Determinants of use of cholesterol- and blood pressure-lowering interventions in the UK and other European countries
Project Reference: NDPH/MT16/002
Although still a leading cause of mortality worldwide, the prevalence of cardiovascular disease has decreased in recent decades. Cholesterol- and blood pressure-lowering medications, shown to cost-effectively reduce cardiovascular risk in high risk patients and recommended in clinical guidelines, have been at the forefront of cardiovascular prevention. However, whilst their use has been improving, it has remained suboptimal even in high-income countries with comprehensive healthcare provision1, with substantial proportion of high risk patients remaining untreated. There is also an ongoing debate whether drug interventions are complements or substitutes of health behaviours2.
The aim of the project is to comprehensively investigate the role of socioeconomic, behavioural and cognitive factors in the use of cholesterol- and blood pressure lowering interventions using large population surveys from the UK and Europe.
- Kotseva K et al. Cardiovascular prevention guidelines in daily practice: a comparison of EUROASPIRE I, II, and III surveys in eight European countries. Lancet. 2009;373(9667):929-940.
- Kaestner R et al. Are investments in disease prevention complements? The case of statins and health behaviors. J Health Econ. 2014;36:151-163.
Research Experience, Research Methods and Training
The project will include:
- Review of use of cholesterol- and blood pressure lowering medications with focus on socio-economic (e.g. education, income and employment), behavioural (smoking, alcohol consumption, diet, physical activity) and cognitive factors.
- Assess relevance of these factors to use of preventive intervention in categories of participants determined by prior vascular disease, particular risk factors and cardiovascular risk using the UK Biobank data source (~500,000 UK individuals 40-69 year old at recruitment with long-term morbidity and mortality data; http://www.ukbiobank.ac.uk/).
- Use individual participant data in the Survey of Health, Ageing and Retirement in Europe (SHARE: longitudinal data on ~25,000 individuals 50+ years old across Europe; http://www.share-project.org/) to investigate trends since 2004 and potential for interaction between preventive drug use and health behaviours.
The project will allow the student to develop skills in health economics and epidemiological analyses and work with large and complex datasets in the context of population health. The student will work in a multi-disciplinary environment with experts in population health, economics, statistics and epidemiology.
Field Work, Secondments, Industry Placements and Training
Training will be offered in relevant analytical methods, software, and working with complex databases. Further training opportunities will be considered. The student will be encouraged to attend seminars, regularly present their work and interact with other researchers.
An additional supervisor (to be confirmed) will be appointed prior to the commencement of study for any applicant accepted to this project.
The project would suit an applicant with a background in a quantitative discipline, and interest in health research.