University of Minnesota

“If It Isn’t Fun.” – The International Society and Foundation of Cardiology, It’s Research Committee and Scientific Councils

World leaders in cardiology founded the International Society of Cardiology (ISC) in the late ’40s, about the same time as the American Heart Association (AHA) was taking off in the States. The ISC was for a long time Eurocentric and pretty much an exclusive club of elite practitioners and academic cardiologists. Their interests were colloquial, in the finer clinical points for the finer students and practitioners, for the more prestigious consultants, Les Grands Patrons.

These leaders were primarily concerned with planning for and sharing the treasures and glory of the World Congresses of Cardiology, the first of which was held in Paris in 1950. But early on, this club admitted a ringer, Paul Dudley White of Boston. PDW, unchallenged dean of American cardiologists, visited his colleagues’ clinics around the world with open eyes and an open mind; he pondered early the disparity in heart disease frequency and variety in the many lands where he was invited to lecture and “round.” He was among the first of modern cardiologists to think of causes beyond the individual to the culture. And he was gregarious, tireless, and diplomatic in bringing the cardiological world together.

In the interim between the Paris congress and the one held in Washington, D.C. In 1954, PDW was catalyst to a reaction among distinguished clinicians and curious scientists of many persuasions, pathology, physiology, metabolism, biochemistry, and the fledgling dabblers in epidemiology. White, in fact, let the genie out of the bottle: that is, the study of causes and prevention of heart diseases in whole populations. Even I, as a fellow puttering in the Laboratory of Physiological Hygiene in 1954, was able to bask, along with young colleagues, in the lights reflected from White, Keys, Kimura, and Biörck on stage of that ’54 Washington World Congress. Theirs was the first ever such international panel to deal with cardiovascular disease variations and their possible causes in populations, in the first international symposium ever held on CVD epidemiology.

The chemical reaction started by PDW achieved vigorous ferment, as did the field as a whole, by the time of the 1958 World Congress in Brussels, where major symposia were included on prevention. Moreover,  a bright new Research Committee of the ISC was established, with PDW and Ancel Keys named co-chairs. These two were very different birds, PDW a lanky aristocratic up-easter who thumped chests authoritatively and wondered folksily why, always why, and AK a brilliant, tempestuous type with a vision of the Grail that would be the key to finding differing population rates and risk of heart attacks.

Once they got started, and got together, these two could not be stopped. They cajoled, hounded, and sometimes even mugged the conservative leaders of cardiology around the world into acknowledging issues about heart disease that lay outside the clinic, into recognizing the science of CVD epidemiology, and into practicing their new invention, the clinical specialty of preventive cardiology. They never let up trying to persuade the baffled grand old consultants to support and sometimes even to attend their Research Committee sessions held in exotic places, in Dalmatia in 1958 and again in 1963 and 1968, in Mexico in 1962, Venice in 1965, Delhi in 1966, and in Pioppi/Minnelea in 1967. 

At the World Congress of Cardiology in New Delhi in 1966, the ISC adopted, after much laboring and casting about, the American Heart Association pattern of Scientific Councils, councils which had witnessed and participated in the great leap forward of cardiovascular research and practice in North America. Some bemoaned the loss of control by the inner circle of grand clinicians. “We,” however, thought the new organization meant great progress.

The obstreperous new Council on Epidemiology and Prevention of the ISFC (the Society and the Foundation had merged), soon claimed a share in the congresses’ direction and symposia, a place in the central leadership of the society, a vigorous orientation toward training in, and wider recognition of a population-wide, public health view of heart diseases, and even announced plans for its own International Conference of Preventive Cardiology. All this was quite beyond the ken of most of the eminent cardiological practitioners and academicians in the ISFC of the day.

The vigor of the new field was infectious, irresistible. For more than 30 years since their origin, International 10-Day Seminars in CVD Epidemiology and many regional spin-offs have involved several thousands of young cardiovascular types. They have been introduced to concepts of monitoring, and to understanding CVD as it arises in the population, and in preventing it through combined public health, personal, and medical strategies. Epidemiology has assumed its natural place as one of the complementary “three beauties” of cardiovascular research: clinical, laboratory, and epidemiological.

Much of the vision, organization, and thrust of CVD epidemiology and preventive cardiology internationally stems directly from the pioneer locomotives, Paul White and Ancel Keys. The engines were the ISFC (now, finally, the World Heart Federation), the AHA, NIH, and WHO. We collaborating laborers and conductors happily fed the boilers and punched the tickets.

All these developments pulled me inexorably into the international cardiological scene, where I became accepted everywhere as a protegé of Keys and White, and where I assumed (rather comfortably) the mantle of “young comer to be dealt with and relied upon.” I came to serve as rapporteur at the 1963 Makarska meeting of the Research Committee, reported elsewhere here, and was graciously appointed, as everything he did was gracious, by the new President of the Federation, Pierre Duchosal of Geneva, to convene the ECG-VCG and Computer Applications Group and to make plans for its program at the 1966 Delhi World Congress. All this I was more than pleased to do.

These efforts involved my active correspondence with Pierre Duchosal, Eugene Lepeshkin, Hans Schaefer, Otto Schmitt. Jean Lequime, Pierre Rylant, and many international leaders in basic CVD research. I thrived on these activities at the center of such a respectable universe, and fortunately did not dwell excessively on my fundamental deficiencies. In turn, the experts seemed to respect my quiet organizational efforts. For example, this comment came from Duchosal in 1965: “I am glad to see that the symposium of which you are the coordinator is nearly ready for the Congress of New Delhi. This cannot be said, unfortunately, of the other symposia and I am a little worried about this fact. Yours very sincerely, P.W Duchosal, President.” Whether he wrote in French or English, you felt warmly stroked, even elevated, by notes from ce grand gentilhomme de cardiologie.

The Research Committee of the IFSC met again, vigorously and at length, in April, 1965, on the faerie isle of the Hotel Cipriani in Venice, where, as I wrote later to the distinguished physiologist, Hans Schaefer, “There occurred a very fruitful meeting of minds among physiologists, clinicians, and epidemiologists.. We attempted to formulate meaningful guides about instrumentation problems without restrictive standards or precise specifications. I would be most grateful for your comments on these prior to their being submitted to the International Society for publication. Is there a possibility that you will join us in Delhi?”

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