University of Minnesota

“If It Isn’t Fun.” – International Symposium on the Preventive Aspects of Cardiovascular Diseases, Mayo Clinic, May, 1968

Part of the new career direction for which I felt such a need in the late 1960s was provided in a role as chair of the Professional Education Committee of our local heart association. An enterprising group, it put together a cardiac rehabilitation clinic and the International Symposium on Preventive Aspects of Cardiovascular Diseases, held at the Mayo Clinic. My activist committee colleagues were Jack Spittel, Ken Berge, and Hal Mankin from the Mayo, and Arne Adicoff, Dave Feigel, Jerry Grismer, Harley Racer, Mary Ann King, and Bill O’Brien from the Twin Cities. John Juergens blessed us as MHA president. We saw the Mayo conference as crystallizing the status of prevention at the peak of the North American coronary epidemic, and as a platform to launch research and policy initiatives for prevention. It turned out to be a fine international assemblage.

Recall that during these very days of 1968, a dentist in South Africa, a certain Dr. Blaiberg, was walking around with the first transplanted heart in his chest, put there by Minnesota-trained headline-seeker Christiaan Barnard. Dramatic, life-saving cardiac surgery was all the rage.

The dean of cardiologists, Paul Dudley White, opened our prevention conference with his personalized history of heart attacks from the time of Pliny the Elder to modern times, intoning with his characteristically folksy bent: “A heart attack after age 80 is an act of God; before age 80 it is a medical failure,” and, “I have been trying to persuade young people in this country and overseas to rebel not against their parents but against their parents’ bad habits.”

Ancel Keys concluded at our conference that “prevention is essential for any real control over…heart disease…; [and] prevention is not only essential, it is possible.” Tom Dawber from the Framingham Study posited the view that “reasonable physicians [should] act in accordance with the maxim of Samuel Johnson: “Nothing will ever be attempted if all possible objections must first be overcome.” Others talked about blood lipid metabolism, and Kannel and Castelli gave their major paper suggesting that alpha and beta-lipoprotein, HDL and LDL, were independent predictors of coronary risk.

Don Fredericksen, then heading up the influential Inter-Society Commission for Heart Disease Resources, and soon to be NHI and then NIH director, talked about smoking; Oley Paul and Herman Hellerstein talked about physical inactivity; and then the great summarizer, Jeremiah Stamler, outlined a broad prevention strategy of: “treatment before illness, … long-term care of those who have recovered, systematic mass detection efforts of a public health nature [intermeshing] the mechanisms of society as a whole with the approach of the individual and his physician.”

Impressive as this program and its participants seem from the vista of 30 years, I doubt that the influence of the Minnesota conference was great in itself. But the gathering clearly added to the understanding and commitment among those then defining prevention policy and program internationally. As conference organizer, I confess to have enjoyed my role at the center of things “preventive.”

And there’s no question that I like to be at or near the center, but just to be there, part of the gang, not to direct the show!

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