Oglesby Paul

Quotes

In the Beginning

I became interested in epidemiology for various reasons, but one of them was that I was quite active in American Heart and one of my activities involved being Chairman of the Council on Community Service, which included an interest, obviously, in epidemiology. In 1956 I believe it was, I went to a meeting at Arden House in Harriman, NY, which was sponsored by the National Heart Institute as it was then and the American Heart Association. There were about six or eight of us there. It was chaired by Tommy Francis who was the epidemiologist at Michigan and who was the one particularly responsible for the National Polio Program. In any case, as a result of this meeting, which included representatives from Framingham, Tom Dawber, Joe Doyle from Albany, NY. A small group of people. It was agreed that we needed more long-term studies of coronary heart disease. So beginning in 1957 I was the chief investigator for a long-term coronary project at the Western Electric Company in Chicago. (1)

MRFIT

In any case, I was the first Chairman [of MRFIT] and was Chairman for 10 years and that was a big project, which involved a group of centers around the country and was destined to try to prove that using the risk factor profile and working on treatment of high blood pressure by diet, weight loss and lowering cholesterol particularly with diuretics, treatment by example, and by interview and rhetoric getting people to stop smoking, those were the particular areas of involvement. And we worked on that for a 10-year period. Then it was 1982 I think, when our first report came out. I think it was a little disappointing, but we found out that one thing happened that when we gave patients quite large doses of diuretics to get their blood pressures down at the same time we might do a certain amount of harm in that the blood potassium levels tended to rise and this may have been a factor in some of the untoward events which occurred. In any case, I don’t think we had a smashing success, but we had also success in that we trained a great many people in epidemiological techniques and we also provided a good bit of information about the treatment of some of the risk factors which were present. (4)

The limited role of Paul White in epidemiology, according to his biographer

Paul White was really not an epidemiologist. He was really a clinician. He was a cardiologist. Many patients from around the world were referred here and he had a great fund of knowledge, enormous energy, and he was a person who handled patients very well. And I think epidemiology was sort of a side interest of his and because of his stature he was much admired, he did become active in the field of epidemiology, particularly by knowing Ancel Keys and by knowing certain others in the field. He sometimes accompanied Ancel Keys as you’ll see in the my book to Italy where they made some investigations. But really I think Paul White’s role in epidemiology was not his major role. I think this was a rather minor one and he was really not an epidemiologist. He was a clinician. (6)

Early status of CVD Epidemiology

Initially, I think the whole field of epidemiology of cardiovascular disease was frowned upon. I think it was looked upon during the 1950s, when I began to be most active in American Heart and in Chicago Heart, looked upon as being sort of poor science. And one of the problems I think, frankly, was Ancel because he wasn’t an MD, he was a PhD and he wasn’t always friendly and warm in his relations with people. So I think epidemiology was looked upon as being a sort of marginal area of pseudo science or partial science. And it was only, I think, after 1960 that it began to be more active and more involved. Partly, I think, because the Framingham Study, as well as our studies, as well as Albany, as well as others, showed that there was a significant relation between risk factors, including high blood pressure, blood lipid levels, smoking habits, with the incidence of coronary heart disease. So from being sort of a step-child it became of real interest to cardiologists and I think by the 1970s it had been fully accepted. And as you know, now at the end of the Twentieth and the beginning of the Twenty-first century it has become an enthusiastically supported area. I think that here at Harvard it’s been looked upon with less enthusiasm than it has in some other areas such as Minnesota. Leadership at the School of Public Health I think subscribes to epidemiology of cardiovascular disease as being important, but I’m not sure that they have the enthusiasm and the energetic intervention aspects that Jerry Stamler has had. (10)

On the future of CVD Epidemiology

I do not wish to neglect epidemiology, because I think it has been a very important aspect of this, but I think we are going on now to other areas. And when you asked me if we are continuing to expand and develop and encourage this kind of epidemiology, I’d have to say no. I think we are now going into more basic, fundamental, cellular, biochemical, immunologic aspects of it. I think when you meet Jerry he’s very persuasive, he’s very effective, he’s very good. But others are also bringing now together new ideas which he and Ancel Keys and Paul White and I and many other people didn’t think particularly about. (14)

On Management

And when I was Chairman of MRFIT, which I was for 10 years, I had to run a lot of meetings and one of the problems I had was just what you’re bringing up and that is giving young people an opportunity to feel really that they belong and we respected their role. It’s very easy, you know the Blackburns and the Keys and the Stamlers and the Louis Katzes and the Paul Whites, they’re all rather large, important figures. It would be very easy to have each of them really given the talks, write the papers, do all of the work. So it’s more work, but in the long run… or profitable, I think, to let some of these younger people get their feet wet, get involved, learn how to speak, learn how to write, learn how to take on responsibility. So that was one area where I think I did not agree totally with some of these… I found that most of the committee… partly because many of them were young or middle-aged agreed with me. But I think some of the senior people did not. I think now in retrospect, I’m very glad I did what I did. (15)