Clinical Notes on the Illness and Death of President Franklin D. Roosevelt

The Framingham Heart Study and the epidemiology of cardiovascular disease: a historical perspective

“…Years later, reflecting on President Roosevelt's premature death, his cardiologist wrote: “I have often wondered what turn the subsequent course of history might have taken if the modern methods for the control of hypertension had been available.” 5 The Framingham Heart Study was the product of a bill signed into law by President Roosevelt's successor. Fittingly, it has made many contributions to the understanding of the very cardiovascular conditions that led to President Roosevelt's death.…”

“…Franklin Delano Roosevelt, the United States' war-time President from 1933 to 1945, was in no way exempt from the epidemic, suffering from heart failure due to undiagnosed, and later untreated, risk factors. 5 The present article will describe how medical care provided to the President preceding his sudden death while still in office in 1945 illustrates the poor state of our understanding of cardiovascular disease in the mid-20th century. These events likely played a role in prompting the creation of the Framingham Heart Study in 1948.…”

“…9 Cardiologist Dr. Howard G. Bruenn, one of only a few hundred such specialists in the entire nation, attended to the President. Dr. Bruenn noted that the patient appeared “slightly cyanotic,” with “blood pressure 186/108” mmHg and a chest x-ray showing an “increase in size of the cardiac shadow.” The young cardiologist gave the President his first diagnosis of “hypertension, hypertensive heart disease, and cardiac failure.” 5 However, Dr. Bruenn had few therapeutic options to provide, suggesting digitalis and salt intake reduction. After at first rejecting the cardiologist's advice, the President eventually started digitalis with some symptom relief, and a follow-up chest x-ray 2 week later showed reduced cardiomegaly.…”

“…His daughter thinks he is not really ill, and his doctor backs her up.” As predicted, President Roosevelt died a few weeks later on April 12, 1945, at the age of 63, from cerebral hemorrhage with a blood pressure of 300/190 mmHg. 5 Like countless other Americans, he had succumbed to the national epidemic of cardiovascular disease.…”

Framingham contribution to cardiovascular disease

“…In the 1940s, CVDs were the number one cause of mortality among Americans, accounting for 1 in 2 deaths. Prevention and treatment were so poorly understood that “most Americans accepted early death from heart disease as unavoidable.”[ 4 ]…”