Foreword

Over the last 70 years, there has been a major increase in atherosclerotic coronary artery disease, with a result of cardiovascular disease accounting for 50% of all deaths in the USA. During the last 40 years, there has been a major reduction of deaths from coronary artery disease, which is the result of remarkable advances in the diagnosis and treatment of these disorders. The advances included the availability of (1) pharmacologic agents to treat angina, hypertension, lipid abnormalities, thrombolytics, antithrombotic, antiplatelet agents; and diabetes; (2) diagnostic tests both invasive and noninvasive; (3) myocardial revascularization with percutaneous catheter interventions and coronary artery bypass graft surgery; and (4) characterization of acute coronary syndromes and their treatments. At the same time, the incidence of smoking has decreased but the incidence of obesity has increased.

To put all this material together so that it is clinically appropriate required the mind, skill and knowledge of a superb senior clinician, teacher, and scientist. Robert O'Rourke is such an individual. The Editorial Board and I are grateful and obliged to him for his article, which is a masterful contribution. It is insightful and comprehensive and applies to chronic stable angina. We are also grateful to Drs. Robert Frye⁎ and Gerald Gau† for their comments.