Samuel Fox, MD

Born: 1923

Sam Fox, former head of the Heart Disease and Stroke Control Program (HDCP) of the USPHS, was educated at the University of Pennsylvania and served in the U.S. Navy Medical corps, eventually becoming chief of cardiology at Bethesda Naval Hospital.

The HDCP under his direction in the 1960s enlisted a generation of young Public Health Service officers in researches on CVD prevention, scattered about in leading laboratories. It made major contributions to the concepts and methods of physical fitness measurement, stress testing and electrocardiology, and of pilot studies relating activity to cardiovascular function and disease.

This culminated in a groundbreaking pilot trial on Physical Activity in the Prevention of Coronary Disease that established new trial methods, including the “faint of heart period” prior to randomization to maximize participation, and graded exercise tests to maximum performance. The trial validated and formalized much of the experimental methodology of activity and fitness assessment used today. Its investigators also produced the first proposal for a multiple risk factor trial after they established that a definitive single factor trial of physical activity was probably infeasible.

Exercise physiology, trial design, and the new specialty of preventive cardiology owe much to the innovations and sound methods of Fox’s rigorous program of paramilitary service, through cardiovascular research, during the Viet Nam period. The forward-looking Heart Disease and Stroke Control Program was unceremoniously closed down by President Nixon’s staff in the early 1970s. (HB)