Objective:

Understanding the health status of political leaders is crucial, as it can affect their decision-making abilities and the course of history.

Background:

The Yalta Conference of 1945 brought together three of the most influential leaders of the 20th century: Franklin D. Roosevelt, Joseph Stalin and Winston Churchill. Surprisingly, all three leaders would go on to suffer strokes after the conference.

Design/Methods:

While there is a common theme of vascular risk factors and subsequent neurovascular presentations in all “The Big Three”, one can spot differences in their lifespan and their health management strategies through the years.

Results:

In the case of Roosevelt, because of his poorly managed hypertension through the years and constant emergency hypertensive episodes, unfortunately he had a massive brain hemorrhage, which resulted in his demise. It is worth noting that as recently as 1945, hypertension was not seen as a significantly detrimental medical condition. In both the cases of Stalin and Churchill, we encounter repetitive TIAs and smaller strokes that preceded their ultimate fatal stroke. While both Roosevelt and Stalin died from a hemorrhagic stroke, Churchill died of an ischemic stroke. Nonetheless, nothing really “came out of clear sky”, leading one to speculate whether there may have been subtle, subclinical alterations in these men’s mental state, triggered by vascular incidents over the years.

Conclusions:

It is important to note the limited knowledge of prevention and management, as well as a general unawareness, of vascular disease in those years. We often examine the ultimate medical outcomes of these three pivotal historical figures as interconnected, due to their roles in shaping the post-World War II landscape. Roosevelt's demise, prior to the conclusion of the war, triggered a leadership transition during a critical moment in history, while Churchill and Stalin's passing shaped the early Cold War.