It’s with unimaginable gratitude that we recognize Dr. Tom Easterling, as he retires from his role as Director of the Preeclampsia Foundation Medical Advisory Board. To talk about Dr. Easterling’s legacy is to talk about the 25 years of transformative change of the Preeclampsia Foundation itself.

In the late 1990s, Dr. Easterling was a practicing high-risk obstetrician in Washington (state), already overseeing severe and difficult cases related to hypertensive disorders of pregnancy. He received his MD from the University of North Carolina Medical School, served as a professor at the University of Washington Medical School, and received numerous awards and recognitions for his work in the field of hypertensive disorders of pregnancy, including the Leon Chesley award from the International Society for the Study of Hypertension in Pregnancy in 2016.

After a traumatic near-death experience during her third pregnancy in 1996, preeclampsia survivor Anne Garrett started researching preeclampsia and learned that she had experienced HELLP syndrome. Her fourth and final pregnancy in 1999 was therefore managed under Dr. Easterling’s careful eye. Everything proceeded normally during pregnancy and labor, but one week postpartum, Anne’s blood pressure skyrocketed, requiring aggressive management to save her life.

When Anne asked Dr. Easterling where she could send a check to help improve research and treatments for this life-threatening condition, he confessed, “There is nowhere.”

In 1999, preeclampsia was listed by the US National Institutes of Health as a “rare and orphaned” disease, not because it was rare, but because it was “orphaned” – meaning it had no advocacy group working on its behalf. So together with her then-husband Anil Singh-Molares and fellow advocate Joan Lambert, Anne and Tom began the Preeclampsia Foundation – the first-ever patient advocacy organization for hypertensive disorders of pregnancy in the United States. (The Foundation was officially incorporated as a 501(c)(3) not-for-profit organization in August 2000, which is why this year, we will be celebrating its 25th Anniversary!)

“Early in his professional career seeing high-risk patients, Tom studied hemodynamics as early predictors of preeclampsia, and the impact that tighter blood pressure control – specifically using beta blockers - could have on decreasing the adverse outcomes related to preeclampsia,” said Preeclampsia Foundation CEO Eleni Tsigas.

She reflected that although Dr. Easterling was passionate about his research findings, he always recognized that a rigorous scientific process was needed to validate and corroborate his hypothesis so that it would lead to clinical utility, and that the biology of preeclampsia was so complex it would need a multitude of great thinkers tackling the problem.

“He believes strongly that science builds on itself, so that clinicians could be sure that we were doing what was best for the patient and her baby,” said Tsigas. “Studies like the CHIPS Trial in the UK, the CHAP trial here in the US, and the subsequent rapid changes to clinical guidelines, are a testimony to his initial research on blood pressure management during pregnancy, as well as his commitment that changing care practices should always follow due scientific process.”

Dr. Easterling’s contributions continued for the last 25 years as the Preeclampsia Foundation’s biggest champion, supporting the need to amplify patient voices and inviting the Foundation’s patient advocate leadership into spaces that had previously only been confined to researchers and healthcare providers. Dr. Easterling also wisely recommended that the Foundation keep research and improving clinical care at the center of its mission, inspiring the next generation of physician-researchers to tackle this conundrum. The problem of preeclampsia would not be fixed simply by supporting patients after their traumatic health event occurred, though that strategy was important for building a community of motivated supporters. He inspired medical and scientific colleagues – a veritable “Who’s Who in Preeclampsia” experts – to join the medical advisory board and bring scientific rigor to the organization’s investment in novel research and young investigators.

Last year, Dr. Easterling graciously transitioned the leadership of the Medical Advisory Board to Dr. Ira Bernstein. A long-time colleague, member of the Medical Advisory Board, and a preeminent leader in the field of hypertensive disorders of pregnancy, Dr. Bernstein was Chair of Obstetrics, Gynecology and Reproductive Sciences at the University of Vermont College of Medicine and medical director of women’s services at Fletcher Allen Health Care.

“As a fellow Maternal Fetal Medicine provider, I first heard Dr. Easterling present his research work over 35 years ago,” said Dr. Bernstein. “His research contributions, examining hemodynamic factors that contribute to preeclampsia, laid the groundwork for our recognition of preeclampsia subtypes and launched a new wave of investigation examining cardiovascular adaptations in pregnancy and their implications. His insights contributed to much of my own work. I am honored to have been chosen to succeed him with the leadership of the medical advisory board and hope I can effectively serve his legacy."