Despite what we might wish, neither doctors nor researchers -- nor those of us who fit both categories -- have access to a crystal ball. Therefore, predicting the future of cardiology over the next 10 years is an impossible task. But I can write about what I wish the state of cardiology to be within a decade, and what tools we have to achieve that goal.
In the first place, I wish that in 10 years cardiovascular illness will not be the primary cause of mortality and hospitalizations in both rich and developing countries. I could say that this will happen because we will discover the magic pill that reduces cholesterol, cures hypertension, eliminates the addict's desire to smoke, inspires us to exercise, or, simply put, eliminates the six known avoidable risk factors. But no. This is not what will happen.
The truth is that it would not be good news if this did happen. What I hope will happen in the next decade is that we will become ever more responsible for our own health, that we will pay attention to our cardiovascular health, and that we will reduce our chances of suffering these kinds of events.
I believe it is realistic to think that things can change for the better in this way, due to health initiatives such as those we are implementing now, and whose impacts we will see reflected in the coming years. In this way, the program to educate children about their health -- in Spain it is called SI, but it is also underway in Colombia and soon will appear in the United States -- has already been able to achieve significant changes in the behavior of the young. These children, who will nearly be adults in 10 years, will be individuals with lower cardiovascular risk, and so it is not utopian to think that the rate of pathology can change as the result of our own actions.
Of course, I believe that in the next decade we will bear witness to revelatory advances in research and treatment. We have already begun to see some of them. Take, for example, early detection. It is a known fact that cardiovascular illness is slow to show symptoms, a fact which has given way to the name "The Silent Epidemic." Therefore, it is our obligation to confront the silent nature of the pathology and succeed in early detection, when the arteries have only just begun to accumulate harmful substances -- arterial plaque, or the condition known as arteriosclerosis -- when we can still reverse the condition by therapeutic or behavioral intervention. And it will be approximately within the next decade that we will have the most interesting results of our project known as PESA-CNIC-Santander, an ambitious initiative which consists of the analysis of 5,000 apparently healthy individuals who have participated in innovative tests to determine whether they suffer from preclinical illness. The first results suggest that this will succeed, and we hope that in 10 years we will be able to correlate preclinical pathologies with risky behaviors, biometrics, etc... all so that we can prevent this silent killer.
Also in 10 years I hope to have contributed to solving another of the great problems that devastate cardiology, and for which, disgracefully, we have not done much.
The situation could appear extremely simple: if a person suffers a myocardial infarction (heart attack) and survives, they have to take care of themselves. These precautions, apart from the obvious changes in lifestyle, include the daily administration of medication. From the outside, anyone might say: "Why not?" But the reality is quite different.
Numerous studies have determined that a large percentage of this population does not take the necessary medications to prevent a second cardiovascular event. They don't do it for a number of reasons. It is not appealing to anyone to take three or four pills every day, and much less to someone who feels invulnerable, which is a quality that human beings all share, and which has caused great harm to our cardiovascular health.
For this reason, we will develop the cardiovascular multi-pill, which combines three medicines active in secondary prevention into a single pill. Although this is already a reality, within 10 years we will know how this tool has affected mortality. Thanks to the SECURE study, which begins shortly, we will know if our hypothesis is true: that deaths due to cardiovascular illness will be reduced when people take their medications more reliably, because they are simpler and more economical.
Certainly, the future of cardiovascular health is more promising now than in recent years. With the change in mentality that allows us to shift our focus from illness itself to the overall promotion of health, the integration of the study of cardiovascular illness with mental pathologies, and the development of effective tools for genomics, tissue imaging and regeneration, I hope that when the Huffington Post celebrates its twentieth, the problem of coronary illness will be much less severe than it is today. Without a doubt, we are working to achieve that.
This post is part of a series commemorating The Huffington Post's 10 Year Anniversary through expert opinions looking forward to the next decade in their respective fields. To see all of the posts in the series, read here.