The Beginnings of Hypertension
Louis Tobian’s successful crusade to persuade the American Heart Association (AHA) to establish a journal covering the field of hypertension was a herculean accomplishment, but I like to think that John Shepherd and I played significantly positive roles in the final decision. In November 1975, I became President-elect of the AHA and so was very soon in the middle of the great debate concerning the request of the Council for High Blood Pressure Research for a new AHA sponsored journal focusing on hypertension. As it so happened, John Shepherd was President which meant two supporters in the ruling hierarchy of the AHA; I believe that helped.
I cannot remember who of the then-current movers and shakers of the AHA’s Publications and Steering Committees were against AHA publishing another journal, but there were several. Lou Tobian had a big job of persuading the recalcitrant, but he finally prevailed. The Steering Committee approved the request in late 1977, and the Board approved establishment of this journal in early 1978.
This approval did not come with carte blanche but had several stipulations: “the journal must be of high quality, provide critical peer review of submitted articles, publish results of both laboratory and clinical investigations, be international, become self-supporting and submit to a progress review in three years to decide its value to the field and its future viability.” In the beginning, there were to be six issues per year. “If the number of excellent articles exceeds the allotment of editorial pages, the Publications Committee will consider increasing the number of pages and/or publishing the journal monthly.”
Once the new journal was approved, then came the task of choosing an Editor-in-Chief. That responsibility was assigned to John Shepherd as Chairman of the Search Committee. It wasn’t easy. Whereas all members of the Council had strongly supported establishing a journal dedicated to hypertension research, nobody wanted the task of being responsible for it. The original idea was to select a noted hypertension researcher. Several were approached, but none wanted the job. Finally, I suggested to John Shepherd that I be given a chance because the search had been fruitless although my name had never been on the committee’s list—either long or short.
The reason I offered to do the job was because I had been at the School of Medicine at the University of Alabama for about a year and would have the strong support of Suzanne Oparil and Henry Overbeck as Associate Editors. The School was pleased to have the journal, and space was available. So, it came to pass that I was named Editor-in-Chief. We decided to call the journal Hypertension and organized ourselves to receive contributions and publish the first issue in January 1979.
Those first years were hard. Again, the members of the Council were not consistently helpful. Sure, they wanted the journal, but they wanted it to be a prestigious journal not a struggling effort, just barely scraping along. A few examples will suffice. We were concerned to receive contributions from members that were not their best work, yet they were most unhappy when the papers were rejected. At one point in my five-year tenure, I asked Merlin Bumpus where the papers were from the Cleveland Clinic? Sent to other journals, I was told, because Hypertension was not well enough known. So much for loyal support, and from friends, too.
The readers should not get the idea that all council members were disinterested and unhelpful. The first issue contained 8 papers, 7 of which were from well known members, and the papers were of high quality. I shall always be grateful to those authors because their papers gave the journal a good start.
The editorial office was open for business in June 1978. We editors were anxious because we were committed to a first issue for January-February 1979. We were right to be anxious because by the end of that year we had received only 76 articles. We did put that first issue together, as noted above, and as I rereview it now I am much more pleased with it than I was at the time.
By July 1, 1979, representing 13 months in business, we had received 196 articles—a far cry from the over 1000 articles received in 1996. Twenty-five papers came from the 1978 meeting of the Council; 22 of them made up the May-June issue with Dr Michael Brody as Guest Editor. We had originally hoped that submission rates would be high enough so that the journal could be published monthly. That required at least 450 papers per year, and in the first five years we never came close to that number. The “best” year was 1982 when 299 manuscripts were received. As we, the old editors, passed the responsibility to the new—Edgar Haber, Victor Dzau, Robert Graham and Randall Zusman—we were hopeful that the business was picking up because for the first six months of 1983, 209 papers had been contributed. We were right to be optimistic because the journal was published monthly beginning in 1986.
We worked hard to increase submissions. Investigators presenting hypertension research reports at meetings other than the annual council and AHA meetings received letters suggesting that they submit their manuscripts to Hypertension. I personally solicited funds from pharmaceutical companies so that proceedings of the annual council meetings could be published as a supplement thus releasing editorial pages for individually submitted papers. We published several supplements containing papers from non-AHA hypertension meetings in the hope that doing so would increase awareness of the new journal. Brian Hoffman, who was at that time Editor of Circulation Research, encouraged authors who submitted hypertension research articles to that journal to send them to Hypertension.
No one can tell whether these efforts to recruit manuscripts had a beneficial effect. All we can say is that by the time Ed Haber et al passed the journal on to Allyn Mark and colleagues, it was a well respected monthly journal. As far as I can see, it has done nothing but grow in strength in the 20 years of its existence. The AHA Publications Committee and Board of Trustees should be proud of their decisions to approve its establishment; it filled a real need and never faltered even though its beginnings were a bit rocky.