The progression of heart disease is associated with changes in the neurohumoral mechanisms that control cardiac function. The degree to which this neurohumoral remodeling occurs, even before overt signs of cardiac disease become manifest, is important for prognosis. To determine why some patients experience sudden death while others sustain life in the presence of severely compromised cardiac function, the neuronal control of cardiac electrical and mechanical events must be ilk are the sole valid measures of progress in the United States, the authors offer a fuller and deeper view of our nation's quality of life, gathering together statistical information on such factors as the well-being of America's children and youth, the accessibility of health care, the quality of education, or the adequacy of housing. Readers will find solid information about drug abuse, children in poverty, life expectancy, homicides, and health insurance coverage. And w e getthese facts in context, so that we know where we are improving--for instance, poverty among the elderly, infant mortality, and the high school dropout rate have all declined. Equally important, we discover where we are losing ground--suicide rates among the young are 40 percent higher than in 1970, for example, and income inequality is at its worst level in 50 years. Here then is the key to the true State of the Union. The first national survey in the U.S. to bring toget the other. With our cumulative understanding of these interdependent processes, new avenues for time-appropriate, targeted methods of treating heart diseases can be developed.

J. Andrew Armour's profile page

Jeffrey L. Ardell's profile page

J. Andrew Armour is an Associate Professor of Pharmacology at the University of Montréal Faculty of Medicine. Jeffrey L. Ardell is a Professor of Pharmacology, James H. Quillen College of Medicine, East Tennessee State University.