In the field of cardiovascular medicine, Dr. Nissen says that doctors have largely relied on mechanical solutions to biochemical problems. For example, atherosclerosis, the hardening of the arteries and a major cause of cardiovascular disease, is a biochemical problem caused in part by corrosive fluid "rusting" the tubes in our body. Yet heart surgeons and cardiologists have relied on surgical procedures, such as bypass grafts, as well as devices called stints to relieve clogged arteries.
Both treatments are mechanical interventions that have their limits, Dr. Nissen says. He says the future of the rapidly changing field is going to see fewer of these mechanical interventions as doctors and patients move "from an interventional era to a prevention era."
Dr. Nissen says that much of the burden of heart disease and stroke—the principal components of cardiovascular disease—could be eliminated by reducing their major risk factors: high blood pressure, high blood cholesterol, tobacco use, diabetes, physical inactivity and poor nutrition.
"If we can intervene early enough—particularly now that we know the disease starts early—and change that metabolic, that chemical milieu, then we can largely prevent these kinds of problems," he says.