European Perspectives

and honorary consultant in public health, Liverpool Primary Care Trusts, has published widely on the epidemiology, modelling, and prevention of cardiovascular disease.He is an author of 2 recent articles in Circulation.The first demonstrates that the American Heart Association target of improving cardiovascular health by 20% by 2020 will not be reached if current trends continue.1 The second shows that the socioeconomic gradients in the incidence and prevalence of heart failure in England are reducing, the UK National Health Service treatment is generally equitable and independent of socioeconomic circumstances, and no significant inequality in outcomes are apparent.2 Cardiovascular epidemiology and policy modelling explore recent coronary heart disease and stroke trends and compare the potential impact of future treatment and risk factor strategies in diverse populations.Using their IMPACT model, which simulates the dynamics of cardiovascular disease in a population, Professor Capewell and his colleagues showed that ≈50% of the decline in deaths from coronary heart disease in the United States from 1980 to 2000 may be attributable to reductions in major risk factors and ≈50% to evidence-based medical therapies.3 Professor Capewell says that this article is one of his 2 most important articles of the ≈250 articles he has published during his career.His other most important article, published in 2012, is titled, "Potential Cardiovascular Mortality Reductions with Stricter Food Policies in the United Kingdom of Great Britain and Northern Ireland." 4 "Our deterministic epidemiological model, IMPACT, has been used to help explain coronary heart disease mortality trends in >20 diverse populations, including England and Wales, Scotland, Ireland, Finland, Sweden, Iceland, Poland, the Czech Republic, Italy, Spain, Portugal, China, New Zealand, Canada, and the United States," says Professor Capewell."The model aims to be comprehensive, synthesising data on all standard treatments in all patient groups, plus changes in all major risk factors.It has been tested and refined over 16 years and can now quantify deaths prevented or postponed, life-years gained, and cost-effectiveness of different interventions, and estimate the future deaths prevented by increases in specific treatments or decreases in particular risk factors.Results have increasingly informed policy debates in the United Kingdom, Europe, the United States, and beyond.