H. Mitchell Perry, Jr, MD
One of the leading workers in the hypertension field since the early days of the development of antihypertensive therapeutic agents was H. Mitchell Perry, Jr, MD. Not only was he totally committed to new therapeutic advances, but his investigative activities were also focused in the laboratory where he was deeply immersed in identifying the role of environmental substances that may participate in the pathogenesis of hypertension. In these studies he was a world authority on the role of such specific metallic ions as cadmium and lead.
“Mitch” Perry, as he was referred to by his many friends, spent his entire professional career in St. Louis at Washington University. Thus, after completing his undergraduate education at Swarthmore College, he entered that university, completing his medical education within 3 years. Then, following his training in internal medicine at Barnes Hospital and a stint in the US Army in Frankfurt, Germany, he returned to Washington University for further training in the basic sciences with the Coris at the time they received the Nobel Prize. After his training in biochemistry, he began his fellowship with Doctor Henry Schroeder. They were among the first to demonstrate the efficacy of hydralazine in controlling arterial pressure and in reversing the unrelenting course of malignant hypertension toward certain death. Mitch was one of the original members of the Council for High Blood Pressure Research, and he described, in his extensive studies of hydralazine, its ability to induce lupus erythematosis and its association with the slow-acetylator genotype in treated patients. ⇓
But, later in his years as Chief of the Medical Service at the St. Louis Veterans Administration Medical Center, he championed the value of antihypertensive therapy in reversing the unrelenting course of hypertensive disease. He was among the first to join the landmark Veterans Administration (VA) multicenter studies with Dr Edward Freis; and he continued in these efforts until his death. Indeed, at the time of his death, he was working on a paper with Ed Freis and me in analyzing the predictive value of the increased arterial pulse pressure in predicting future morbidity and mortality in 90 000 veterans who entered this long-lived multicenter study.
Largely because of his efforts, the VA established the Hypertension Screening and Treatment Program Clinics, of which he was the Physician Coordinator until his death. This program, initiated in 1975, permitted recruitment of thousands of VA patients to obtain the recently proven stepped-care approach (in 1971) for the now well-accepted antihypertensive therapy. In addition, he used the newly developed role of physician’s assistant to provide this treatment cost-effectively and to enter the valuable clinical data into a national computerized database. It was under Dr Perry’s direction that this program continued to assure continued viability to the Veterans Administration Cooperative Studies; and I was privileged to work closely with him from the outset of the Cooperative Study, in the joint VA-National Institutes of Health Cooperative Study on Mild Hypertension and many other efforts.
The history of hypertension and antihypertensive therapy will note that Mitch Perry unrelentingly served us in the establishment of the National High Blood Pressure Education Program. He was a drafter of the preliminary report, even before the first report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC-1) was developed and approved at Airly House under the organization of Dr Theodore Cooper, then Assistant Secretary of the Department of Health Education and Welfare of Health. He continued to represent the VA on each of the Joint Coordinating Committee’s further reports until his death; and, again, it was my personal pleasure to work closely with him throughout these 30 years.
Mitch Perry’s contributions to the cause of hypertension were legion and this should bring to his family much satisfaction and solace at this difficult time for them. His life at work was supported valuably in the laboratory by his wife Betty. As a role model at home, he stimulated two sons, Horace M. (“Mike”) and Clayton, and one daughter, Holly, to pursue careers in medicine; and his character and human qualities were equally important to a second daughter, Heather, and 12 grandchildren in their own lives. Dr Perry has certainly made a lasting impact on his family, friends, colleagues, and all of humankind; and, Mitch, we shall certainly miss you—especially next month at the forthcoming meeting of the National High Blood Pressure Education Program when your first absence will be duly noted.