More on the NHLBI fiasco

October 10, 2002

NHLBI is now issuing this standard response, as a result of all the e-mails that have poured in to protest the Women's Heart Health Awareness Campaign.

It is obvious that they are hearing us, but not yet listening. Maybe a few more irate messages will do the trick:

Again, Dr. L'Enfant's direct e-mail is lenfantc@nhlbi.nih.gov (lenfantc-at-nhlbi.nih.gov)

Now that we have their attention, let's not let up. Tell them that the NHLBI has never done a Heart Health Awareness Campaign exclusively for men, so why are they now doing a Heart Health Awareness Campaign exclusively for women?

The National Heart, Lung, and Blood Institute (NHLBI) has received a number of communications expressing concern that it may not be devoting appropriate attention to cardiovascular disease issues in men. To address these comments, the Institute has prepared the following statement.

From its inception as the National Heart Institute in 1948, the NHLBI has consistently addressed the health of all Americans. The Institute's long history of programs to address the needs of both men and women began in 1948 with the Framingham Heart Study, which included approximately equal numbers of each. However, during the Institute's earlier years, it placed particular emphasis on heart disease in men for the simple and compelling reason that they were experiencing heart disease morbidity and mortality at alarming and growing rates. More recently, the Institute has implemented selected efforts to fill the gaps in knowledge relating to cardiovascular disease in women. For example, current approaches to evaluating chest pain in men are often ineffective in establishing a diagnosis in women, and better approaches are being sought.

It is certainly true that the preponderance of participants in NHLBI-supported clinical research in 1998 were women (251,000 men versus 543,367 women). However, this does not in any way imply that the Institute neglects the health needs of men. In fact, much of the apparent excess is attributable to the 162,000 women enrolled in the Women's Health Initiative (WHI), a trial sponsored by the National Institutes of Health that addresses a number of health issues relevant to postmenopausal women. The WHI is counted in the NHLBI totals only because the NHLBI administers it, not because it is part of our research portfolio. Also counted in the NHLBI totals are nearly 50,000 women participating in trials evaluating the efficacy of aspirin and antioxidant vitamins in preventing heart disease - issues that were resolved for men in a separate men-only trial (the Physicians' Health Study) conducted some years ago. In addition, the NHLBI total includes over 30,000 women participating in studies related to complications of hypertension during pregnancy.

The NHLBI has, for 30 years, supported health education programs that translate the results of our research programs into practical recommendations for health-care professionals, patients, and the public. Readers may be interested to learn that the two longest-running and most influential programs, which concern high blood pressure and cholesterol, were launched on the basis of findings from large-scale clinical studies conducted in men alone. Over the years, the Institute has directed its health-education messages to persons of both sexes and all racial/ethnic groups, and much evidence indicates that they have been highly effective. However, it has become apparent over the past several years that many women, unlike men, fail to understand their risk of developing heart disease and neglect to take steps to reduce it. Accordingly, we have developed some new campaigns and materials, specifically designed for women, to address this gap in our health promotion efforts.

Carl A. Roth, Ph.D., LL.M.
Associate Director for Scientific Program Operation
National Heart, Lung, and Blood Institute
Bldg. 31/Rm. 5A03
31 Center Drive MSC 2482
Bethesda, MD 20892-2482
Phone: 301-496-6331
Fax: 301-402-1056
Email: rothc@nih.gov