Large-scale Observational Epidemiology

Reliable assessment of the main determinants of cardiovascular disease


The University of Oxford’s cardiovascular epidemiological research priorities are determined both by UK and international public health considerations. Hence, these large-scale research projects typically involve wide collaboration between many investigators not just in the UK but also throughout Europe, Africa, Asia and the Americas. Previous observational epidemiological studies have helped to identify a number of causative factors for cardiovascular disease and there is, perhaps, the perception that little more can be learnt from further such studies, particularly for established risk factors (such as smoking, blood pressure, blood lipids and obesity). But, the effects of such factors can vary enormously from one population to another, and there is still substantial uncertainty as to how important these are in different circumstances, and as to how their importance is changing with time. Small prospective and case-control studies, involving just a few hundred people with cardiovascular disease, may suffice to identify a risk factor, but (due to their inherent statistical uncertainties) do not generally suffice to assess the age-specific quantitative importance of such factors or any "interactions" with other risk factors.

Consequently, Oxford research groups have established a range of large prospective studies (involving at least a few hundred thousand people and a few thousand cardiovascular events) and large case-control studies (with thousands of vascular disease "cases") that are helping to reduce the quantitative uncertainties about known vascular risk factors and to identify new causative risk factors. By involving populations that have not previously been studied extensively (e.g. very different developed and developing populations), these studies should allow more reliable assessments of the importance of various causes of vascular disease. One such study is the Kadoorie Biobank Study in China. During 2004-8, 515,000 adults aged 35-74 from 10 regions across China were enrolled, with extensive data collection for each participant by laptop-based questionnaire, physical measurement, and with storage of blood samples (including DNA) for future research. Long-term follow-up of study participants, using established linkages with death registries and health insurance claim databases, is expected to identify ~120,000 hospital admissions and ~25,000 deaths during the next 5 years, including about 4,000 new cases of ischaemic heart disease and 10,000 cases of stroke. Much of what is discovered in the next few years, and beyond, in this uniquely large study will be relevant to disease prediction and prevention, and to better understanding of disease mechanisms.

Oxford has also established laboratories that are especially orientated towards the development and use of methods suitable for the particular constraints of large-scale epidemiological studies involving tens, or hundreds, of thousands of blood samples.

PIs involved in this research theme

Prof Colin Baigent - (Theme Leader)

Prof Zhengming Chen

Dr Robert Clarke

Prof Rory Collins

Prof Sarah Darby

Dr Jonathan Emberson

Dr Jane Green

Dr Jemma Hopewell

Dr Sarah Parish

Prof Hugh Watkins