Biostatistics at NIH: The Early Years---Reduction in Mortality from Coronary Heart Disease and Stroke

• Activity Number: 269
• Type: Invited
• Date/Time: Tuesday, August 5, 2014 : 8:30 AM to 10:20 AM
• Sponsor: Biopharmaceutical Section
• Author(s): David DeMets*+
• Companies: University of Wisconsin-Madison
• Keywords: Mortality ; Primary prevention ; Secondary prevention

Abstract

Over the past 4 decades, morbidity and mortality from heart disease and stroke have continued to decline as a result of a series of beneficial interventions. These successes have been in both primary and secondary prevention. For example, aspirin and statin use in individuals at moderate to high risk have reduced the onset of a first major cardiovascular event. Other interventions following a myocardial infarction (heart attack) have reduced mortality and recurrence of a second event. Mortality and morbidity from heart failure have also seen dramatic reductions due to a series of successful drug and device interventions. Along the way, many other interventions were demonstrated to not be beneficial or in some cases harmful. Some interventions which were suggestive of being beneficial based on observational studies have been demonstrated to be either not effective or even harmful. Randomized clinical trials were essential in sorting out which interventions were beneficial and which were not. Biostatistics was central and essential to the design, conduct, monitoring, final analyses, and interpretation of these studies.