NHLBI: 50 years young

By Richard McCarty
Executive Director for Science

The National Heart, Lung and Blood Institute (NHLBI), one of the largest institutes of the National Institutes of Health (NIH) in Bethesda, Md., has accomplished a great deal in its 50?year history. Indeed, the vast majority of people in this country have had some aspect of their lives affected by NHLBI research findings and policy recommendations. As health-care consumers, we all laud the advances in knowledge about, and treatment of, cardiovascular, pulmonary and blood diseases, to which NHLBI researchers have contributed so heavily. But as psychologists, we owe a special debt to NHLBI, and the psychologists who have stoked the forge there, for the leading role the institute has played as a crucible for health psychology research.

Back in the dark ages, before many institute directors at NIH would admit that human behavior could be systematically studied and shown to have profound influences on health, there were psychologists toiling at NHLBI, patiently arguing internally for resources for health psychology and behavioral medicine research. Throughout the 1980s, Stephen Weiss, now at the University of Miami, was a visionary leader of what was then called the Behavioral Medicine Branch of the institute. He was instrumental in steering training dollars and conference funding to benefit behavioral and social science research, especially on cardiovascular issues.

Other psychologists in that branch, including Sally Shumaker, now at the Bowman Gray School of Medicine, helped develop an area of research that investigates and develops quality of life measures. Many psychologists may not be aware that NHLBI was one of the first NIH institutes, and is still the foremost to include quality of life assessments in all its research. And Katrina Johnson helped forward the branch?s work on minority and women?s health.

Behavioral research at NHLBI now benefits from the able leadership of Peter Kaufmann, and his talented colleagues, Drs. Susan Czajkowski, Robin Hill and Sarah Knox. And I happily give credit where it is due: Claude Lenfant, who has served as director of NHLBI for the past 16 years, is unfailingly open to discussing behavioral contributions to health and illness, and to allocating the resources of the institute toward these vital research issues.

A bright future

Behavioral research has been an important element in the NHLBI portfolio, and the future looks especially bright. Indeed, many critical issues facing NHLBI for the next fifty years are tied to behavioral science issues. These opportunities for research and practice in the behavioral sciences are presented in compelling fashion in a report issued by NHLBI in February 1998. The report, 'Behavioral Research in Cardiovascular, Lung and Blood Health and Disease,' was prepared by the Task Force on Behavioral Research chaired by Stephen B. Manuck of the University of Pittsburgh. The task force members took stock of how behavioral research has contributed to a clearer understanding of disease risk, risk reduction and treatment across the spectrum of issues of interest to the institute. In addition, the report stakes out the areas of research where behavioral scientists are poised to make significant advances.

The report conveys to NHLBI that interdisciplinary research, including behavioral science approaches, must be a high priority for future funding initiatives and graduate and postdoctoral training programs. The report also calls for increased attention by behavioral scientists to lung and blood diseases. Given the disparities in prevalence of cardiovascular diseases across ethnic minority groups, the task force encourages additional behavioral research on understudied populations and development of culturally sensitive behavioral interventions. More research needs to be focused on individuals? long-term maintenance of behavior change. And the list goes on.

The report is available on NHLBI?s web site at www.nih.gov/nhlbi/sciinf/taskforc.htm. And an important article by Dr. Lenfant from the July 28, 1998, issue of the journal Circulation, summarizing the report?s findings, is online at www.nih.gov/nhlbi/commdir.behav.htm.

The take-home message of this report is that behavioral science is very much a core area of research at NHLBI. The opportunities are there to be seized. With the dramatic increase in the Fiscal Year 1999 NHLBI budget, the funds are available to implement this compelling set of recommendations.

What great timing as we prepare for the Decade of Behavior. Join me in raising a glass (calcium-fortified, low-sodium and anti-oxidant-rich orange juice, please) to NHLBI on its 50th birthday!