The next 30 years--will the progress continue?

Spectacular progress has occurred in cardiology during the past 30 years.The major advances that have resulted in the better methods of diagnosis and treatment of patients stem from basic research that was often unrelated to the ultimate practical application.An excellent example of this process is the evolution of the concept of ,B blockade from the pharmacology laboratory to practical clinical application in a variety of conditions.The sequence of discovery, translation, and application depends on many factors, but most important is the trained, dedicated investigator.If progress is to continue, a constant supply of bright young men and women must enter careers in basic research and clinical investigation.Recent studies show that the pool of bio- medical scientists is shrinkiing and fewer young people are selecting research careers; thus, the process upon which our future depends is threatened.The socioeconomic forces that tend to turn the potential stars of the future away from research careers have been identified, and they must be counterbalanced.For 30 years. the American Heart Association has been a leader in the conquest of heart disease through research.The faith of the Association in research must be reaffirmed.The relationship of today's basic research to the good medical care of the future must be explained to the people and to their elected represen- tatives in words that they understand.Action must be taken to assure the continuation of the research enterprise that has been respoinsible for the progress of the last 30 years.THE 1979 Conner Lecture represents a break with tradition.In recent years lecturers have described the application of science to clinical medicine: nuclear cardiology, ultrasound in the diagnosis of heart dis- ease, and the mechanism of action of antiarrhythmic drugs have been discussed.This year the President of the American Heart Association, Dr. Jack Eckstein, has become con- cerned that the process of discovery and clinical application of new science, which has been the subject of the Conner lectures, may itself be in danger, and has asked me to address this issue.Research is important to practitioners and to those who are in academic medicine.Every day car- diologists use knowledge that did not exist a few years ago.If progress is to continue, the research establish- ment must remain strong and productive.Progress may not continue at the same rate.We must examine this threat and take action.