Reflections of the Editor-in-Chief

Along with our entire team, I have learned a great deal in the 2 years since I was tapped to be Editor-in-Chief of Circulation . Now, looking back, I have reflected on the insights we’ve gleaned during this early journey.The scope of cardiovascular disease is now more global than ever. Whereas in previous years, communicable diseases were the major killer in low- and middle-income nations, they have largely been replaced by heart disease, vascular disease, and stroke. The prevalence of cardiovascular disease is growing rapidly in Asia and beyond, as lifestyles have evolved to include high-calorie consumption and diminished physical activity.Meanwhile, in the West, the scope of cardiovascular disease is also evolving, with a shift from atherothrombotic manifestations toward disease triggered by metabolic stress. In fact, in many ways, the face of cardiovascular disease in developed countries is increasingly shaped by heart failure, whereas in the developing world the immediately lethal manifestations of myocardial infarction and stroke continue to rise. Heart disease is emerging with 2 faces in different parts of the globe.To address the global manifestations of cardiovascular disease, we have implemented a distributed leadership …