At age 100, the father of preventive medicine is still going strong — as living proof that he was right all along
By CINDY DAMPIER
CHICAGO TRIBUNE |
DEC 26, 2019 | 5:00 AM
Recomendado por AMICOR Flávio Kanter, através de seu irmão Nelson Kanter que atualmente vive nos EEUU.
Dr. Jeremiah Stamler at Northwestern University Feinberg Medical School at a celebration for his 100th birthday in the fall. (Teresa Crawford/Northwestern University)/.../
O Jerry foi muito importante para mim, desde sua participação na 2nd. National Conference on Cardiovascular Diseases, na área de Community Services & Education que usei como informação epidemiológica pela inexistência de informações nossas, para a Análise Institucional da SS da qual participei em 1971-72. Vim a conhecer pessoalmente o Professor Stamler posteriormente, mas suas informações relacionadas com os EEUU deram-me respaldo para dizer ao recém empossado Secretário da Saúde - dr Jair Soares, que eu queria licença para deixar meu posto, e assumir a disciplina de Cardiologia na PUCRS, porque onde eu estava não havia programa preventivo e de saúde pública na área Cardiovascular - somente fazíamos assistência, o que eu poderia continuar fazendo na nova instituição. Foi quando ele me surpreendeu com a pergunta desafiadora: "porque não fazes uma proposta?"
Assim começou a abordagem preventiva de doenças cardiovasculares e outras doenças crônicas no Rio Grande do Sul, depois no Brasil e em muitos países pelo mundo afora com o apoio da Organização Panamericana da Saúde/Organização Mundial da Saúde, abordando Fatores de Risco, chegando à Promoção da Saúde.
Pioneer in cardiovascular disease prevention. He was born in Brooklyn, NY, USA, on Oct 27, 1919 and died in Sag Harbor, NY, USA, on Jan 26, 2022 aged 102 years.
Seldom has a person's life offered more compelling support to the value of his own convictions than that of Jeremiah Stamler, founding chair and Professor Emeritus of Preventive Medicine at Northwestern University's Feinberg School of Medicine in Chicago, IL, USA. He spent his career helping to identify risk factors for cardiovascular disease and campaigning to have them recognised—he also enjoyed the Mediterranean diet he advocated and lived to become a centenarian. “He was one of a small group of people who really founded the discipline of cardiovascular epidemiology”, says Donald Lloyd-Jones, Chair of Feinberg's Department of Preventive Medicine and Eileen M Foell Professor of Heart Research. Paul Elliott, Professor of Epidemiology and Public Health Medicine at Imperial College London, UK, agrees: “Jerry was a colossus in cardiovascular epidemiology and prevention.”
The circulatory system dominated Stamler's research from the outset. After a bachelor's degree at New York's Columbia University he went on to study medicine at what is now SUNY Downstate Health Sciences University in Brooklyn. He graduated in 1943 and served as an army radiologist before taking a job at the Michael Reese Hospital in Chicago. “He started in the late 1940s in the laboratory of [cardiologist] Louis Katz, whose research included feeding cholesterol-rich chow to chickens,” says Lloyd-Jones, who is also President of the American Heart Association. The birds developed a build-up of atherosclerotic plaque. Stamler himself studied the effects on the cardiovascular system not only of lipids, but of hormones, blood pressure, and diet more generally. In 1958 he moved to Chicago, where he joined the Board of Health and organised its first heart disease control programme, as well as Northwestern's Department of Medicine.
Before the 1960s and 1970s, heart disease was still not much related to risk factors and behaviour. Stamler set out to challenge that view. In 1972 he was appointed chair of Feinberg's newly created Department of Community Health and Preventive Medicine and began organising or taking part in national and later international trials that identified the risk factors for heart disease. “He and others demonstrated through animal studies and in human population studies that these risk factors were likely causing atherosclerosis and heart attacks”, says Philip Greenland, Harry W Dingman Professor of Cardiology and of Preventive Medicine at Northwestern. But the possibility of intervening to prevent heart attacks was still considered radical. “Stamler was a pioneer of optimal assessment techniques in diet”, says Lloyd-Jones. “He did some of the best studies ever.” One such was Intersalt, a 1988 study of more than 10 000 people aged 20–59 years from 32 countries that showed a clear link between salt intake and blood pressure. Paul Elliott, a junior research fellow at the time of the study, helped in its design. The US salt industry's trade body, the now defunct Salt Institute, was unhappy with its findings. “The Salt Institute demanded a reanalysis of data to their specification, which the investigators willingly carried out”, Elliott recalls. “The publication of the reanalysis in 1996 showed, if anything, stronger findings on salt and rise in blood pressure with age than the original analysis.”
Some of Stamler's fellow doctors had joined the chorus of dissent. As Greenland recalls: “There were editorials by prominent cardiologists…saying…it's time to give up on this crazy idea that heart disease can be prevented”. But Stamler was undeterred. “One of the things that characterised him was his sense of what is right and what is true, and if you believe something is right and true you fight for it,” says Greenland. This outlook extended beyond matters of health. In 1965, Stamler was summoned to appear before the US Government House Un-American Activities Committee (HUAC), accused of having been a member of the Communist Party. The accusation was false, but Stamler refused to testify, argued that the HUAC was unconstitutional, was charged with contempt of Congress, and filed a lawsuit against the HUAC. The contempt charge was dropped, but not until 1973.
Stamler “was rigorous and intensive in his work, and persistent”, says Greenland. “You never doubted he was a towering intellect when you were in his presence”, says Lloyd-Jones. “But he was gentle and good at listening…He really valued the people he worked with. He was intensively collaborative, and he understood that everybody on the team had something to offer.” Stamler is survived by his son, Paul, and stepsons, Jonathan and Michael.
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Published: 12 March 2022
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