Cardiovascular disease (CVD) includes all the diseases of the heart and circulation such as coronary heart disease, angina, heart attack, congenital heart disease and stroke. Despite improvements in the prevention and treatment of CVD, it remains the leading cause of death worldwide particularly in developed countries.
We design and conduct large studies to understand the causes of cardiovascular disease and to help prevent them. Examples of population studies investigating cardiovascular disease include the China Kadoorie Biobank (500,000 people), the Mexico Prospective Study (150,000 people), and studies in Russia, Cuba, and India. In total, such studies involve around 1.7 million participants. Our meta-analyses of prospective studies explore both established risk factors such as smoking, blood cholesterol, adiposity and blood pressure and emerging risk factors such as aspects of diet, lipid fractions, and renal disease.
We pioneered large randomised trials, for the treatment and prevention of cardiovascular disease, and meta-analyses of randomised trials that helped to determine the benefits and risks of treatments. Our trials in the field of blood cholesterol include the 20,000 patient Heart Protection Study (HPS), the Study of the Effectiveness of Additional Reductions in Cholesterol and Homocysteine (SEARCH), the Study of Heart and Renal Protection (SHARP), and the 30,000 patient REVEAL trial which found that adding anacetrapib to intensive statin therapy reduced the blood level of LDL ("bad") cholesterol by around 20% and doubled the level of HDL cholesterol.
We coordinate the Cholesterol Treatment Trialists’ (CTT) Collaboration meta-analysis of large trials of lipid modification, which has helped to guide the use of statins.
The Million Women Study is one of the world’s largest studies of cardiovascular diseases in women,with over 100,000 cases of heart disease and 20,000 strokes identified through linked databases. Researchers in the Cancer Epidemiology Unit (CEU) study the effects of known cardiovascular risk factors, such as obesity, smoking and physical activity, as well as less-studied exposures including reproductive history, vegetarian and vegan diets, and early life and social factors. Increasingly, we are incorporating blood-based studies into this work, including genetics of heart diseases, stroke and venous thrombosis. The Million Women Study has shown that the risk of venous thrombosis is associated with use of hormone replacement therapy and greatly increased after surgery.
EPIC-Oxford, which includes large numbers of vegetarians and vegans, offers a unique opportunity to investigate the relationship between diet and cardiovascular disease, and is part of EPIC-Europe, a long-term cohort study of 500,000 people.