On Not Being the Last to Give Up the Old or the First to Adopt the New

Abstract

As the Hypertension editorial office prepares to move to Jackson, Miss, those of us who have worked on the editorial staff can confidently say that we have learned a great deal from the experience. The opportunity to observe the scientific review process up close could not help but raise issues and questions for later consideration. One of the more interesting things about the past 8 years is the recognition that science has indeed progressed, that the field has been advanced in a meaningful way, and that Hypertension has played at least a small part in that progress by giving voice to the work of so many. Eight years ago, the biology of angiotensin type 1 and type 2 receptors was not well understood, the role of angiotensin-(1-7) was unclear, the benefits of ACE inhibitors in diabetes and vascular disease were unappreciated, and the utility of angiotensin receptor blockade was more a promise than a reality.1–4 Progress has been made in all these areas and many others. Medicine advances. The system does work. On the other hand, one cannot help but wonder whether the system works optimally. The deliberate evaluation of new data, the careful honest skepticism that greets any new formulation of biology, and the continual demand for confirmatory data are all essential to orderly progress. This is particularly important in those areas of clinical research in which extremely stringent standards must be applied to results that could modify patient care. But could it be that in other areas the system sometimes is too slow to adopt the new, or that fashions are too hard to change? Perhaps I raise this …