/Health

There's a detail in this story that I find more interesting than it looks at first: for ten years, basically one man and his team decided what counted as "relevant cardiovascular science" for the rest of the world. That's not nothing. Dr. Joseph A. Hill is leaving his post as editor-in-chief of Circulation at the end of June, the flagship scientific journal of the American Heart Association and one of the most respected publications (maybe the most respected, honestly) in cardiology. For his leadership at the journal, and for a career built entirely around cardiovascular research, he's receiving the Gold Heart Award, the highest honor the AHA gives to volunteers. The ceremony is June 23rd, in Irving, Texas. ## A hundred papers a week, six survive That number is hard to ignore. Every week, around 100 papers come in for review at Circulation. Of those, usually about six end up getting published. The rest don't make it. The selection happens in weekly virtual meetings, with associate editors spread across 17 different countries arguing over which studies actually bring something new and methodologically sound. And it's not a quick skim either: every approved paper has already passed through six to ten people, between editors and outside reviewers, before it turns into a printed (or digital, sure) page. Hill described the process as redundant and exhausting, but according to him, it's exactly that redundancy that makes the whole system work. What's interesting is he said these meetings are, like, the highlight of his week. Not because of the weight of the decisions themselves, though that's part of it, but because of the company. People who clearly put real time and serious attention into the papers, but who also swap personal news and dumb jokes like any work group that's been together for years. That's the part he said he'll miss most when he leaves. ## The number that more than doubled Under his leadership, the journal's impact factor (a somewhat dry metric to explain, but basically it measures how often published papers get cited later in other research) jumped from 19 to 41. That's a big leap by the field's standards. It helped cement Circulation as the most influential cardiology publication in the world. But there's a caveat Hill himself is quick to raise: for him, that citation number doesn't tell the whole story. What actually matters is whether the journal is helping doctors treat patients, even when those doctors never formally cite a single Circulation paper anywhere. That thinking is also what led him to expand the number of themed issues — he made the "Go Red for Women" issue, focused on women's heart health, an annual feature, and created others centered on cardiovascular surgery and on disparities in access to cardiovascular care. ## Who the guy behind it actually is Hill isn't just an editor, worth remembering that. He's a professor of internal medicine and molecular biology at UT Southwestern Medical Center in Dallas, where he still sees patients and trains medical students, residents, fellows. He spent 21 years (yes, 21) as chief of the institution's Division of Cardiology and now directs the Harry S. Moss Heart Center. His research line looks at how the heart remodels itself under stress, basically trying to understand the molecular and cellular mechanisms behind heart disease. One of his current focuses is heart failure, a condition that, he says, has been growing quite a bit in recent years. And the explanation isn't as obvious as it sounds: it's not that the disease itself is spiraling out of control, it's that more people now survive heart attacks, arrhythmias and cancer treatment, and those situations leave damage on the heart that, in the past, would've simply killed the patient before it ever became a chronic problem. He trained in medicine and did a PhD in pharmacology at Duke. The choice to go into cardiology came, he says, from wanting to combine real research with direct patient contact, something not every specialty allows quite as well. In 2015, when the editor-in-chief position opened up, it was a phone call from Eugene Braunwald, widely seen as the "father of modern cardiology" and Hill's mentor during his clinical training, that convinced him to apply. ## And then there's the volunteer work, which is basically a second career Outside the journal, Hill has been (or still is) involved in pretty much every front the AHA has to offer. He chaired regional boards in Dallas and the Southwest region of the US, sat on scientific councils covering both clinical practice and research at the national level, led several internal committees, and helped shape the content of major field conferences, including Scientific Sessions, the association's flagship scientific meeting. Nancy Brown, the AHA's CEO, spoke about his scientific output — hundreds of peer-reviewed papers over the course of his career — and the impact his mentorship has had on generations of researchers. According to her, he expanded the journal's global reach and strengthened its reputation as a trustworthy source of current cardiovascular science, always with a lot of rigor and attention to accuracy. ## What's left after the role Hill said he's not entirely sure yet what he'll do with the more than 20 hours a week he used to put into the journal. The simplest idea he mentioned was something as basic as taking a Sunday afternoon off, without guilt. When medical students ask him how he defines success, his answer tends to be straightforward: family is, by far, the most important thing. His two sons, Christopher and Teddy (from his marriage to Beverly), are now following the same path, studying medicine. Hill thinks they picked up, from years of conversations at home, this idea of trying to leave the world a little better than you found it, even if in the end that just means having tried, with no guarantee of any result at all. Either way, it's the kind of career that mixes technical rigor with a lot of behind-the-scenes work, the kind nobody really sees. Worth keeping in mind next time someone cites a Circulation paper like it's obvious it got there on its own. --- *Based on original reporting by Katherine Shaver, published by the American Heart Association.*