Edward D. Frohlich, MD Editor-in-Chief
Clearly, one of the leading investigators in the field of hypertension is Edward D. Freis. It was his unique concept in the late 1950s that introduced the first randomized, placebo-controlled, multicenter trial in cardiovascular medicine and, more specifically, with antihypertensive agents. His creation has been the forerunner of many drug trials, not only in hypertension but also in cardiovascular medicine broadly. His subtle innovations included riboflavin-tagged medications that permitted the clinician to know whether the patient was taking the medication, the use of protocol-monitoring teams, safety and ethics committees, and many others. Under his leadership, antihypertensive therapy was shown not only to be safe and efficacious but also to significantly reduce morbidity and mortality.
But few investigators today are aware of his other major contributions; his hemodynamic concepts, published in Physiological Reviews in 1960, remain a classic for all who are interested in this area of basic hypertension. He is responsible for our thinking of relieving the ventricle for pressure and volume overload, for considering the role of plasma volume as a dynamic factor in understanding effective and ineffective therapy, for the importance of large arterial mechanics in more completely understanding hemodynamics and therapy, and for the importance of transcapillary migration of intravascular particles in the pulmonary, renal, and peripheral circulations. Unfortunately, many of his introductions to our thinking are not cited in today’s scientific literature, but they are reflected in the remarkable scientific progress of hypertension research. For is this not the basis of all scientific progress, observations, and confirmation of hypothesis made by our investigative forebears? It is for these and many other reasons, that we have invited Ed Freis to submit the foregoing paper for peer review and publication. We hope that its review by the readers will be as meaningful and satisfying as it has been for us.