Brian PrichardBMJ 2010; 341 doi: https://doi.org/10.1136/bmj.c5441 (Published 11 October 2010) Cite this as: BMJ 2010;341:c5441
- Janet Fricker
In 1964 Brian Prichard published two seminal papers in the BMJ that showed for the first time that β blockers lower blood pressure. In the first, a double blind trial of patients with angina, he noticed that pronethalol produced a small fall in blood pressure (BMJ 1964;1:1227-8, doi:10.1136/bmj.1.5392.1227). This drug was withdrawn in 1963 because it produced tumours in mice. In the second he produced the same effect with propranolol (BMJ 1964;2:725-7, doi:10.1136/bmj.2.5411.725).
At first the medical profession was sceptical, not least because β blockers inhibit cardiac contraction, viewed as an undesirable effect and also reduced cardiac output. Also, the fall in blood pressure was not seen in animals, and the mechanism of action was unclear. Prichard spent the remainder of the 1960s championing the cause, and persuading the drug company ICI to increase the dose of propranolol tablets from 10 mg to 250 mg to allow sufficient dosing of hypertensive patients. Before this patients had to take as many as 40 tablets a day.
Initially it was not fully appreciated that clinicians needed to take time to search for the optimal dose for individual patients to achieve the best possible therapeutic results. Use of β blockers in hypertension heralded a new era in pharmacology. Before their development patients took drugs only if they were not feeling well, but afterwards patients without symptoms starting taking drugs to prevent the effects of hypertension, shifting the emphasis from treatment to prevention.
“It’s Brian’s enduring legacy that in the past 50 years, millions of patients have been treated with β blockers to control blood pressure and so prevent heart attacks and strokes,” said Raymond MacAllister, a colleague from the department of clinical pharmacology at University College, London.
But Prichard’s biggest hobby horse was undoubtedly fish oils. A keen advocate of the omega three diet, he ate pilchards twice a day, and packed vast quantities when he went on his travels. “He was so fastidious that he’d wash them to get rid of the tomato sauce, then replace it with low salt sauce,” remembered MacAllister. “On one occasion he nicked himself shaving and attributed the fact he bled for hours to the beneficial effects of fish oil on his platelet function.”
Medicine was only one aspect of the rich tapestry of Prichard’s life. He was a local Tory politician (elected Mayor of Wandsworth in 2009), a life long abstainer (the founding chairman of the Institute of Alcohol Studies), an advocate of healthy eating, a committed Christian (serving as a deacon at Trinity Road Chapel, Wandsworth), and a supporter of the Boys’ Brigade (where he was medical director and organised many camps).
“My father’s life view came out of the Christian Democratic Labour party ethics of the 1920s and ’30s. Christianity, medicine, and politics were completely entwined in his life. At his core was the idea that you should serve other people,” said his oldest son Andrew, an ear, nose, and throat surgeon, adding his father’s many interests were helped by prodigious energy and a supportive wife.
“He was a complete workaholic. The feeling you always had to be doing something productive was ingrained from childhood as was his loyalty to the causes he espoused,” said his friend Derek Rutherford, chairman of the Institute of Alcohol Studies.
Brian Prichard was born in Wandsworth, southwest London, in 1932, the second child of Sir Norman Prichard, who later became Labour chairman of London County Council in 1956, and Winifred Prichard, one time president of the National British Women’s Abstinence Society. His was a heavily political family.
Skull and crossbones
Qualifying in medicine in 1957 from St George’s Hospital, London, Prichard held junior posts at St George’s before being appointed in 1962 as a lecturer in clinical pharmacology at University College Hospital Medical School. He became professor in 1980.
There Prichard undertook research, did general medical takes, ran hypertensive and lipid clinics, and had an additional interest in organising the alcohol detoxification unit. Legend has it that he undertook ward rounds brandishing a hip flask with a skull and crossbones attached. Altogether Prichard published more than 200 papers, and wrote the text book Beta Blockers in Clinical Practice with John Cruickshank.
Prichard served as a councillor for more than 40 years on Wandsworth Council, standing first for Labour and then, after a dispute with the local party, crossing over to the Conservatives. He championed the disadvantaged, taking a particular interest in education and social services. One of the main difficulties he faced becoming mayor in May 2009 was the tradition of serving alcohol at functions. Prichard got round this potential embarrassment by erecting a large notice next to the trays of drinks that said “This fluid is dangerous to your health. Handle carefully if at all.” As chairman of the Conservative Medical Society, he had advised the Thatcher government on health. He was awarded Commander of the Order of the British Empire in 1996 for his service to politics.
Healthy eating, stemming from his work on reducing cardiovascular risk, was a life long obsession. “It would take him two hours to do any food shop since he’d read all the labels,” recalls his grandson Tom, now a medical student, adding that his grandmother managed to nip round the shop in under 20 minutes.
“An example of the overlap between different aspects of his life was the fact that at Boys’ Brigade camps dad would stand in the canteen making sure that the butter on the children’s bread was so modest that it was barely visible,” said his younger son, the Reverend Ian Prichard.
He leaves his wife Denise, who he married in 1956, and four children.
Cite this as: BMJ 2010;341:c5441
Brian Prichard, clinical pharmacologist (b 1932; q 1957, St George’s, London), died 6 April 2010 from complications of myeloma.
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