Associate Professor Nick Wilson, Dr Nhung Nghiem, Professor Tony Blakely, Professor Rod Jackson
It is now possible to readily estimate individual risk of future cardiovascular events with a large number of online calculators – including a NZ-specific calculator that has been available for some years (“Know Your Numbers”). In this blog we consider if such risk calculators could be improved upon. The clear answer being “yes” – and in many ways.
Associate Professor Nick Wilson, Professor Tony Blakely, Dr Cristina Cleghorn, Dr Nisha Nair
We recently did a blog post on dietary salt and health, particularly with regard to a new large prospective study (the PURE Study). This facilitated useful feedback from others, along with input from colleagues in a journal club we ran. Based on these discussions, we now have stronger concerns about remaining reverse causation in the PURE Study (and persisting concerns regarding other aspects). Here we update some of our thinking and conclude that the totality of the available evidence is sufficient for health authorities to continue taking a range of evidence-based actions to reduce the hazard of high salt intakes. Again however we invite critical comment on our assessment and suggestions on where to from here.
Associate Professor Nick Wilson, Professor Tony Blakely, Dr Cristina Cleghorn
A large prospective study on dietary salt and health has recently been reported in the New England Journal of Medicine. While reinforcing extensive past work that a (very) high intake of salt is hazardous to health – an increased hazard was also found for low intakes of salt (i.e., a “J-shaped” or “U-shaped” relationship). This blog post considers this new study in more detail and suggests that we need a high-level international review to clarify the research and policy agenda from here. Our interpretation should be treated as preliminary on what may be an important study; therefore, we welcome and encourage comments on this blog post. [SEE MULTIPLE COMMENTS ON THIS BLOG BELOW. AND IN PARTICULAR SEE SUBSEQUENT BLOG WHERE WE UPDATE ANALYSIS BELOW BASED ON DISCUSSIONS WITH COLLEAGUES – IMPORTANT.]
Professor Tony Blakely, Associate Professor Nick Wilson, Professor John Attia (University of Newcastle and Hunter Medical Research Institute, Australia)
Many observational studies suggest that moderate alcohol consumption reduces cardiovascular disease (CVD) risk. The so-called J-shaped curve. We summarised the ‘state of play’ on this topic at PHE Blog in early 2014. In the last few weeks a large ‘Mendelian randomisation’ study (like a genetically determined RCT of alcohol consumption – a study design with much potential for identifying causal (as opposed to confounded) associations) has been published suggesting that any alcohol consumption increases CVD. If true, this means the overall health harm from alcohol consumption in our society is even higher than currently thought. If so it would make cost-effective interventions such as alcohol taxation even more justified.
Professor Tony Blakely
Compared to a ‘normal’ body weight (BMI 20-<25), being obese (BMI ≥ 30) is associated with a 69% higher coronary heart disease death rate and a 47% higher stroke death rate . The same excess rates for overweight (BMI 25-<30) are 26% and 13%, respectively. In this blog, we look at a recent combined analysis of 97 studies on how much of the overweight/obesity association with cardiovascular disease (CVD) deaths is due to high blood pressure, cholesterol or glucose , and what this means for how health policy can address the obesity epidemic. We also reflect on a seminal paper on BMI and mortality by the late Gary Whitlock.