While many of us recall that President Franklin Delano Roosevelt had polio, few remember that he died in 1945 from another cause: stroke. The sentiment of his physician — that it “had come out of the clear sky” — reflected the prevailing view that heart attack and stroke were bolts from the blue that doctors could act on only after the event.
But a few mavericks challenged this “salvage” paradigm, establishing the Framingham Heart Study in 1948 to identify predictors of cardiovascular events. One leading maverick, Dr. William Kannel, who passed away last month, coined the term “risk factors” to describe these predictors. Acting on the insight that controlling risk factors could prevent cardiovascular disease saved the lives of more than 150,000 Americans from heart disease alone between 1980 and 2000.
Judging by the surviving medical records, Roosevelt’s stroke may have been preventable with treatment for one such risk factor, hypertension. How different would the world have been had his persistent high blood pressure been treated?
The world is different now, not all for the better. High blood pressure has been attacking more and more children over the last 30 years, …