Louis Tobian (1920–2006)
The hypertension community lost an outstanding scientist, clinician, educator, and friend with the death of Louis Tobian on September 2, 2006, after a relatively brief illness. Lou was born and raised in Dallas and received his BA degree from the University of Texas. He attended Harvard Medical School in an accelerated program during World War II and received his MD degree in 1943. After postgraduate training at the Peter Bent Brigham Hospital in Boston, the University of California Hospital in San Francisco, and the Parkland Hospital in Dallas, he joined the faculty at the University of Texas–Southwestern Medical School. In 1954, he was appointed associate professor of medicine at the University of Minnesota School of Medicine, where he spent the remainder of his career, leading the Division of Renal Diseases from 1964 to 1976 and the Hypertension Section from 1964 to 1994.
Lou attributed his pursuit of a career in hypertension in part to the influence of the legendary Tinsley Harrison, who offered Lou a position in the Department of Medicine at Texas–Southwestern. According to Lou’s version of the offer, Harrison told him that he could either join the infectious diseases unit at a salary of $100 per month or work on hypertension for $200 per month. Always the pragmatist, Lou decided on hypertension. Whatever his motivation, we are fortunate that Lou made the choice that he did.
Louis Tobian made several contributions to our understanding of the role of the kidney and of sodium in the development of hypertension and the influence of potassium in protecting against vascular and renal injury. In his early work, he demonstrated that experimental hypertension was associated with an increase in sodium content in arteries and arterioles. He then carried out a series of experiments on the function of the juxtaglomerular apparatus of the kidney and showed that the juxtaglomerular cells are important sensors for intravascular pressure. Other major contributions to understanding the role of the kidney in blood pressure regulation included his work on the relationship of osmiophilic granules of the renal medulla to the depressor function of the kidney and the demonstration that the salt-sensitive Dahl rat required elevated levels of renal perfusion pressure to excrete sodium at a normal rate. In the latter part of his career, Lou focused on the role of potassium in hypertensive complications. He demonstrated that dietary potassium supplementation protected against arterial and arteriolar injury in both the Dahl salt-sensitive rat and the stroke-prone spontaneously hypertensive rat and markedly reduced the incidence of stroke in these animals despite minimal changes in blood pressure. These many scientific accomplishments were achieved even though Lou worked with only a small number of research associates. He believed in performing much of the work himself. The size of his group was certainly not indicative of the magnitude of his contributions.
Recognition of the importance of Lou Tobian’s research came from many quarters; innumerable honors and awards were bestowed on him during his career. He was the sole recipient of the highly prestigious Ciba Prize for Hypertension Research in 1978. Other major honors included the John P. Peters Award in Clinical Nephrology of the American Society of Nephrology, the Franz Volhard Award of the International Society of Hypertension, the Richard Bright and Outstanding Leadership Awards of the American Society of Hypertension, and the Karger Memorial Foundation Award for Endocrine Aspects of Hypertension. He was a past president of the American Society of Hypertension and served on several editorial boards, National Institutes of Health study sections, and scientific advisory boards.
Lou was a very active member of the Council for High Blood Pressure Research and served in many of its leadership positions. He was its chairman from 1975 to 1977 and played a key role in the creation of this journal. In 1999, he wrote an article titled “Story of the Birth of the Journal Called Hypertension,” which recounted in typical Tobian fashion some of the events that led to approval of the publication. He wrote:
The creation of a new journal in the AHA hierarchy requires the positive recommendation of the Publication Committee. I knew personally about 75% of the people on the committee. I telephoned each one of these about 2 weeks before the “big” committee meeting and explained why it would be a great thing if the AHA sponsored the first journal in the world devoted to hypertension.
The Chairman of the Publication Committee was strongly opposed to this new journal. [He] opened up the committee meeting. Then he said he had to leave for some other AHA business and would not be back that whole morning. Finally, our project appeared on the agenda. I stood up there, “heart in throat,” and gave my best argument for creation of a new journal. Arthur Guyton got up and gave a ringing endorsement, along with several others. And the Chairman was not there to rain on our parade; so mirabile dictu, a vote was taken and the committee voted strongly in favor of the new journal. So it came to pass, the world’s first (and best) hypertension journal made its appearance.1
Lou was also a superb clinician who maintained a clinical practice throughout his career. He recognized early on the importance of translational medicine and bringing research advances to the clinic. He dealt with his patients in the same meticulous and capable manner that he carried out in his research activities.
Lou had an enormous thirst for scientific knowledge. At most meetings, he would sit in the front row, listen intently, and take copious notes. He liked to comment on others’ presentations, always constructively and never antagonistically. The audience loved to see him get up to make his pithy and folksy comments, which were tinged with characteristic Tobian humor. He did not want to miss any of the presentations, and, when late, he would bring his breakfast tray heaped with potassium-containing foods into a meeting room and consume its contents during the presentations.
Lou’s curiosity and love of learning extended to many other areas as well. He enjoyed life to its fullest. After scientific meetings, he and I often traveled together with our respective wives, Frances and Jasmine, to investigate historic sites, museums, art galleries, and, particularly, good restaurants in the area. He was the unofficial gourmand of the international hypertension community. The small black book that he always carried with him contained the names and contact information of outstanding restaurants throughout the world. Lou had a voracious appetite. He was the only person I knew who could eat both a huge lunch and full-course dinner at Michelin-starred restaurants in the same day. He would never hesitate to travel more than 100 miles for a good meal, but he always left the driving either to Frances or me while he slept in the car.
Lou became an excellent golfer and skier who used his methodical approach to solving scientific problems to master these sports. According to Frances, he kept detailed notes about his own performances and often reviewed them before going out again on the golf course or ski slope.
Lou is survived by his beloved wife of 54 years, Frances, his daughter Anne Berman, 2 granddaughters, and his sister, Jean Eisenberg. He was a wonderful friend whose passing leaves a great void within the hypertension community and for me personally. He will be sorely missed, but he leaves a rich legacy for the generations to come.