Dr Thomas Dawber

Framingham Heart Study pioneer

Thomas Royle Dawber, epidemiologist: born Duncan, British Columbia 18 January 1913; Director of the Framingham Study, US National Heart Institute 1949-66; Chairman of Preventive Medicine, Boston University 1966-80; married 1937 Eleanor Ronimus (one son, one daughter); died Naples, Florida 23 November 2005.

Thomas Dawber led the Framingham Heart Study, the research that identified the major risk factors for heart disease. Based on the residents of Framingham, a town near Boston, Massachusetts, with a stable population, the study looked for the causes of heart disease and tested strategies to prevent it.

Unlike earlier research, which looked at heart patients and tried to deduce a common thread in their lives, the study recruited 5,209 healthy men and women aged 30 to 60 and followed their life styles and medical histories. Thus, when any developed heart disease, researchers could identify the causes. This goal, to find the cause of heart disease and prevent it, was a confused one; heart disease was so poorly understood that it was too early to prevent it, so Dawber focused on looking for causes.

In 1961 he and colleagues published a landmark study, "Factors of Risk in the Development of Coronary Heart Disease - six-year follow-up experience: the Framingham Study" in The Annals of Internal Medicine, that put forward the concept of risk factors in coronary heart disease, and identified the major ones. These were high blood pressure, high cholesterol levels and defects in the heartbeat rhythm. It also noted hints of a connection between smoking and heart disease. In 1988, they reported the association between "type A behaviour" - tenseness and aggression - and heart disease. Heart disease caused by the build-up of fat in arteries had previously been considered an inevitable part of the ageing process. Framingham showed that this was not so.

The Framingham Study was started in 1948 by the US public health service. It did not do well in its first year, which is why Dawber was appointed: his clout as a physician motivated the townspeople of Framingham to participate. Funding was rapidly taken over by the newly established US National Heart Institute. In the early days, other medical scientists looked on the project as a fool's errand.

Dawber was born in Duncan, British Columbia, where his father was a Methodist minister; his parents had emigrated from Knutsford, Cheshire, two years earlier. They later moved to Philadelphia, where he went to Haverford College. He entered Harvard medical school in 1933, graduating in 1937 before working for 12 years with the US coastguard service, based at Brighton Marine Hospital, near Boston, where he ended up as chief of medicine.

He spent two decades at the Heart Institute, also in Boston, working on Framingham, until 1966, leaving in part because of budget cuts to move to Boston University as chairman of preventive medicine. The Framingham Study had been planned to last 20 years and the US government wanted to close it down.

Dawber spent the following 14 years at Boston University, taking the Framingham Study with him, although he stood down as director. He raised $500,000 from private sources to keep it going. As the work continued, the US government relented and resumed the funding. Further findings included the connection between high blood pressure and stroke, and the benefits of "good" (high-density) cholesterol. The study continues and now includes the children and grandchildren of the original participants. Dawber retired when he was 67 to Naples, Florida, and spent much of his time sailing.

Tall, distinguished-looking, with early grey hair and a twinkle in his eye, "Roy" Dawber felt it wrong to boast about his accomplishments. He was a good carpenter, played the piano and wind instruments, and was an Elvis fan.

Caroline Richmond

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