William B. Kannel, MD, Pioneer in Cardiovascular Epidemiology, 1923-2011

William B. Kannel, MD
William B. Kannel, MD

William B. Kannel, MD, died Saturday, Aug. 20, 2011. He made the courageous decision to refuse medical interventions for cancer and chose to die with dignity with the help of hospice, family and friends. He is survived by his wife, four children, 12 grandchildren and 23 great-grandchildren.

Dr. Kannel was born in 1923 in New York, where he attended high school, and then graduated from the Medical College of Georgia in Augusta in 1949. He was trained in internal medicine in the US Public Health Service at Staten Island, New York, and was a fellow of the American Heart Association, the American College of Cardiology, the American Epidemiology Society, the American College of Epidemiology and the American College of Preventive Medicine. Dr. Kannel was Emeritus Professor of Medicine and Public Health at the Boston University School of Medicine (BUSM). He was a past Chairman of the Council of Epidemiology of the American Heart Association and a past Chief of the Section of Preventive Medicine and Epidemiology in the Department of Medicine at BUSM. He was a recipient of numerous national and international awards and honorary degrees, notable among which were the AHA Distinguished scientist award (2006), the Lifetime Achievement award from the New York Academy of Medicine (2006), and the Joseph Stokes Award from the Board of the American Society for Preventive Cardiology (2011). Other important awards received by him include the Dana Award in Preventive Medicine (1972), the Dutch Einthoven Award (1973), the Canadian Gairdner Award (1976), the CIBA Award for Hypertension Research (1981), the James D. Bruce Memorial Award of the American College of Physicians (1982), and the Charles A. Dana Award for Pioneering Achievement in Health (1986). He served on the editorial board of numerous scientific journals, including Hypertension, the American Journal of Cardiology, and the American Heart Journal.

Dr. Kannel has been active in the field of cardiovascular epidemiology for more than 60 years and led the way for the world famous Framingham Heart Study to become the leader in cardiovascular epidemiologic research that it is today. He joined the Heart Study in 1950 and in 1966, he became the NIH Director of the Heart Study, replacing Dr. Thomas R. Dawber, the original architect of the study, serving in this capacity until 1979. Between 1979 and 1987, as Professor of Medicine at Boston University, he served as the Principal Investigator of the Framingham Study. Subsequently, he continued work as the senior-most investigator at the Heart Study until his recent illness curtailed those efforts.

The Framingham Study has been acknowledged among the top ten medical advances in the last century in several reports, in no small measure attributable to Dr. Kannel’s scientific contributions. He published over 600 medical articles, numerous editorials and book chapters in premier texts. His work at the Framingham Study established the utility of population-based research for seeking out correctable predisposing conditions for cardiovascular disease (CVD), putting prevention at the forefront of cardiology. Dr. Kannel coined the medical term ‘risk factor’ in 1961 in a landmark publication in the Annals of Internal Medicine, and promoted the concept that CVD is multifactorial in origin, that is, that there is no single cause that is essential or sufficient by itself for CVD occurrence. He promoted the notion of combining information about multiple risk factors mathematically to estimate risk of CVD (the Framingham risk score). His research established the importance of distinguishing between usual (average in the population) and optimal risk factor levels. He described the risk factors for both heart attacks and brain attacks (stroke), and identified the importance of irregular heart beat (atrial fibrillation) as a precursor of stroke and high blood sugar (diabetes) as a risk factor for CVD.

In several seminal papers he dispelled the concept of “benign essential hypertension” and showed the systolic component of the blood pressure to be no less important than the diastolic level. Pioneering work conducted by him also identified risk factors for the individual components of CVD, including sudden death, heart failure, and peripheral artery disease. Data collected by Dr. Kannel and his colleagues at the Heart Study in the late 1950s and early 1960s determined CVD population incidence at a time when only mortality statistics were available. In 1971 (approximately three decades before the completion of the human genome project), Dr. Kannel began the second generation study called the Framingham Offspring Study that quantified the hazard of a family history of CVD based on observations on parents and their offspring. His research on the two generations of Study participants provided path-breaking insights on mechanisms of atherogenesis (build up of cholesterol plaques in the blood vessels), including: LDL and HDL dyslipidemia, obesity-induced clustering of CVD risk factors, importance of physical activity in CVD prevention, and smoking as a trigger for heart and brain attacks. His research stimulated national campaigns against smoking, high cholesterol, high blood pressure, and obesity.

There are few areas in cardiovascular disease epidemiology Dr. Kannel did not explore. His research highlighted the lethal nature of congestive heart failure and a thick left ventricular wall, the frequent occurrence of clinically silent myocardial infarction and the factors predisposing to sudden death, which until then had been under-appreciated. His research warned in 1985 of the lack of efficacy and danger of estrogen replacement for preventing CVD. In 2008, along with his colleagues he formulated the ‘Framingham General CVD risk score’, a profile that enables primary care physicians to pull together risk factor information to assess the global risk of heart attacks, failure, strokes, and peripheral artery disease.

By his example, Dr. Kannel influenced several generations of cardiologists and physicians and was one of a handful of “founding fathers” of preventive cardiology utilizing prospective observations to draw conclusions usually readily applicable to clinical practice. He also trained scores of postdoctoral research fellows at the Heart Study who are following in his footsteps inspired by the depth and breadth of his research.

All are welcome at the funeral, which will be held at 11 a.m. Tuesday, Aug. 23, at Temple Beth Am, 300 Pleasant St., Framingham, MA. Burial will be private.

Contributions may be made in Dr. Kannel’s memory to the Friends of the Framingham Heart Study, 73 Mt. Wayte Ave., Suite 2, Framingham, MA 01702.

