Almost 75% of all deaths in industrialized countries, including Germany, are caused directly or indirectly by vascular dysfunction. The high mortality associated with cardiac ischemia and stroke results from organ failure. Yet, the underlying cause for these diseases is vascular dysfunction. Similarly, neoplastically transformed tumor cells are at the heart of the cancer problem. Yet, tumors cannot grow without blood vessels and metastatic spread is critically dependent on blood and lymphatic vessels. In addition to being a major determinant of human mortality, vascular dysfunction is also critically involved in numerous medically and socioeconomically relevant chronic diseases.

These include peripheral arterial occlusive disease with its resulting amputations, diabetic micro- and macro-angiopathies resulting in diabetic nephropathy (renal insufficiency / renal replacement therapy) and diabetic retinopathy (blindness), as well as a number of organ-related disorders such as vascular dementia, senile macular degeneration, pulmonary hypertension, liver cirrhosis, portal hypertension, and inflammatory vascular diseases such as rheumatoid arthritis and psoriasis.

Hypertension is one of the most important risk factors for a number of the serious vascular diseases listed above and the ageing population is also significantly contributing to the increasing importance of vascular diseases and their complications. High-level medical care of these patients is generally well ensured; however, the pace of improving the care of patients with acute life-threatening vascular diseases (acute myocardial infarction/stroke) has been substantially faster compared to the rather modest progress made in the care of chronically ill patients.

The standard of health care in all areas of vascular medicine is very high throughout Germany. In contrast, a concerted effort to develop Centers of Excellence in vascular and cardiovascular research is largely missing. Yet, there is an urgent need considering the importance of vascular dysfunction for human health. University-based vascular research is mostly pursued at physiology and pharmacology departments. There is, however, a serious shortage of junior scientists in the field, which is alarming considering how enormously important intensified basic vascular research will be to feed the pipeline for translational efforts in the field of vascular medicine.

The shortage of junior scientists may be due to the widespread recruiting problems in all areas of pre-clinical medicine as pre-clinical physicians have fewer career opportunities compared to their clinical colleagues. University-based clinical research in the field of vascular medicine is mostly pursued in cardiology, neurology, nephrology or endocrinology departments. There is, however, considerable variability in the scope and strength of this research collectively contributing to an overall insufficient critical mass of cutting-edge vascular research.

There are presently only five collaborative research centers (SFBs) and one transregional collaborative research center (TRR) in the field of cardiovascular research funded by the Deutsche Forschungsgemeinschaft (DFG) (of a total of 280 SFBs in Germany). Most of these focus primarily on cardiac and not on vascular research. Among the translational German Health Centers, the German Center for Cardiovascular Research (DZHK) similarly focuses on cardiology and only one DZHK partner site (Frankfurt) has a primary vascular mission. Similarly, the Max Planck Society supports basic vascular and cardiovascular research only to a limited extent. Two of the four departments at the Max Plank Institute for Heart and Lung Research in Bad Nauheim have a vascular focus and there are two vascular departments at the Max Planck Institute for Molecular Biomedicine in Münster.

The Helmholtz Association has set up a program in cardiovascular and metabolic diseases. However, there is not a single major Helmholtz Center fully concentrating only on this field as has been established for cancer research (Heidelberg), infectious diseases (Braunschweig) or neurodegenerative diseases (Bonn). In comparative terms, cancer research receives almost five times the budget of the cardiovascular research program.