Where am I going? The future of academic cardiovascular medicine.

c d p n the last three decades, the U.S. life expectancy has been rolonged by about one or two years each decade due to dvances in cardiovascular medicine. This improvement is he result of the development of better therapies rather than ardiovascular disease (CVD) prevention. Despite this imrovement, CVD continues to be the leading cause of death y far (Table 1), and its prevalence is increasing (1). The picture is particularly grim when looking at the lobal burden of CVD. In comparing mortality data for 990 versus estimates for 2020, developing countries will xperience about a 100% increase in mortality due to CVD. or developed countries, such as the U.S., cardiovascular ortality is expected to increase by about 20%, from pproximately five million deaths annually in 1990 to six illion in 2020 (2). In terms of the combined incidence of oronary artery disease (CAD) and CAD mortality, in eveloped countries, for the same time period we expect to ee a 29% increase among women and a 48% increase mong men. In developing countries, it is astonishing: we xpect to see a 120% increase in CAD and CAD mortality mong women and 137% in men (3) (Table 2). So, while we re certainly prolonging life, a huge problem remains.