[The future of cardiology in Spain from the perspective of the last 30 years].

Socioeconomic and geoenvironmental factors combined with technological advances play a decisive role in diseases control and in the imbalances in health care among countries and also among social groups within one country. We discuss the frequency and trends of cardiovascular disease in Spain during the last 30 years, the socioeconomical changes in health care and the role of the cardiologist over the last decade, as a background for the challenges to be addressed as the year 2000 approaches: the role of the demographic changes in the frequency of cardiac diseases, the control of "new" postsurgical populations, the integration of basic research in departments of cardiology, the selection of new technologies in terms of cost-effectiveness by means of randomized trials and the need to bridge the gap between the overflow of protocols, recommendations and consensus and their application to the population.