Dr. Peter O. Kwiterovich Jr., an internationally known expert on lipid disorders who was the founder and director of the Johns Hopkins Lipid Clinic and was an early advocate for routine cholesterol screening in children, died Friday of prostate cancer at his Roland Park home. He was 74.
"We have lost a true giant in the field of cardiovascular disease. He was one of the quiet pioneers at Hopkins," said Dr. George J. Dover, pediatrician-in-chief at Johns Hopkins Hospital and director of the Johns Hopkins Children's Center.
"Peter's lab and clinic were pioneers in defining lipid disorders and premature atherosclerosis in families with genetic predisposition to strokes and heart disease," said Dr. Dover. "His work transformed our understanding of fat metabolism and lipid malfunction and the role they play in fueling premature heart disease."
Dr. Kwiterovich's work, which spanned nearly half a century, not only defined normal cholesterol values for children but also resulted in new therapies that slowed or halted the progression of heart disease and averted premature death for thousands of children and adults.
"If you can stop adult diseases before they occur, then do it in children," said Dr. Dover.
In a 1997 interview with The Washington Post, Dr. Kwiterovich said, "I think parents should first worry about their own cholesterol. If they are OK, then I would be less concerned about the child."
"Peter Kwiterovich was a legendary figure in preventive cardiology and atherosclerosis management," said Dr. Roger S. Blumenthal, professor of medicine and director of the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease.
"His work was an early catalyst that not only reshaped our approach to screening and prevention, but also helped fill in some important gaps in our understanding of the evolution of heart disease across the life spectrum, showing that the most common form of the disease begins at a far younger age than many had suspected," said Dr. Blumenthal.
The son of Dr. Peter Oscar Kwiterovich Sr., a physician, and Mary Marks Kwiterovich, a homemaker, Peter Oscar Kwiterovich Jr. was born and raised in Danville, Pa.
After graduating from Georgetown Preparatory School, he earned his bachelor's degree in 1962 from the College of the Holy Cross in Worcester, Mass.
He then entered a two-year program at Dartmouth Medical School, which sparked his interest in genetics. He completed his medical degree at the Johns Hopkins School of Medicine in 1966.
Dr. Kwiterovich completed an internship in pediatrics at Children's Hospital in Boston, which was followed by three years of study in the molecular disease branch of the National Heart, Lung and Blood Institute in Bethesda. He then returned to Hopkins in 1970, where he completed his residency in pediatrics in 1972.
While at the National Heart, Lung and Blood Institute, he developed an interest in "cholesterol and inherited disorders of cholesterol metabolism," Dr. Kwiterovich explained in a 2000 interview with Dartmouth Medicine magazine.
"I had changed my thrust from originally being interested in the biochemical basis of mental illness to the biochemical basis of cholesterol and heart disease," he said.
"I was more attracted to the preventive aspects of the cholesterol field and heart disease. I saw the potential of diagnosing people who carried these genes making them at risk for heart disease later," said Dr. Kwiterovich.
In 1972, Dr. Kwiterovich received a National Institutes of Health grant that allowed him to establish the Johns Hopkins Lipid Clinic, which he directed until his retirement in 2014. It was in this clinic that he launched a clinical trial that would prove his theory regarding cholesterol.
"If you took somebody with high cholesterol and lowered it, you could prevent heart disease," Dr. Kwiterovich said in the Dartmouth interview.
Because he was able to see more than 2,000 pediatric and adult patients a year, investigators had a rare opportunity to collect and compare biochemical and genetic data across multiple generations.
The clinic also served as a training ground for clinicians and scientists who later fanned out across the world.
Also during the 1980s, he and colleague Dr. Allan Sniderman of the Royal Victoria Hospital in Montreal made an important discovery that apoB and hyperapoB were better identifiers of coronary artery disease than HDL, or high density lipoprotein, which is commonly known as "good" cholesterol.
At the Hopkins School of Medicine, he also established the Lipid-Atherosclerosis Division in the Department of Pediatrics, which is one of a handful in the nation.
Dr. Kwiterovich was one of the lead investigators on a multi-center trial that discovered a low-fat diet is safe for teenagers with moderately high cholesterol.
Dr. Kwiterovich was the author of more than 200 peer-reviewed publications and 75 academic reviews and book chapters. His "The Johns Hopkins Complete Guide to Preventing and Reversing Heart Disease" and "Beyond Cholesterol" remain two popular clinical texts.
He was also the author of "The Johns Hopkins Textbook of Dyslipidemia," a comprehensive textbook on caring for children and adults who have been diagnosed with lipid disorders.
In his interview with Dartmouth, Dr. Kwiterovich envisioned a time in a century or so when doctors would be able to use diagnostic chips to identify a patient's exact genetic defect that would put them at risk for certain diseases and how to avoid them.
"I think … eventually, we'll really practice true preventive medicine and it will be based primarily in genetics," he said.
He had been an active member, president and vice president of the Roland Park Civic League.
A funeral Mass will be offered at 2 p.m. Wednesday at the Roman Catholic Cathedral of Mary Our Queen, 5200 N. Charles St.
Surviving are his wife of 15 years, the former Martha Walker; two sons, Peter Oscar Kwiterovich III of Baltimore and Adam Kwiterovich of Roland Park; three daughters, Karen Perritt of Severna Park, Virginia Shelton Kwiterovich of Roland Park and Dr. Kris Ann K. Oursler of Salem, Va.; two sisters, Pamela Skwish of Wilmington, Del., and Deborah Kwiterovich-Hoover of Malvern, Pa.; and five grandchildren. An earlier marriage to the former Kathleen Ann Justin ended in divorce.