Professor Allan Hackshaw

This course is compulsory on the Executive MSc in Health Economics, Outcomes and Management in Cardiovascular Sciences. This course is not available as an outside option.

By the end of this course, students will be able to describe trends in cardiovascular disease incidence, survival and mortality over the last decades in different populations. The course will examine the evidence on well-established and emerging risk factors for cardiovascular disease, including behavioural risk factors such as dietary habits, physical activity, obesity and smoking, as well as metabolic risk factors such as blood pressure, serum lipids and glucose-insulin homeostasis. The course will also introduce students to evidence on the role of environmental risk factors including cultural, social, and physical (built- environment) factors, as major determinants of population-wide cardiovascular risk. The basic principles of nutritional and genetic epidemiology will also be discussed. The course will outline the principles of cardiovascular disease prevention. It will provide students with the skills to interpret findings from cardiovascular epidemiological studies. It will discuss evidence of preventive interventions that have been effective in reducing cardiovascular disease incidence and mortality around the world. The course will also discuss the key challenges for cardiovascular disease prevention over the next decades, with a particular focus on the clinical implications of population ageing for cardiovascular disease prevention.

Each course session will consist of 10 one-hour lectures introducing key concepts of cardiovascular epidemiology, and five two-hour seminars that deal with the key evidence, principles and challenges of cardiovascular disease prevention. Seminars will also discuss strengths and limitations of studies assessing cardiovascular disease prevention interventions, and it will draw clinical implications of specific cardiovascular disease prevention strategies shown to be effective.

10 hours of lectures and 10 hours of seminars in the MT. 2 hours of help sessions in the ST.

Students will be expected to produce 1 essay in the LT.

One non-assessed essay (2,000 words). This essay will be a first proposal of the final essay of the course, and will consist of a first proposal for an in-depth analysis of a specific cardiovascular disease prevention strategy. This essay should first identify a challenge in cardiovascular disease prevention (e.g., the obesity epidemic, hypertension control, smoking). Students will then review in the essay the available evidence of interventions to address this challenge, and they will critically assess the available prevention strategies to tackle the selected problem. Students will be expected to draw as much as possible on the concepts and principles of cardiovascular disease epidemiology and prevention discussed in class.

Ford ES, Ajani UA, Croft JB, Critchley JA, Labarthe DR, Kottke TE, Giles WH, Capewell S.  Explaining the decrease in US deaths from coronary disease, 1980- 2000. N Engl J Med. 2007;356:2388–98

Mozaffarian D, Afshin A, Benowitz NL,et al. Population approaches to improve diet, physical activity, and smoking habits: a Scientific Statement from the American Heart Association. Circulation 2012;126:1514–63.

Feigin VL, Lawes CM, Bennett DA, Anderson CS. Stroke epidemiology: a review of population-based studies of incidence, prevalence, and case-fatality in the late 20th century. Lancet Neurol. 2003;2(1):43–53.

Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Am J Clin Nutr. 2010;91:535–46.

Murray CJ, Lauer JA, Hutubessy RC, et al. Effectiveness and costs of interventions to lower systolic blood pressure and cholesterol: a global and regional analysis on reduction of cardiovascular-disease risk. Lancet 2003;361(9359):717–25.

Goldstein LB, Adams R, Alberts MJ, et al. Primary prevention of ischemic stroke. a guideline from the American Heart Association/American Stroke Association Stroke Council: Cosponsored by the Atherosclerotic Peripheral Vascular Disease Interdisciplinar y Working Group; Cardiovascular Nursing Council; Clinical Cardiology Council; Nutrition, Physical Activity, and Metabolism Council; and the Quality of Care and Outcomes Research Interdisciplinar y Working Group. Stroke. 4 May 2006.

Eaton CB. Traditional and emerging risk factors for cardiovascular disease. Prim Care. 2005;32(4):963–76, vii.

Helfand M, Buckley DI, Freeman M, et al. Emerging risk factors for coronary heart disease: a summary of systematic reviews conducted for the U.S. Preventive Ser vices Task Force. Ann Intern Med. 2009;151(7):496–-507.

Take home exam (50%) and other (50%) in the LT.

The other assessment will be a PowerPoint presentation based on a published journal article with an accompanying media news article.