Improving Health

Heart, Lung, and Kidney Health

Artificial Heart Valves

NIH supported the development of the first artificial heart valves, leading to the first successful artificial replacement of the mitral valve—the valve that connects the left chambers of the heart—at the NIH Clinical Center in 1960. Today, over 182,000 heart valve replacements are performed each year in the U.S. to treat irreparable heart valve disease.

Image credit: NIH

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  • In 1960, the first successful artificial replacements of two of the four types of heart valves—aortic and mitral—were conducted.
  • The first successful artificial mitral valve replacement was carried out by NIH researcher, Dr. Nina Braunwald—the first female cardiac surgeon and the first woman to perform open-heart surgery.
  • About 2.5% of the U.S. population has heart valve disease, which occurs when one of the four heart valves is damaged—becoming stiff, narrow, or leaky—disrupting proper blood flow.
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Aspirin Guidance

NIH-funded research on aspirin’s risks and potential benefits for preventing heart disease challenged previously held assumptions on its benefits and led to revised usage guidelines. By following the guidelines, physicians are now less likely to prescribe unnecessary daily aspirin to older adults to prevent heart disease.

Image credit: FlairImages/iStock/Thinkstock

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  • In the past, doctors had encouraged adults without existing heart disease to consider taking low-dose aspirin daily to help prevent the first occurrence of a heart attack or stroke.
  •  NIH-funded research found that in healthy older adults, aspirin did not reduce the risk of heart attack or stroke. Those taking aspirin had an increased risk of bleeding, which was already a known risk of regular aspirin use.
  • In 2021, based on this research on aspirin, the U.S. Preventive Services Task Force proposed changes in recommendations for aspirin use to prevent heart disease.
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Heart Disease

Deaths from heart disease fell 67.6% from 1969 to 2015, driven by research advances such as the NIH-funded Framingham Heart Study, which identified risk factors for heart disease and led to new prevention strategies.

Image credit: Daniel Soñé/NCI

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  • The Framingham Heart Study and other NIH-supported research identified risk factors for heart disease, such as cholesterol, smoking, and high blood pressure. 
  • Approximately half the decline in heart disease deaths since the 1960s are due to changes in lifestyle and from medications developed to reduce these risk factors. 
  • Despite this decline, heart disease is still the leading cause of death in the U.S.
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Congenital Heart Disease

Decades of NIH-supported research led to advances in diagnosis, treatment, and newborn screening mandates for congenital heart disease (CHD). As a result, over 85% of children born with CHD now survive well into adulthood.

Image credit: Shutterstock

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  • CHD is the most common type of birth defect, affecting about 8 per 1000 live births in the U.S., and is the leading cause of infant death in the U.S.
  • NIH-supported research helped inform the HHS Secretary’s decision in 2011 to add CHD to the recommended uniform infant screening panel. Screening is now mandated in D.C. and all states but California, which does require that the screening be offered.
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Type 1 Diabetes

NIH-supported research has contributed to technologies that are giving the more than 1.8 million people in the U.S. with type 1 diabetes new options for more easily managing their disease, resulting in improved health and quality of life.

Image credit: Tandem Diabetes Care

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  • In the 1990s, NIH-supported research showed that intensive management of blood glucose levels reduced the risk of long-term complications from diabetes. 
  • Type 1 diabetes affects approximately 5% of the diagnosed diabetes cases in adults and the majority of diagnosed cases in children in the U.S.
  • Two FDA-approved technologies to manage type 1 diabetes include continuous glucose monitors (CGMs), which provide real-time data on blood glucose levels without the need for finger sticks, and artificial pancreas systems, which pair a CGM with an insulin pump to adjust insulin dosage automatically.
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Type 2 Diabetes

NIH research led to the development of medications to treat type 2 diabetes—which affects more than 35 million people in the U.S.—by helping to lower blood glucose and reduce the risk of cardiovascular disease, the number one cause of death in people with diabetes.

Image credit: National Center for Biotechnology Information (https://pubchem.ncbi.nlm.nih.gov/compound/Glucagon)

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  • Risk of early death for adults with diabetes is 60% higher than for adults without diabetes.
  • Decades of basic research supported by NIH laid the foundation for the development of two classes of diabetes drugs, GLP-1 receptor agonists and SGLT2 inhibitors.
  • GLP-1 receptor agonists are also approved to treat obesity, a strong risk factor for type 2 diabetes.
  • SGLT2 inhibitors improve blood glucose control and can also reduce kidney and heart complications, two major causes of death in people with diabetes.
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Diabetes Prevention

NIH research showed that improvements in diet and physical activity can lower the risk of developing type 2 diabetes by 58% in adults at high risk. NIH support has helped to adapt the Diabetes Prevention Program’s (DPP) lifestyle-focused intervention, and it is now available in communities across the U.S. and is covered by Medicare and Medicaid.

