Department of Internal Medicine
William J. Lawton, M.D.
Associate Professor (Emeritus)
Dr. Lawton's research has involved studies of hypertension. Dr. Lawton was the Principal Investigator for the University of Iowa component of ALLHAT (50 study subjects) in a completed multicenter trial of 40,000 subjects. This study sought to determine if newer antihypertensive agents (Lisinopril or Amlodipine or Doxazosin) were better or worse than a diuretic (Chlorthalidone) regarding myocardial infarction and other cardiovascular events. There was also a lipid-lowering arm (Pravastatin vs. diet therapy) for subjects with hypercholesterolemia. This ALLHAT Study (Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial) found that diuretics were as good as, and in some instances better, than Amlodipine or Lisinopril in preventing myocardial infarction or cardiovascular events. The monotherapy arm with Doxazosin was stopped early due to excessive congestive heart failure.
Dr. Lawton and other members of the Renal Division also completed studies determining the optimal target treatment level for diastolic pressure to determine if diastolic pressure less than 90mmHg reduces cardiovascular and renal events. The optimal level for minimizing cardiovascular events is BP 138/83 with recommendations to treat blood pressure to 130-140/mid 80's. There was no "J" curve phenomenon (worsening cardiovascular events with lower pressures) observed. This multicenter trial was called the HOT Study (Hypertension Optimal Treatment). Dr. Lawton was had a longstanding interest in the inter-relationship between dietary sodium and potassium, hypertension, neurogenic factors and renal vascular responses, and has completed studies in this area. Dr. Lawton is currently serving with two humanitarian-mission programs: 1). Providing lectures and consultation on hypertension and renal disease in developing countries (Moldova) and 2). Conducting hypertension screening and diet therapy in Ghana and Egypt.
Dr. Lawton and Clinical Psychologist Dr. Alan Christensen have been collaborating in several studies regarding cognitive behavior techniques, which may improve compliance in dialysis patients. These studies are unique in: a) In longitudinally following psychological profiles and coping techniques over a period of years in patients approaching dialysis and transplant, through the transition to renal replacement therapy, and beyond; b) Determining psychological factors which best suit patients for successful adjustment to home dialysis vs center dialysis; c) Intervening through small group programs to improve compliance with dietary and medication regimens in dialysis. Dr. Lawton is currently an Investigator with Dr. James Rossen, cardiologist for the CORAL Study (Cardiovascular Outcomes in Renal Atherosclerotic Lesions). The CORAL study will test the hypothesis that "Medical therapy with stenting of hemodynamically-significant renal artery stenoses, in patients with systolic hypertension, reduces the incidence of adverse cardiovascular and renal events, compared to medical therapy alone. Dr. Lawton has served as the Medical Director of Dialysis at the UIHC and VAMC from 1987 - 2003.
Honors, Awards, and Organizations
American Association for the Advancement of Science
Diplomate, American Board of Internal Medicine and Board of Nephrology
American College of Physicians, Member
American Heart Association
Council on High Blood Pressure Research, Fellow
American Society for Artificial Internal Organs
American Society for Nephrology
Beta Beta Beta, Biological Honor Society
Christian Medical and Dental association
Inter-American Society of Hypertension
National Kidney Foundation of Iowa: Past President
Society for Experimental Biology
Ernest O. Theilen Clinical Service and Teaching Award
Leonard Tow Humanism in Medicine Award