Paul Ivan Korner
Paul Korner died on October 3, 2012 after a short illness on the day he was to receive a Lifetime Achievement Award from the International Society of Hypertension in recognition of his contribution to our understanding of cardiovascular disease, particularly hypertension. His legacies include his own original contributions in the field of circulatory control, the work of many esteemed scientists and academics he trained, and his recent monograph: Essential Hypertension and Its Causes.
In >330 publications spanning from the 1950s to the present day, he made important contributions in the field of central nervous control of the circulation, particularly baroreflex and chemo reflex function. He studied how structural adaptations are responsible for many characteristics of the hypertension phenotype, developing the concept of the cardiac and vascular amplifier having been influenced by his friend Bjorn Folkow. In many of these fields, he not only introduced new concepts but also methodologies that were taken up by others. Techniques for studying the baroreflex and autonomic versus nonautonomic contributions to peripheral vascular resistance are examples. He was also among the first to understand that reduction of overall risk was the objective in the prevention of coronary heart disease and helped found a risk reduction clinic in the 1970s. His focus on the integration of control systems required him to study emerging fields in genetics, cell biology, and cell signaling in his retirement. This ensured that his book, although a very personal collection of evidence, ideas, and, perhaps, prejudices, included much contemporary data at the time of publication in 2007.
Titled “Essential Hypertension and Its Causes: Neural and Non-neural Mechanisms,” he considered this book to be his defining work.1 It reads as a coherent and sequential explanation of the mechanisms whereby some people respond more to mental stress and modern daily life in certain centres of the brain and subsequently develop hypertension. He proposed that other regulatory systems are recruited, not only the nervous system but also the heart, vasculature, kidneys, and hormones. All these systems have advocates who claim that hypertension starts there. Korner characteristically did not walk around the stone wall that proponents of the stress hypothesis of hypertension generally meet: How does repetitive but short-term exposure to stressful aversive stimuli turn into a long-term change manifest as high blood pressure? Why does the nervous system not just adapt or forget? He provided evidence of a special kind of adaptive memory in the control systems of the body acting in the context of multiple genes and environmental factors, particularly salt and obesity. He stopped short of telling us the fundamental abnormality leading to susceptibility to hypertension but proposed localization to certain hypothalamic neurons.
At the time of his death, a manuscript on mathematical explanations for the vascular amplifier was in the final stages of preparation for submission with his long-term collaborator James Angus.
He was an eloquent and civilized man, forthright and rigorous in the scientific arena and inspirational to generations of researchers, who also loved family, music, and literature. Paul Korner came to Australia in 1939 at the age of 14 years, having been born in Moraska Ostrava in the former Czechoslovakia. He studied science and medicine at the University of Sydney, graduating in the latter in 1951. He was then awarded an overseas research fellowship and worked at Hammersmith Hospital with John Shillingford and at Harvard Medical School with Cliff Barger from 1954 to 1956 when he graduated MD from the University of Sydney. He was Foundation Professor in Physiology at the University of NSW from 1960 to 1968 but resigned from the University when he and the Vice Chancellor could not agree on the appropriate pass rate for students of physiology. His next appointment as Scandrett Professor of Cardiology at Royal Prince Alfred Hospital in Sydney brought him into the clinical domain for the first time since his residency. Many clinician scientists with distinguished subsequent careers flourished in this department.
In 1975, he became Director of the Baker Medical Research Institute in Melbourne, a position he held until retirement in 1990. Founded in 1926, the Baker had been home to many outstanding scientists but remained a small institution with disparate groups studying a range of subjects from cardiology to Antarctic medicine. The Baker did, however, have a close relationship with the adjacent Alfred Hospital, and Paul Korner built on this relationship to ensure that fundamental research programs at the Institute were either followed up in the clinical arena or were informed by the everyday issues facing clinicians. In this sense, he was an early pioneer of translational medicine, and this ethos remains with the Institute to this present day. During his directorship, the Baker Medical Research Institute became dedicated entirely to cardiovascular research with a major program in hypertension that Korner led himself and an atherosclerosis program led by Paul Nestel and subsequently Philip Barter. Under his stewardship, the Institute flourished and his trainees, fellows, and investigators subsequently populated many major academic centres around the world. He was Director of the clinical arm of the Institute, The Alfred and Baker Medical Unit at The Alfred Hospital, Professor of Medicine at Monash University and in 1987 assumed the role as President and Chairman of the Board of Management at The Alfred, Caulfield, and also the Southern Memorial hospitals.
His professional achievements were widely recognized as a fellow of the Australian Academy of Science in 1974, an Officer of the Order of Australia, Presidency of the 29th IUPS (International Union of Physiological Sciences) Congress of Physiology, and the Volhard Award of the International Society of Hypertension among other distinctions. The Hypertension community has lost a passionate and inspirational leader and scientist. His wife Jennifer, his children Nicholas, Anthony, and Harriet, and his grandchildren Marrichio, John, Brayan, Tom, Daniel, and Paul survive him.
Baker IDI Heart & Diabetes Institute
- © 2013 American Heart Association, Inc.
- Korner PI