A Half Century of Achievement

Beginning in the 1940s and continuing through the intervening decades, Boston University Medical Center cardiovascular disease researchers have been responsible for a number of breakthroughs in the understanding and control of cardiovascular disease. Certain approaches to treatment that are in common use today everywhere in the world began at Boston University Medical Center.

The Medical Center’s lead role in hypertension research has been broad-ranging: In 1940, a faculty member and chairman of the Department of Surgery, Reginald H. Smithwick, M.D., reported the first operation to control hypertension surgically, a procedure called surgical sympathectomy. Nine years later in 1949, the head of the Section of Cardiology of the Department of Medicine, Robert W. Wilkins, M.D., led the team that developed a drug that would prove to be the world’s first acknowledged means of controlling hypertension medically, derived from rauwolfia serpentina. This preparation of the root of a plant found in India proved to be the first medication that could be relied upon to lower blood pressure safely and effectively. Dr. Wilkins became the major proponent of drug treatment for hypertension, stating in 1952, “No case of hypertension with normal renal function is accepted as impossible to treat medically until so proven.”

Four decades ago, the prevailing medical opinion was that once a person developed hypertension, any attempt to lower his or her blood pressure with drugs posed a danger. High blood pressure was necessary, so this reasoning went, to force the blood through the patient’s narrowed arteries. Dr. Wilkins and his BUMC associates insisted, however that high blood pressure itself posed a danger. Accordingly, they persisted in trying to find safe, effective ways to lower it.

In addition to Dr. Wilkins, Aram V. Chobanian, M.D., and William Hollander, M.D., were the first in the world to use the diuretic chlorothiazide and the aldosterone antagonist spironolactone for the treatment of patients with high blood pressure. Seminal reports of the Joint Nation al Committee on Detection, Evaluation and Treatment of High Blood Pressure (JNC III, IV, and now VII), a federally appointed committee that has been chaired by Dr. Chobanian, have provided the treatment recommendations that currently serve as the national standards for the management of hypertension.

Dr. Haralambos Gavras and his associates introduced the medication captopril for hypertension in 1977, and later that year used angiotensin converting enzyme (ACE) inhibitors in congestive heart failure. Captopril is one of a line of angiotensin converting enzyme inhibitors that have been investigated here. These advances underlie the climate of scientific investigation that the Whitaker Cardiovascular Institute has come to exemplify and keep intact.

Dr. Haralambos Gavras and his associates were the first to introduce the use of angiotensin converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) for  the treatment of hypertension and heart failure.  Their earliest experimental animal and clinical studies throughout the 1970’s used the parenternal experimental ACEI teprotide and experimental ARB saralasin  to produce “proof of concept” that blockade of the renin-angiotensin system is beneficial in hypertension, ischemic heart disease and heart failure.  Subsequently, oral ACEI’s and ARB’s became standard therapy for these conditions and are considered some of the most important advances in cardiovascular medicine.

With the appointment in 1994 of Dr. Joseph Loscalzo as Director, the focus of the Institute’s interests has expanded to include the areas of thrombosis, nitric oxide, free radical biology, gene therapy, angiogenesis, stem cell biology, and heart failure. Recent recruits of the Institute, Drs. Kenneth Walsh, Jane Freedman, Noyan Gocke, Martin Feelisch, and Jane Leopold, exemplify the widening focus of the Institute and represent experts with widely recognized strengths in their areas.

In February of 2008, Kenneth Walsh, PhD was appointed Director and the Institute is actively recruiting faculty to enhance the resesearch areas. The growth of the Institute in this fashion will help to ensure its continued success well into the next century.