Emergence of the concept of cardiovascular disease

Historically, the concept of cardiovascular disease is a recent and evolving concept. Well into the eighteenth century, cardiac and vascular diseases were little known and considered a rarity. Description of the circulation by William Harvey (1578–1657) in 1628 marks the beginning of the changes that ensued. However, knowledge was slow to accrue and not until the nineteenth century was the heart taken as a specific object of study. The description of end-stage kidney disease by Richard Bright (1789–1858) in 1827 launched studies of the vasculature, which were to lead to the recognition of hypertension and subsequent identification of the lesions of arteriosclerosis (1833) and atherosclerosis (1904) as diseases of the vasculature. Only between the two world wars did the full impact of these lesions on mortality and morbidity come to be finally recognized. Their study and therapy has defined much of the profound changes that affected twentieth century medicine.