Image credit: Darryl Leja, National Human Genome Research Institute, NIH

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  • DPP showed that behavioral interventions, such as increased physical activity and healthier eating, could delay type 2 diabetes onset by 15 years.
  • NIH-supported research has made it possible to deliver adaptations of the DPP lifestyle intervention to millions of people at risk for diabetes in the U.S. 
  • DPP contributed to the U.S. Preventive Services Task Force’s decision to recommend routine screening for type 2 diabetes in middle-aged and older U.S. adults with overweight or obesity.
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References

Artificial Heart Valves

  1. Collins JJ. N Engl J Med. 1991; 324(9)624-6. PMID: 1992323.
  2. Harken DE, et al. J of Thor and Cardio Surg. 1960; 40:744-62. PMID: 13711583.
  3. Braunwald NS, et al. J of Thor and Cardio Surg. 1960; 40:1-11. PMID: 13804040
  4. Report: Cardiac Surgery Market Size, Share, and Trend Analysis: https://idataresearch.com/product/cardiac-surgery-market-united-states/
  5. Sabharwal N, et al. Tex Heart Inst J. 2017; 44(2)96-100. PMID: 28461793.
  6. Valvular Heart Disease: https://www.cdc.gov/heartdisease/valvular_disease.htm
  7. Frankel WC, et al. JAMA. 2021; 325(24)2512. PMID: 34156406.
  8. Heart Valve Replacement: https://my.clevelandclinic.org/health/treatments/23966-heart-valve-replacement

  9. Aspirin Guidance

  10. Arnett DK, et al. Circulation. 2019;140(11):e596-e646. PMID: 30879355.
  11. Article: Daily low-dose aspirin found to have no effect on healthy lifespan in older people: https://www.nia.nih.gov/news/daily-low-dose-aspirin-found-have-no-effect-healthy-lifespan-older-people
  12. Article: Daily Aspirin May Not Benefit Healthy Older Adults: https://newsinhealth.nih.gov/2018/11/daily-aspirin-may-not-benefit-healthy-older-adults
  13. U.S. Preventive Services Task Force: Task Force Issues Draft Recommendation Statement on Aspirin Use to Prevent Cardiovascular Disease: https://www.uspreventiveservicestaskforce.org/uspstf/sites/default/files/file/supporting_documents/aspirin-cvd-prevention-final-rec-bulletin.pdf
  14. Final Recommendation Statement: Aspirin Use to Prevent Cardiovascular Disease: Preventive Medication: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/aspirin-to-prevent-cardiovascular-disease-preventive-medication

Heart Disease

  1. Weir HK, et al. Prev Chronic Dis. 2016;13:E157. PMID: 27854420.
  2. Levy D. Nat Rev Drug Discov. 2008;7(9):715-715. PMID: 19172683.
  3. The Framingham Heart Study: Laying the Foundation for Preventive Health Care: https://www.nih.gov/sites/default/files/about-nih/impact/framingham-heart-study.pdf
  4. Heart Disease Facts: https://www.cdc.gov/heartdisease/facts.htm

Congenital Heart Disease

  1. Gurvitz M, et al. J Am Coll Cardiol. 2016;67(16):1956-64. PMID: 27102511.
  2. American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. 2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: Executive Summary. 2018. https://www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000000602
  3. Interagency Coordinating Committee on Newborn and Child Screening (ICC): Screening for Critical Congenital Heart Disease: https://www.hrsa.gov/sites/default/files/hrsa/advisory-committees/heritable-disorders/reports-recommendations/response-congenital-cyanotic.pdf
  4. Actions in Support of Newborn Screening for Critical Congenital Heart Disease — United States, 2011–2018: https://www.cdc.gov/mmwr/volumes/68/wr/mm6805a3.htm?s_cid=6805a3_e
  5. Burns KM, et al. Pediatr Cardiol. 2017;38(5):974-980. PMID: 28349207.
  6. What are Congenital Heart Defects?: https://www.nhlbi.nih.gov/health-topics/congenital-heart-defects

