病、肾病和其他常见慢性病的类似控制工作提供了模板。