Request for Information (RFI) for Bethesda+40: Forty Years after the Bethesda Conference on Declining Mortality from Coronary Heart Disease

Notice Number: NOT-HL-16-440

Key Dates
Release Date: September 13, 2016
Response Date: "New Date - January 13, 2017" as per issuance of NOT-HL-16-463 (old response date: December 31, 2016 ) 

Related Announcements

Issued by
National Heart, Lung, and Blood Institute (NHLBI)


The purpose of this Request for Information (RFI) is to solicit input on a conference that will address international trends in cardiovascular morbidity and mortality.  This conference will be convened in 2018, on or near the 40th anniversary of the landmark “Conference on the Declining Mortality from Coronary Heart Disease” (CHD), which took place in Bethesda, Maryland on October 24-25, 1978.


The 1978 Bethesda Conference on the Declining Mortality from Coronary Heart Disease brought together a panel of international experts from a wide range of disciplines and expertise, including: epidemiology, clinical cardiology and public health. The panel called attention to and illuminated the previously unappreciated and unexplained abatement of the epidemic of heart disease.  A voluminous report was published as a result of the 1978 conference and served in many ways as a model for a systematic and careful analysis regarding the decline in CHD mortality. At the time, the panel concluded that the decline was almost certainly real and that a range of factors acting together, from changes in risk factor profiles to improved clinical management, were all likely to have contributed to this new trend. Strikingly, however, this phenomenon appeared to be confined to the US with only equivocal evidence that similar declines were occurring in other countries.

In the ensuing years, age-specific cardiovascular death rates have continued to decline sharply throughout the world and are still declining today. In 1978, few if any of the conference participants could have foreseen how deep and continuous the decline would be. Now, nearly 40 years later, despite the huge growth in knowledge and advances in treatment, there remain some remarkable and unresolved issues about this decline.

Information Requested

The NHLBI proposes to bring together leading experts in a broad range of fields to consider from a global perspective where we are in terms of understanding the direction, magnitude, differences, and drivers of trends in cardiovascular disease worldwide. The meeting would of necessity be transdisciplinary. To answer the big questions about the drivers of past changes and the likely trajectories in the future is something that cannot be achieved by scientists from one area only. Leaders in clinical medicine would need to work with epidemiologists, public health specialists, health policy specialists, implementation research experts, big data experts, as well as researchers exploring more basic mechanisms in biomedical, behavioral, and social science research.  To aid in the design of this planned conference, the NHLBI asks for comments and suggestions related to, but not limited to, the following scientific issues:

  • Current understanding of the long term trends in cardiovascular disease in national populations, and variations between them, in countries with reasonable cause-specific mortality data.
  • Knowledge on the absolute levels and temporal trends in mortality rates from heart disease and stroke and associated risk factors in low- and middle-income countries
  • Data on trends in cardiovascular risk factors and implementation of new treatments and prevention strategies and the role these have played in the declining trends in cardiovascular morbidity and mortality.
  • The role played by socioeconomic and other disparities in access to medical care
  • The likelihood that declines in mortality rates from heart disease and stroke in high   income countries will continue into the future, and what needs to be done to maximize the chance that this decline will continue and benefit all sections of society, defined by age, sex, ethnicity and socio-economic position
  • Data needs and new modelling strategies required in order to improve our capacity to monitor cardiovascular disease burden and anticipate future trends in different areas of the world: high, middle and low income
  • Implications for education and training of the research workforce
  • Strategic priorities for biomedical research funding agencies that could lead to an even bigger impact than the original Bethesda Conference made on research, data collection, and policy development in support of continued declines in cardiovascular disease mortality rates in coming years.

Submitting a Response

All responses must be submitted to by December 31, 2016. Please include the Notice number NOT-HL-16-440 in the subject line. Responders are free to address any or all of the categories listed above. The submitted information will be reviewed by NIH staff.

Responses to this RFI are voluntary. Please do not include any proprietary, classified, confidential, or sensitive information in your response. NIH will use information submitted in response to this RFI at its discretion and will not provide comments to any responder's submission. The collected information will be reviewed by NIH staff, may appear in reports, and may be shared publicly on an NIH website.

The Government reserves the right to use any non-proprietary technical information in summaries of the state of the science, and any resultant solicitation(s). The NIH may use information gathered by this RFI to inform development of future funding opportunity announcements.

This RFI is for information and planning purposes only and should not be construed as a solicitation or as an obligation on the part of the Federal Government, the National Institutes of Health (NIH), or individual NIH Institutes and Centers. NIH does not intend to make any awards based on responses to this RFI or to otherwise pay for preparation of any information submitted or for the Government's use of such information. No basis for claims against the U.S. Government shall arise as a result of a response to this request for information or from the Government’s use of such information.


Inquiries an mailed responses should be sent to:

George A. Mensah, MD
National Heart, Lung, and Blood Institute (NHLBI)
Telephone: 301-435-0422