Dr Robert Clarke
This profile is taken from the MRC Annual Review 09/10, Seven Ages, which borrows Shakespeare’s famous theme to show how MRC-funded research benefits everyone, at every stage of life.
Reader in epidemiology and public health research medicine at the Clinical Trials Service Unit (CTSU), Oxford.
Dr Robert Clarke’s work focuses on treating and preventing heart disease and stroke, which are still a major problem for people in middle age.
The CTSU, which is part-funded by the MRC, is based in the elegant Richard Doll Building in Oxford, where airy walkways connect labs and offices. Here, Robert and his colleagues look at well known risk factors for heart disease like smoking and high blood pressure, along with more recently discovered risk factors like genetic make-up, in an attempt to better predict risk of cardiovascular disease.
Robert trained as a doctor in his native Ireland, and specialised in internal medicine and cardiology. But while attending a seminar in Cuba, he met the eminent epidemiologist Geoffrey Rose, who changed his career path for life:
“After ten days beside the beach learning from Geoffrey I knew I wanted to spend my life in epidemiology. He understood that even modest differences in the distribution of risk factors within populations can have a substantial impact on reducing the incidence of cardiovascular disease and the number of deaths from it. That was quite a radical concept at the time.”
Geoffrey set up the Whitehall study, which tracked the health and lifestyles of 19,000 middle-aged male civil servants living in London. The study was set up between 1968 and 1970, at the height of the UK heart disease epidemic. Thirty years later, Robert and colleagues at CTSU, together with Michael Marmot and Dave Leon at the University of London, traced the records of 18,863 of the men and re-examined the 7,044 surviving participants. The re-survey provided invaluable information on risk factors for heart disease when measured in both middle age and in old age.
A recent analysis of the data led by Robert has uncovered the sobering finding that that middle-aged men who smoke, have high blood pressure and high cholesterol can expect to live 10 to 15 years less than men without these risk factors.
“Being able to communicate the risk as a 15-year difference in life expectancy associated with differences in a few key risk factors had a lot of currency for individuals. It means a lot more to people than it does to be told that you’ve got a doubling in risk of developing a certain condition,” he explains.
Findings from the Whitehall Study and other research carried out at the CTSU have contributed to many public health policies on preventing cardiovascular disease, from banning smoking in the workplace to tackling high blood pressure by reducing salt in the diet. Robert is proud to have been part of it.
“Our work on highlighting the importance of cholesterol, blood pressure and smoking has saved millions of lives worldwide. I don’t claim any personal credit for any of that, but it’s been a privilege for me to be part of that team, and I see my work in that context.”
Published November 2010