Type 1 Diabetes

  1. National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States https://www.cdc.gov/diabetes/data/statistics-report/index.html
  2. Brown SA, et al. N Engl J Med. 2019;381(18):1707-1717. PMID: 31618560. 
  3. Breton MD, et al. N Engl J Med. 2020;383(9):836-845. PMID: 32846062.
  4. Article: FDA Approves UVA-Developed Artificial Pancreas: https://newsroom.uvahealth.com/2020/01/02/fda-approves-uva-developed-artificial-pancreas/
  5. Article: Artificial pancreas system better controls blood glucose levels than current technology: https://www.nih.gov/news-events/news-releases/artificial-pancreas-system-better-controls-blood-glucose-levels-current-technology
  6. Article: Artificial pancreas effectively controls type 1 diabetes in children age 6 and up: https://www.nih.gov/news-events/news-releases/artificial-pancreas-effectively-controls-type-1-diabetes-children-age-6
  7. Article: Bionic pancreas improves type 1 diabetes management compared to standard insulin delivery methods: https://www.nih.gov/news-events/news-releases/bionic-pancreas-improves-type-1-diabetes-management-compared-standard-insulin-delivery-methods
  8. Article: Four pivotal NIH-funded artificial pancreas research efforts begin: https://www.nih.gov/news-events/news-releases/four-pivotal-nih-funded-artificial-pancreas-research-efforts-begin

Type 2 Diabetes

  1. National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States https://www.cdc.gov/diabetes/data/statistics-report/index.html
  2. Diabetes Fast Facts: https://www.cdc.gov/diabetes/basics/quick-facts.html
  3. Prevalence of Obesity and Severe Obesity Among Adults: United States, 2017–2018: https://www.cdc.gov/nchs/products/databriefs/db360.htm
  4. Wadden TA, et al. JAMA. 2021;325(14):1403-1413. PMID: 33625476. 
  5. Article: FDA OKs Injectable Semaglutide for Chronic Weight Management: https://www.medpagetoday.com/endocrinology/obesity/92936?xid=NL_breakingnewsalert_2021-06-04&eun=g950414d0r
  6. Abbasi J. JAMA. 2021;326(2):121-123. PMID: 34160581. 
  7. Article: FDA Approves New Drug Treatment for Chronic Weight Management, First Since 2014: https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014?utm_medium=email&utm_source=govdelivery
  8. Yanovski SZ, et al. JAMA. 2021;326(2):129-130. PMID: 34160571.
  9. Sanyal AJ, et al. N Engl J Med. 2021;385(17):1559-1569. PMID: 34670043. 
  10. Article: Story of Discovery: SGLT2 inhibitors: harnessing the kidneys to help treat diabetes: https://www.niddk.nih.gov/news/archive/2016/story-discovery-sglt2-inhibitors-harnessing-kidneys-help-treat-diabetes

Diabetes Prevention

  1. A Snapshot: Diabetes in the United States: https://www.cdc.gov/diabetes/pdfs/library/socialmedia/diabetes-infographic.pdf
  2. Diabetes Prevention Program: https://www.niddk.nih.gov/about-niddk/research-areas/diabetes/diabetes-prevention-program-dpp/Pages/default.aspx
  3. Diabetes Prevention Program Outcomes Study: https://dppos.bsc.gwu.edu/
  4. ClinicalTrials.gov Diabetes Prevention Program page: https://clinicaltrials.gov/ct2/show/NCT00004992
  5. ClinicalTrials.gov Diabetes Prevention Program Outcomes Study page https://clinicaltrials.gov/ct2/show/record/NCT00038727?term=diabetes+prevention+program
  6. NIDDK Central Repository: Diabetes Prevention Program: https://repository.niddk.nih.gov/studies/dpp/
  7. NIDDK Central Repository: Diabetes Prevention Program Outcomes Study: https://repository.niddk.nih.gov/studies/dppos/
  8. dkNET Search for “DPP study”: https://dknet.org/Any/search?q=DPP%20study&l=DPP%20study&restarted
  9. dkNET Search Results for “DPPOS study” https://dknet.org/Any/search?q=DPPOS%20study&l=DPPOS%20study
  10. Type 2 Diabetes Knowledge Portal: https://t2d.hugeamp.org/
  11. Article: NIH study finds interventions to prevent type 2 diabetes give good return on investment: https://www.nih.gov/news-events/news-releases/nih-study-finds-interventions-prevent-type-2-diabetes-give-good-return-investment
  12. Siu AL. Ann Intern Med. 2015;163(11):861-8. PMID: 26501513. 
  13. Klabunde CN, et al. Am J Prev Med. 2022;62(2):e77-e86. PMID: 34657771. 
  14. What Are Overweight and Obesity?: https://www.nhlbi.nih.gov/health/overweight-and-obesity

This page last reviewed on December 8, 2023