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Preface—Adapted from the First Edition

Cardiovascular disease is the greatest scourge affecting the industrialized nations. As with previous scourges—bubonic plague, yellow fever, and smallpox—cardiovascular disease not only strikes down a significant fraction of the population without warning but also causes prolonged suffering and disability in an even larger number. In the United States alone, despite recent encouraging declines, cardiovascular disease is still responsible for almost 1 million fatalities each year and more than half of all deaths; almost 5 million persons afflicted with cardiovascular disease are hospitalized each year. The cost of these diseases in terms of human suffering and material resources is almost incalculable. Fortunately, research focusing on the causes, diagnosis, treatment, and prevention of heart disease is moving ahead rapidly.

In order to provide a comprehensive, authoritative text in a field that has become as broad and deep as cardiovascular medicine, I chose to enlist the aid of a number of able colleagues. However, I hoped that my personal involvement in the writing of about half of the book would make it possible to minimize the fragmentation, gaps, inconsistencies, organizational difficulties, and impersonal tone that sometimes plague multiauthored texts.

Since the early part of the 20th century, clinical cardiology has had a particularly strong foundation in the basic sciences of physiology and pharmacology. More recently, the disciplines of molecular biology, genetics, developmental biology, biophysics, biochemistry, experimental pathology, and bioengineering have also begun to provide critically important information about cardiac function and malfunction. Although Heart Disease: A Textbook of Cardiovascular Medicine is primarily a clinical treatise and not a textbook of fundamental cardiovascular science, an effort has been made to explain, in some detail, the scientific bases of cardiovascular diseases.

Eugene Braunwald

1980