Historical timeline: 1969-2004

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1969 USA First use of artificial heart in human by Denton Cooley.

1972 USA The Stanford Three Community Study started (later becoming The Stanford Five-City Project); this showed a 23% reduction in coronary heart disease risk caused by community-based interventions that change lifestylerelated risk factors such as physical activity, dietary habits and tobacco use.

1972 Finland North Karelia Project began, aimed at preventing cardiovascular disease among residents. Cardiovascular mortality rates for men, aged between 35 and 64 years, decreased by 57% from 1970 to 1992.

1974 Framingham, USA Diabetes linked to cardiovascular disease. 1970s Aspirin recognized as preventing heart attacks and stroke.

1970s Development of computerized tomography (CT) to aid early diagnosis of stroke.

1977 Switzerland First coronary PTCA (percutaneous transluminal coronary angioplasty); Andreas Gruentzig inserted a balloon-tipped catheter into a coronary artery and inflated the balloon, and thus successfully opened a blockage and restored blood flow.

1977 Italy The Martignacco Project community prevention trial resulted in reduction of coronary heart disease through communitybased interventions that change lifestyle-related risk factors such as physical activity, dietary habits and tobacco use.

1977 Framingham, USA Effects described of triglycerides and LDL- and HDL- cholesterol on heart disease.

1978 Framingham, USA Psychosocial factors found to affect heart disease.

1978 Australia North Coast Healthy Lifestyle Programme showed significant reduction in smoking.

1978 Switzerland Swiss National Research Programme community prevention trial resulted in reduction of smoking, blood pressure and obesity.

1978 Atrial fibrillation (irregular heart beat) found to increase the risk of stroke.

1979 South Africa Coronary Risk Factor Study community prevention trial resulted in reduction of smoking, blood pressure and composite coronary heart disease risks.

1979 Germany First use by Peter Rentrop of intracoronary streptokinase, a clot-dissolving drug to stop a heart attack in progress.

1981 Framingham, USA Filter cigarettes found to carry as much risk for coronary heart disease as unfiltered cigarettes. 1981 USA Report on relationship between diet and heart disease.

1982 USA First permanent artificial heart, designed by Robert Jarvik, and implanted by Willem DeVries, in a 61-year-old man.

1983 USA List of 246 coronary risk factors published by Hopkins and Williams (list now much longer).

1980s Minimization of random error for the reliable assessment of cardiovascular treatments by introduction of large-scale "megatrials" (at instigation of Sir Richard Peto).

1986 France First coronary stent implanted by Jacques Puel and Ulrich Sigwart.

1987 Japan M. Okada used a laser to burn channels in the heart muscle to help revascularize the heart in patients with coronary heart disease.

1987 Framingham, USA High blood cholesterol levels found to correlate directly with risk of death in young men.

1988 Framingham, USA High levels of HDL-cholesterol found to reduce risk of death.

1988 ISIS-2 trial shows emergency treatment for heart attacks with aspirin and fibrinolytic "clot-busting" drugs saves lives.

1988 Framingham, USA Isolated systolic hypertension found to increase risk of heart disease.

1988 Framingham, USA Cigarette smoking found to increase risk of stroke.

1990 Randomized trials showed that lowering blood pressure lowers the risk of stroke.

1990 United Kingdom Meta-analysis of trials by Clinical Trial Service Unit (CTSU) in Oxford showed that lowering blood pressure lowers the risk of coronary disease.

1991 China Tianjin CVD Intervention Programme community prevention trial led to the creation of non-smoking environments and increased sales of low-sodium seasonings.

1992 Canada The Victoria Declaration on Heart Health affirmed that CVD is largely preventable, that there is the scientific knowledge to eliminate most CVD, and that the public health infrastructure and capacity to address prevention were lacking.

1990s USA Hostility (including traits such as anger, cynicism, and mistrust), a major component of type A behaviour, shown to be associated with an increased risk of heart attack and other cardiac complications in healthy persons and patients with coronary heart disease.

1992 China First heart-lung transplant in China.

mid-1990s Scandinavia, United Kingdom, USA Remarkable improvement in survival of coronary heart disease patients treated with statins.

1995 Spain The Catalonia Declaration: Investing in Heart Health, and its follow-up convention in 1997, emphasized the importance of investments in heart health and provided examples of many successful CVD prevention programmes worldwide.

1998 USA Hypertension gene in men identified.

1998 New advances: gene therapy grows new blood vessels to the heart; strong confirmation that "superaspirin" IIb/IIIa receptor blocker drugs prevent blood clots; the importance of inflammation in cardiovascular disease recognized; study on the deadly effects of smoking fewer than 10 cigarettes per day.

1998 Singapore The Singapore Declaration: Forging the Will for Heart Health in the Next Millennium.

2000 Canada The Victoria Declaration on Women, Heart Disease and Stroke addressed the importance of science and policy in action and the need to tackle gender disparities in health. It called upon all stakeholders to join forces and take appropriate action to control the cardiovascular disease epidemic.

2000 First World Heart Day, which has become a global annual event.

2000 The entire human genome is mapped.

2000 WHO 53rd World Health Assembly endorsed Global strategy for noncommunicable disease (NCD) prevention and control, which outlines major objectives for monitoring, preventing and managing NCDs with special emphasis on major NCDs with common risk factors and determinants – cardiovascular disease, cancer, diabetes and chronic respiratory disease.

2001 Japan The Osaka Declaration: Health, Economics and Political Action: Stemming the Global Tide of Cardiovascular Disease emphasized the global nature of the CVD burden and highlighted the need to address economic and political factors in order to tackle CVD.

2002 United Kingdom The Heart Protection Study showed that statins could benefit people with diabetes and those with cholesterol levels previously considered low.

2002 USA NASA’s Commercial Invention of the Year Award given for the DeBakey Ventricular Assist Device, based on space shuttle technology, and developed by Michael DeBakey and NASA engineer David Saucier. The pump, used to treat heart failure, was one-tenth the size of previous heart-assist devices, and was first used in a patient in 2000.

2003 Switzerland WHO Framework Convention on Tobacco Control adopted at the 56th World Health Assembly.

2003 Switzerland The World Health Report: "Shaping the Future" highlighted CVD as the first of three growing threats that make up the "neglected global epidemics". The report called for action at the national and global levels to prevent and control CVD.

2004 Switzerland WHO Global Strategy on Diet, Physical Activity and Health endorsed by World Health Assembly.

2004 Italy Milan Declaration on Heart Health: Positioning Technology to serve Global Heart Health.