Epidemiology of coronary heart disease

Question 1

The Epidemiological Approach

Answer 1

The study of the distribution and determinants of health related states or events in specified populations – and the application of this study to the control of health problems

Question 2

Epidemiological Data and Studies

Answer 2

• Surveillance
• Cohort - Longitudinal - Prospective – Retrospective?
• Ecological / cross sectional?
• Case / Control?

Question 3

Appraisal of the data or study

Answer 3

• What are the caveats and weaknesses?
• Sources – representative population, sample? • Reliability and validity?
• Bias / confounding?

Question 4

PERSON: Risk Factors

Answer 4

Non-modifiable:
Age, sex, genetic factors.

Modifiable:
• Personal - Smoking, diet, physical activity, obesity, high blood pressure, diabetes.
• Social/Environmental – deprivation, income, employment, education, housing, air quality.

Question 5

‘There is a “prevention paradox”

Answer 5

shows that interventions can achieve large overall health gains for whole populations but might offer only small advantages to each individual.’

Question 6

By using a systematic epidemiological approach:

Answer 6

• We can find good data, intelligence and knowledge on CHD and its causes
• We can find good studies and research which help analyse and interpret this
• We can apply this to the population and our patients

Question 7

the bell-curve shift in populations

Answer 7

shifting the while population into a lower risk category benefits more individuals than shifting high risk individuals into a lower risk category

Question 8

what is the risk reduction approach

Answer 8

move high risk people into the normal range

Question 9

what is the population approach

Answer 9

encourage everyone to change, shifting the entire distribution

Question 10

Diagnosis

Answer 10

• Good sources of data and intelligence
• Good sources of analysis
• Evidence, evaluation, interpretation.