Akira Takeshita (1940–2009)
Akira Takeshita, a great cardiologist, scientist, and mentor, passed away on March 15, 2009, after a valiant struggle with cancer.
Dr Takeshita was raised in Kumamoto, Japan. He received his medical degree from the Kyushu University in Fukuoka, Japan, in 1965, after which he completed his residency training at Tachikawa US Military Hospital and Mount Sinai Hospital in Cleveland, Ohio. In 1970–1973, he was a cardiology fellow at University of Iowa, where he spent 1 year in research with Dr Allyn Mark. After returning to Kyushu University for a few years, he rejoined the Cardiovascular Division in the Department of Internal Medicine at the University of Iowa in 1976. There he was introduced to research on neural control of circulation and on vascular function and structure, which would later become his lifelong research interests.1,2 He spent 4 years in Iowa as an assistant professor and came back to Kyushu University in 1980. He was promoted to professor at the Department of Cardiovascular Medicine, Kyushu University, in 1990 and had since chaired the department until his mandatory retirement in 2003. He remained active until last year in training young physicians at Iizuka Hospital and Saiseikai Futsukaichi Hospital in Fukuoka, despite the fact that he was fighting an incurable illness.
The years he spent in the United States working with colleagues at the University of Iowa, including Drs Allyn Mark, Frank Abboud, Donald Heistad, and Michael Brody, deeply impacted his academic life. Throughout his career, his research interest had focused on neural control of circulation and vascular biology, and he made major contributions to these fields. He demonstrated the role of the atrial natriuretic peptide in autonomic control of circulation.3 He introduced the importance of NO and reactive oxygen species in vascular biology. He also revealed that NO and oxygen species in the brain play major roles in modulating autonomic activation.4 His incessant research efforts to resolve clinical problems yielded crucial findings that deepen our understanding of major cardiovascular pathophysiology. He and his associates, as pioneers, reported the presence of endothelial dysfunction in patients with hypertension,5 atherosclerosis, and heart failure. They further demonstrated that angiotensin-converting enzyme inhibitors5 and statins improve endothelial function, independent of their blood pressure– or cholesterol-lowering effects. He also proposed a new clinical entity of microvascular angina with normal coronary angiograms.6 He made use of the state-of-the-art molecular biology for better understanding of classic physiology, although he always advocated the importance of integrative physiology.
He served as president of the Japanese Circulation Society from 2002 to 2003 and hosted, as the conference chair, the Annual Meeting of the Japanese Circulation Society in 2003. He was a member of the board of directors of the Japanese Society of Hypertension and served as the conference chair of the Annual Meeting of the Japanese Society of Hypertension in 2000. He was an editorial board member of most of the American Heart Association journals, including Hypertension, and served as an Asian editor of Arteriosclerosis, Thrombosis, and Vascular Biology. He was an active fellow of the American Heart Association and had attended the annual Scientific Session every year except last year because of his illness.
Dr Takeshita was also a superb cardiologist and excellent teacher. His clinical decision making was prompt and appropriate. In clinical training, he valued bedside teaching first and foremost. This attitude toward medical education was highlighted in a presidential lecture that he delivered at the Annual Meeting of the Japanese Circulation Society in 2003. When he chaired the Research Institute of Angiocardiology, the way he managed the institute was evidence of his philosophy and deeds. First, he tried to improve the quality of patient care. Second, he supported young fellows to be independent investigators. He insisted on conducting both clinical and basic research. In the era of molecular biology, he emphasized the importance of integrative physiology. Thanks to his directions, our program has grown enormously and become one of the most active cardiovascular research institutions in the country. The last lecture he gave to medical students was titled, “A Message for Medical Students: What Is “Medicine Is an Art?” In the lecture, he tried to convey the importance of having empathy for patients’ pain (both physical and mental) and having interest in the social aspects of medicine. This is something we often overlook. He kept reminding us that we should not forget our responsibility to save the society as well as individual patients.
Dr Takeshita was a great physician-scientist and made major contributions to the fields of neural control of circulation and vascular biology. Although his death is a great loss to us and many others who worked with him, we need to overcome our grief and take on the responsibility to succeed his wish. His legacy will forever be remembered by so many whom he mentored.
Takeshita A, Mark AL. Neurogenic contribution to hindquarters vasoconstriction during high sodium intake in Dahl strain of genetically hypertensive rats. Circ Res. 1978; 43 (suppl I): I-86–I-91.
Takeshita A, Mark AL. Decreased vasodilator capacity of forearm resistance vessels in borderline hypertension. Hypertension. 1980; 2: 61–616.
Takeshita A. Effects of atrial natriuretic factor on baroreceptor reflexes. Hypertension. 1990; 15: 168–169.
Hirooka Y, Imaizumi T, Masaki H, Ando S-I, Harada S, Momohara M, Takeshita A. Captopril improves impaired endothelium-dependent vasodilation in hypertensive patients. Hypertension. 1992; 20: 175–180.