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The future: cardiovascular medicine in 10 years
  1. Karl Swedberg
  1. Department of Medicine, Sahlgroska University Hospital Östra, S-41685 Göteborg, Sweden
  1. Professor Swedberg email: karl.swedberg{at}

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In the last 10 years important developments have taken place in cardiovascular medicine, and it is necessary to consider these in order to understand fully what can be expected in the coming decade.

Speaking to the Royal College of Physicians in London during 1944, Winston Churchill said “the more you can look back, the further you can look forward”. In the 1970s Julius Comroe, a physiologist at the Cardiovascular Research Institute in San Francisco, coined the term “retrospectoscope” to describe a useful tool for looking at the past with the benefit of hindsight. He discovered that in over 40% of the key discoveries in cardiovascular medicine, the clinical potential of the finding was not realised at the time. It is clearly very difficult to predict the future. Comroe also appreciated the importance of pioneers having ‘the courage to fail’ and a willingness to take risks.



Looking back over 10 years in the management of hypertension, there have been some major breakthroughs: recognition of the importance of systolic hypertension and the treatment of elderly patients; definition of blood pressure targets; and the individualising of treatment based on patient risk factors.

In terms of treatment, many of the drugs used today were available 10 years ago: diuretics, β blockers, angiotensin converting enzyme (ACE) inhibitors, and calcium channel blockers (table 1). One important new …

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