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December 5, 1947

Mrs, John Moran
Mendon Road
Cumberland, Rhode Island

 
  
  
 
 
 

Dear Rita:

pK of the reply which I
bh} regarding the clipping
in which you were ted. This will probably
answer some of the gu bhs you may have had.
W Wi personal regards, lam,

Sincerely yours,

John E, Fogarty, M. C.

a”
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

 

PUBLIC HEALTH SERVICE BETHESDA 14, MD.

 

NATIONAL INSTITUTES OF HEALTH

November 29, 1957

Dear Mr. Fogarty:

I am glad to comment on the research findings mentioned in
the clipping enclosed with your letter of November 21.

Chlorothiazide is a non-mercurial compound which has marked
ability to increase the excretion of sodium and chloride. Clinical
studies at a number of institutions, including the National Heart
Institute, have shown it to be a good diuretic and a useful addition
to the drugs available for the treatment of edema since to date it
appears to have no serious side effects. The studies reported by
Drs. John H. Laragh and Felix E. Demartini of Columbia University
show that it is useful in treating many patients who have in the past
required use of injected mercurials or other measures.

The known fact that depletion of salt in the body increases
the blood-pressure-lowering effect of antihypertensive drugs prompted
investigations by Drs. William Hollander and Robert W. Wilkins of
Boston University and by Dr. Edward D. Freis and co-workers of George=
town University to study the effects of diuretics on hypertension.
Of the various oral diuretics tried by both groups, only chlorothiazide
was found to have consistent pressure-lowering action. Both groups
have found that, when given in combination with commonly used anti-
hypertensive drugs, it enhances pressure-lowering effects. Since
chlorothiazide has only recently become available, these reports are
preliminary and long-term effects of the drug are not presently known.

It will be of interest to you that Drs. Laragh, Wilkins, and
Freis are all research grantees of the National Heart Institute and
that Dr. Hollander has a Heart Institute Research Fellowship.

The research by Dr. William Likoff of the Albert Einstein
Medical Center, and his associates, on radioactive fat absorption
patterns is of much interest since it contributes additional evidence
indicating that the process underlying atherosclerosis may be due to
abnormalities of fat metabolism.

National Cancer Institute National Heart Institute National Institute of Allergy and Infectious Diseases National Institute of Arthritis and Metabolic Diseases
National Institute of Dental Research National Institute of Mental Health National Institute of Neurological Diseases and Blindness The Clinical Center
Division of Biologics Standards Division of Business Operations Division of Research Grants Division of Research Services
Mr. John E. Fogarty--

It is in the area of fat metabolism that the Heart Institute
has made substantial contributions to knowledge, A large part of the
Institute's research program is concerned with the study of mechanisms
involved in the absorption, distribution, and utilization of fat and
fatty substances in the body. The aim is to determine how these |
processes operate normally, at what points they may become disturbed,
and to determine the departures from the normal in patients with
atherosclerosis and disorders associated with the development of
atherosclerosis.

Fats absorbed from the intestine are transported to the tissues
in the form of large molecular aggregates of fat and protein. Heart
Institute studies have discovered that there is in the tissues a lipo-
protein lipase, or “clearing factor” system, which is responsible for
removal of the fat and its deposition in the tissues, and for the later
breakdown of tissue fats to supply the needs of the body for fuel. The
various components of this lipoprotein lipase system have been identi-
fied and their significance is under continuing study. It has also
been shown that unesterified fatty acids released from the body's fat
depots by specific enzyme action are a major resource in meeting the
caloric requirements of tissues. The regulation of their release and
uptake is under intensive study since when there is interference with
this process, large fatty aggregates of the type associated with athero-
sclerosis appear in the blood. We are convinced that a basic under-
standing of normal and abnormal fat metabolism is an essential part of
the solution of the problem of atherosclerosis.

Kind personal regards,

Sincerely,

 

/ Watt, Me De
/ / Director
ional Heart Institute

Hon. John E. Fogarty
House of Representatives

Enclosure