William B. Kannel, MD, Pioneer in Cardiovascular Epidemiology, 1923-2011

William B. Kannel, MD, died Saturday, Aug. 20, 2011. He made the courageous decision to refuse medical interventions for cancer and chose to die with dignity with the help of hospice, family and friends. He is survived by his wife, four children, 12 grandchildren and 23 great-grandchildren.

Dr. Kannel was born in 1923 in New York, where he attended high school, and then graduated from the Medical College of Georgia in Augusta in 1949. He was trained in internal medicine in the US Public Health Service at Staten Island, New York, and was a fellow of the American Heart Association, the American College of Cardiology, the American Epidemiology Society, the American College of Epidemiology and the American College of Preventive Medicine. Dr. Kannel was Emeritus Professor of Medicine and Public Health at the Boston University School of Medicine (BUSM). He was a past Chairman of the Council of Epidemiology of the American Heart Association and a past Chief of the Section of Preventive Medicine and Epidemiology in the Department of Medicine at BUSM. He was a recipient of numerous national and international awards and honorary degrees, notable among which were the AHA Distinguished scientist award (2006), the Lifetime Achievement award from the New York Academy of Medicine (2006), and the Joseph Stokes Award from the Board of the American Society for Preventive Cardiology (2011). Other important awards received by him include the Dana Award in Preventive Medicine (1972), the Dutch Einthoven Award (1973), the Canadian Gairdner Award (1976), the CIBA Award for Hypertension Research (1981), the James D. Bruce Memorial Award of the American College of Physicians (1982), and the Charles A. Dana Award for Pioneering Achievement in Health (1986). He served on the editorial board of numerous scientific journals, including Hypertension, the American Journal of Cardiology, and the American Heart Journal.

Dr. Kannel has been active in the field of cardiovascular epidemiology for more than 60 years and led the way for the world famous Framingham Heart Study to become the leader in cardiovascular epidemiologic research that it is today. He joined the Heart Study in 1950 and in 1966, he became the NIH Director of the Heart Study, replacing Dr. Thomas R. Dawber, the original architect of the study, serving in this capacity until 1979. Between 1979 and 1987, as Professor of Medicine at Boston University, he served as the Principal Investigator of the Framingham Study. Subsequently, he continued work as the senior-most investigator at the Heart Study until his recent illness curtailed those efforts.

The Framingham Study has been acknowledged among the top ten medical advances in the last century in several reports, in no small measure attributable to Dr. Kannel’s scientific contributions. He published over 600 medical articles, numerous editorials and book chapters in premier texts. His work at the Framingham Study established the utility of population-based research for seeking out correctable predisposing conditions for cardiovascular disease (CVD), putting prevention at the forefront of cardiology. Dr. Kannel coined the medical term ‘risk factor’ in 1961 in a landmark publication in the Annals of Internal Medicine, and promoted the concept that CVD is multifactorial in origin, that is, that there is no single cause that is essential or sufficient by itself for CVD occurrence. He promoted the notion of combining information about multiple risk factors mathematically to estimate risk of CVD (the Framingham risk score). His research established the importance of distinguishing between usual (average in the population) and optimal risk factor levels. He described the risk factors for both heart attacks and brain attacks (stroke), and identified the importance of irregular heart beat (atrial fibrillation) as a precursor of stroke and high blood sugar (diabetes) as a risk factor for CVD.

In several seminal papers he dispelled the concept of “benign essential hypertension” and showed the systolic component of the blood pressure to be no less important than the diastolic level. Pioneering work conducted by him also identified risk factors for the individual components of CVD, including sudden death, heart failure, and peripheral artery disease. Data collected by Dr. Kannel and his colleagues at the Heart Study in the late 1950s and early 1960s determined CVD population incidence at a time when only mortality statistics were available. In 1971 (approximately three decades before the completion of the human genome project), Dr. Kannel began the second generation study called the Framingham Offspring Study that quantified the hazard of a family history of CVD based on observations on parents and their offspring. His research on the two generations of Study participants provided path-breaking insights on mechanisms of atherogenesis (build up of cholesterol plaques in the blood vessels), including: LDL and HDL dyslipidemia, obesity-induced clustering of CVD risk factors, importance of physical activity in CVD prevention, and smoking as a trigger for heart and brain attacks. His research stimulated national campaigns against smoking, high cholesterol, high blood pressure, and obesity.

There are few areas in cardiovascular disease epidemiology Dr. Kannel did not explore. His research highlighted the lethal nature of congestive heart failure and a thick left ventricular wall, the frequent occurrence of clinically silent myocardial infarction and the factors predisposing to sudden death, which until then had been under-appreciated. His research warned in 1985 of the lack of efficacy and danger of estrogen replacement for preventing CVD. In 2008, along with his colleagues he formulated the ‘Framingham General CVD risk score’, a profile that enables primary care physicians to pull together risk factor information to assess the global risk of heart attacks, failure, strokes, and peripheral artery disease.

By his example, Dr. Kannel influenced several generations of cardiologists and physicians and was one of a handful of “founding fathers” of preventive cardiology utilizing prospective observations to draw conclusions usually readily applicable to clinical practice. He also trained scores of postdoctoral research fellows at the Heart Study who are following in his footsteps inspired by the depth and breadth of his research.

All are welcome at the funeral, which will be held at 11 a.m. Tuesday, Aug. 23, at Temple Beth Am, 300 Pleasant St., Framingham, MA. Burial will be private.

Contributions may be made in Dr. Kannel’s memory to the Friends of the Framingham Heart Study, 73 Mt. Wayte Ave., Suite 2, Framingham, MA 01702.