The National Academy of Medicine at 50 — Conquering Atherosclerotic Cardiovascular Disease

This perspective article marks the 50th anniversary of the National Academy of Medicine and traces the remarkable decline in cardiovascular mortality in the United States, nearly 50% over five decades. It highlights cross-disciplinary advances in genomics, molecular biology, and public health that catalyzed translational discoveries, notably the LDL cholesterol hypothesis, PCSK9 research, and the development of statins and targeted biologics. Landmark trials like SPRINT and LAAOS III shaped evidence-based practice, while evolving social determinants of health and persistent inequities remain pressing challenges. The article proposes a shift from managing late-stage disease toward precision prevention beginning early in life, integrating biomarkers, wearable technology, and digital tools. It outlines how progress in atherosclerosis stems from the fusion of basic science, large-scale trials, public policy, and community engagement, and emphasizes a future focused on genomic risk prediction, preemptive therapeutics, and equitable health strategies.

This perspective article marks the 50th anniversary of the National Academy of Medicine and traces the remarkable decline in cardiovascular mortality in the United States, nearly 50% over five decades. It highlights cross-disciplinary advances in genomics, molecular biology, and public health that catalyzed translational discoveries, notably the LDL cholesterol hypothesis, PCSK9 research, and the development of statins and targeted biologics. Landmark trials like SPRINT and LAAOS III shaped evidence-based practice, while evolving social determinants of health and persistent inequities remain pressing challenges. The article proposes a shift from managing late-stage disease toward precision prevention beginning early in life, integrating biomarkers, wearable technology, and digital tools. It outlines how progress in atherosclerosis stems from the fusion of basic science, large-scale trials, public policy, and community engagement, and emphasizes a future focused on genomic risk prediction, preemptive therapeutics, and equitable health strategies.