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Tribute to Dr. Thomas G. Pickering’s Research

Dr. Thomas Pickering spent 24 years conducting research on behavioral aspects of hypertension and cardiovascular disease at the Weill Medical College of Cornell University Medical Center. There, in the Hypertension Center, he began a program of research that has grown in breadth and depth, and that continues today more strongly than ever. Although he participated in a great deal of physiological research, his research in behavioral determinants and consequences of hypertension formed the heart of the program. Thus, Dr. Pickering was one of the earlier researchers to employ ambulatory techniques in blood pressure monitoring, and contributed to the knowledge that clinic blood pressure measures are prone to both unsystematic and systematic errors, and are hence less useful for the prediction of target organ damage than ambulatory measures. In the course of this research, he began to examine the nature of the errors more closely; for example, he was one of the first to identify the problem of "white coat hypertension", in which patients exhibit poor blood pressure control only in the physician's office, leading to a false diagnosis of hypertension and unnecessary prescription of medication. Dr. Pickering was the Principal Investigator on an NHLBl/NlH Program Project award that began in 1993 and that was approved for competitive renewals in 1998, 2003, and 2009. The Program Project has investigated several phenomena related to the behavioral causes and physiological consequences of hypertension, focusing on white coat hypertension, nocturnal blood pressure "dipping", race differences in sleep disturbance and target organ damage, and the effects of work-related stress on blood pressure and left ventricular hypertrophy (the latter study remains one of the only prospective demonstrations that environmental stress is associated with hypertension and LVH). This study was supervised by Dr. Joseph Schwartz, an epidemiologist and statistician with whom we have worked for more than 20 years. Dr. Pickering was also PI on an R01 which is investigating the possibility that placebo effects may be classically conditioned, and hence be of real therapeutic value. Dr. Pickering moved to Columbia University Medical Center with the entire faculty and staff, to form the Center for Cardiovascular Health.

Tragically, Dr. Thomas G. Pickering passed away on May 14, 2009. He was well loved and is sorely missed by all faculty and staff. He was formerly President of the Society of Behavioral Medicine, the Academy of Behavioral Medicine Research, and a leader in other national and international scientific organizations. He published over 500 articles in scientific journals. His core belief was that much of cardiovascular disease arises from psychosocial factors, and is hence potentially preventable or treatable by modifying these. Always a gentleman, he leaves a legacy of outstanding scholarship, collegiality, and many younger clinical investigators, who are now spread across the world. He was a wonderful mentor and friend and will be greatly missed by his colleagues and co-workers at Columbia University’s Center for Behavioral and Cardiovascular Health and Division of General Medicine.

The Center for Behavioral Cardiovascular Health, as a whole, has several strengths that are worth highlighting. First, together our areas of research expertise cover a broad spectrum of the translational effects of behavioral factors, pathophysiological mechanisms and intervention on cardiovascular disease. As a group, we are experienced in the writing of nationally-funded science and the administration of these studies. An important characteristic of this group is the nature of our collaborative relationships. These are extremely strong not only within our own group, but with colleagues within our own institution and from other institutions, both in and outside of the New York City. Much of this research is supported by NIH. We are also very involved in the application of new technology for both research and treatment. In addition to our work in ABPM, we have used a telephone-linked home blood pressure monitoring system, home polysomnography, and electronic pill containers for evaluating adherence with medications.

Finally, one of our strengths is in the mentoring of promising junior faculty. We routinely work with fellows, residents, and junior faculty members from several departments including cardiology, medicine, nursing, and psychiatry. The focus of this mentoring is twofold: we teach the elements of research, including developing a grant application, the methodology, power analysis, statistical techniques, and so on for a methodologically rigorous study; and we also focus on career development, including more than just grantsmanship and successful publication and presentations.