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Heart disease includes different conditions that affect the heart, such as coronary artery disease, heart failure, valve disease, and arrhythmia (an irregular heartbeat). Coronary artery disease happens when the coronary arteries, which supply blood to the heart, become stiff, narrowed, or blocked. This problem usually occurs because of atherosclerosis (fatty buildups in the artery walls). Coronary artery disease is the main reason for heart failure, which is when the heart muscle can’t pump blood effectively due to weakness or stiffness. Heart failure can be caused by several factors, including problems with the heart valves, which may leak or be too narrow.
Although heart disease is the leading cause of death in the U.S., it’s far from a new problem. Humans have faced matters of the heart since the beginning of time. From the discovery and understanding of the heart to modern-day advancements, let’s take a closer look at the history of heart disease. Here’s an overview of how humans have understood and grappled with heart disease throughout history.
Humans have long recognized the significance of the heart. In the oldest written story, the Epic of Gilgamesh, Gilgamesh says he knew his friend Enkidu was dead when he touched his heart and did not feel it beating.
In Ancient China, the word for heart translated to “heart-mind,” suggesting that the heart was the ruler of the body. Greek mythology is filled with stories about the heart as the source of emotions and love. Aristotle and Hippocrates observed the heart’s anatomy, with early descriptions of its color, shape, and function.
Although heart disease is often connected to our modern-day lifestyles, historians have discovered signs of hardened arteries due to atherosclerosis in ancient Egyptian mummies. It’s not clear what the Egyptians knew about heart disease. But in ancient texts, they describe a “stomach disease” with pain in the arm and breast that can lead to death, perhaps referring to a heart attack (when a coronary artery becomes abruptly blocked with a clot).
In addition, an ancient Arabic poem is thought to describe heart disease. A heartbroken young poet, Qais ibn Al-Mulawah, wrote about his symptoms, including poor appetite, palpitations, and fainting. Based on his writings, researchers believe he died of a heart attack after living with coronary artery disease.
Coronary artery disease was first recognized during the 14th century once the Romans lifted laws against human autopsies. This period of the late Middle Ages ushered in centuries of progress in society and medicine.
Leonardo da Vinci famously studied human anatomy as part of his artistry. His notes described new insights on heart function and circulation. He wrote that “vessels in the elderly restrict the transit of blood through thickening of the tunics,” likely referring to atherosclerosis.
In 1628, William Harvey published a book that officially revolutionized our understanding of the cardiovascular system. As the emperor’s personal physician, Harvey was able to study the king’s deer. He also dissected reptiles. Until this point, the prevailing theory was that the liver makes new blood constantly, and the body’s organs absorb it. Harvey challenged this theory and found that blood is recirculated around the body and pumped by the heart.
During the 1700s, Reverend Stephen Hales was the first person to measure blood pressure by inserting a tube into the artery of a horse. He called his invention a manometer. This set the stage for Samuel Siegfried Karl Ritter von Basch, who later developed a noninvasive method for measuring blood pressure.
The term “angina pectoris” was coined by William Heberden in 1768. He wrote a paper called “Some Account of a Disorder of the Breast.” It was presented at the Royal College of Physicians in London and contains many of the truths we understand about heart disease today.
By the end of the 1800s, it was understood that the heart made electrical currents. And in 1903, a Dutch physician and physiologist, William Einthoven, developed the first electrocardiogram (ECG) to measure them. He named features that are still in use, including the P wave, QRS complex, and T wave. Einthoven was later awarded the Nobel Prize for his discovery.
In 1893, Doctor Daniel Hale Williams performed the first open heart surgery at Provident Hospital in Chicago. His patient, James Cornish, didn’t have the benefits of modern medicine (including antibiotics and X-rays). But he survived the procedure, setting the stage for more advanced heart procedures to come.
The American Heart Association (AHA) was founded in 1924. In 1947, the AHA held its first annual Heart Week, a public campaign to raise awareness about heart disease.
Achievements since then have included:
Statins represent a major breakthrough in modern cardiology. During the 1970s, Doctor Akira Endō was researching fungus in Tokyo. He discovered compactin, also known as mevastatin, after screening over 6,000 fungal samples. Today, statins are a mainstay of cardiovascular care.
During the 1980s several studies found acetylsalicylic acid (aspirin) beneficial in heart attack prevention for people with coronary artery disease. Since then, several other blood thinners like clopidogrel (Plavix) and prasugrel (Effient) have been developed.
CPR was also developed and promoted around this time. In 2008, hands-only CPR was recognized as an effective and safer way for bystanders to take action in an emergency.
The 1970s also saw the beginning of heart-healthy lifestyle initiatives. The AHA published its first cookbook in 1973 after researchers uncovered the link between dietary fat and blood cholesterol levels.
It was also during this decade that the first scientific statement on smoking and heart disease was released. This led to a landmark report by the surgeon general and years of public health initiatives to discourage smoking. In 2009, the AHA wanted stronger laws against tobacco. The Family Smoking Prevention and Tobacco Control Act was passed. It allows the FDA to regulate tobacco, increase warning labels, ban candy-flavored cigarettes, and prohibit tobacco advertising near schools.
According to the American College of Cardiology, the most relevant topics in cardiology today include anti-obesity drugs, artificial intelligence, inflammation, and gene editing.
Medications for type 2 diabetes, including semaglutide (Ozempic, Rybelsus, and Wegovy) and tirzepatide (Zepbound and Mounjaro), have exploded in popularity. However, they’re no longer just for diabetes.
GLP-1 medications are now viewed as anti-obesity drugs. Some are approved to treat obesity by the FDA, while others may be prescribed off-label for their weight loss side effects.
Increasing evidence also shows that these medications provide significant benefits for heart health. Some studies have found that these “anti-obesity drugs” may lower the risk of major adverse cardiovascular events by 20 percent. These effects are about more than weight loss. Researchers suspect they offer additional protection for the heart muscle and the body’s metabolism as a whole, though the exact way they do this is not clear yet.
Artificial intelligence (AI) is changing the way we find and treat heart disease. AI can analyze huge datasets. It leverages this information to determine individuals’ risk of heart disease better than humans have in the past. AI technology has already been incorporated into ECGs to help diagnose multiple heart conditions.
Researchers have known for a while that inflammation promotes atherosclerosis. But now, scientists are looking at specific pathways of inflammation. This allows them to target heart disease on a more individual basis.
Finally, gene editing is a promising new frontier in cardiology. Inherited heart problems like high cholesterol and cardiac amyloidosis are slated to benefit from this new technology. The CRISPR trial is testing ways to alter the genes responsible for certain heart conditions.
The understanding of the heart and heart disease started far back into our history. To this day, researchers continue to make advancements to help those with heart disease access more treatment options and improve their quality of life.
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What do you know about your personal family history of heart disease? How has heart disease impacted your ancestors and modern-day friends and family? Tell us in the comments section or on your Activities page.
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