195 - Endothelial Biomedicine: The Public Health Challenges and Opportunities

Summary

Recent advances in endothelial biomedicine and vascular biology have provided renewed hope that strategies for health promotion and the prevention and control of diseases can be improved substantially. These advances hold promise for the detection, evaluation, prevention, treatment, and control of chronic diseases in general and cardiovascular diseases (CVDs) in particular. However, translating these scientific advances into effective clinical practices poses unique challenges (1–3), and translating them into effective public health practices at the community or population level is even more daunting.

This final translational step is crucial, especially for scientific advances related to chronic noncommunicable diseases and their risk factors, which constitute some of the major public health challenges of the twenty-first century. The World Health Organization has estimated that 35 million people died from chronic diseases in 2005 alone and that heart diseases, stroke, cancer, chronic respiratory diseases, and diabetes accounted for the bulk of these deaths (4). These chronic diseases and their risk factors are major epidemics that are not likely to be conquered at the bedside by using individual patient strategies. However, a combination of individual and population-based strategies built on a sound foundation of biomedical science holds tremendous promise for success.

This chapter presents a review of the major advances in vascular biology likely to provide the bases for successful public health policy, practice, and research initiatives in chronic disease prevention and control. It describes clinicians' frequent failure to recognize the endothelium as a spatially distributed organ system, addresses the relevance for continuing medical education and translational research, and discusses the practical implications for health promotion and the prevention and control of chronic diseases.