Cardiovascular Therapeutics - Applications of Biotechnology in Cardiovascular Therapeutics - page 1

Chapter 1
Cardiovascular Therapeutics
Introduction
Drug therapy of the cardiovascular system is different from delivery to other
systems because of the anatomy and physiology of the vascular system; it supplies
blood and nutrients to all organs of the body. Drugs can be introduced into the
vascular system for systemic effects or targeted to an organ via the regional blood
supply. In addition to the usual formulations of drugs such as controlled release,
devices are used as well. A considerable amount of cardiovascular therapeutics,
particularly for major and serious disorders, involves the use of devices. Some of
these may be implanted by surgery whereas others are inserted via minimally inva-
sive procedures involving catheterization. Use of sophisticated cardiovascular
imaging systems is important for the placement of devices. This chapter will start
with a brief introduction to cardiovascular diseases, historical evolution, and trends
in future therapeutics.
History of Cardiovascular Therapy
Ancient Chinese and Egyptian physicians knew about the heart and the pulse but
there was no concept of circulation or treatment of heart disease. The sixteenth
century father of anatomy, Andreas Vesalius, first described proper anatomy of the
human heart, and the seventeenth century English physician, William Harvey,
described the circulation of the blood. A Cambridge-trained physician, William
Heberden, provided the classic description of pain due to coronary heart disease
and named it angina pectoris. Landmarks in the historical evolution of cardiovascu-
lar therapy are shown in Table 1.1 .