When the European Society of Cardiology (ESC) convened in Barcelona on 30 August 2014, one of the recipients of its prestigious Gold Medal awards was Sir Rory Collins. Collins, a Professor of Medicine and Epidemiology at Oxford University since 1996 and a director of the university’s Clinical Trial Service Unit (CTSU) since 1985, has dedicated his career to revealing the value of large-scale epidemiological studies.
One such project, the Heart Protection Study, changed the ways that statins are used to prevent cardiovascular events upon its publication in The Lancet just over a decade ago. The study revealed that patients with pre-existing diabetes or vascular diseases benefit from lowering their levels of LDL-cholesterol, even if their initial levels were not considered dangerously high. Collins was also involved in the subsequent Cholesterol Treatment Trialists’ collaborative meta-analyses, which confirmed the Heart Protection Study’s results.
‘The Heart Protection Study helped revolutionise the way cholesterol-lowering drugs are used,’ Collins told the audience at the Opening Ceremony of the 2014 ESC Congress. He continues to advocate for the use of statin therapy for a wider range of patients. While there has been some discussion recently about the risks of side effects of statin drugs, said to affect 18 to 20 percent of patients, the National Institute for Health and Care Excellence (NICE) has recommended lowering the threshold for statin therapy from 20 percent to 10 percent CVD risk over a ten year span. Collins supports the position of NICE, and found an error in the claim about side effects reported in the BMJ.
Prof. Collins has advocated for large-scale studies of the causes and treatments of common illnesses such as heart disease, cancer and vascular diseases. Fortunately, mortality trends show a decline in heart disease and stroke in many developed countries, and credit is due Collins and CTSU co-director Sir Richard Peto for their major research trials on statins, smoking, blood pressure and aspirin. The work has demonstrated that large studies of prevalent conditions can dramatically affect public health. In the UK, vascular mortality has dramatically declined in the past thirty years.
Prof. Collins is currently the Principal Investigator and Chief Executive of UK Biobank, which recruited half a million middle-aged British citizens between 2006 and 2010 for the purpose of improving preventive, diagnostic and therapeutic methods for a multitude of common illnesses. 500,000 people between the ages of 40 and 69 underwent tests and provided biological samples for future analysis, which will help in the discovery of the causes of diseases such as arthritis, cancer, dementia, depression, diabetes, heart disease, stroke and osteoporosis.
Collins received a Knighthood for his services to science on 31 December 2010.
References: European Society of Cardiology, UK Biobank