If anyone can say his research influences medical practice for the better, it’s Dr. Salim Yusuf. More than that, his work changed the way certain types of medical studies are performed. He holds multiple titles, among them professor of medicine at McMaster University; director of the Population Health Research Institute, and VP of research at Hamilton Health Sciences. He also holds a Heart and Stroke Foundation of Ontario Research Chair.
At five foot three, with a roundish friendly face and greying hair, Dr. Yusuf’s manner is unassuming, but his name is recognized worldwide among cardiologists and researchers alike. In his field, he is considered a superstar, yet it’s not a way he would describe himself. In fact, he prefers to discuss that which excites him most: emerging ideas and research in the field of treating and preventing heart disease.
He attained his medical degree at St. John’s Medical College in Bangalore, India. In 1976 he received a Rhodes Scholarship which lead him to study at Oxford University where he studied cardiology and internal medicine. While there, he became the first coordinator of the world’s largest multinational, multicentre study of heart disease, the ISIS trial which compared treatments for heart disease. There were four parts to the ISIS trial with increasing numbers of patients; ISIS-1 included 16,000 patients, while ISIS-4 included 45,000.
As the world’s first trials of this magnitude, Dr. Yusuf and colleagues had to figure out how to set-up a trial of this size, how to collect information, and how to analyse and interpret all the data in the most efficient and accurate way.
With that experience behind him, Dr. Yusuf then moved to the US where he worked for the National institutes of Health where his expertise was vital for developing other large clinical trials. He set up the first large program in the world for heart failure while at the NIH – the SOLVD trial which showed that treatment with ACE inhibitors could reduce mortality in a broad group of people with heart failure.
Large trials are needed to determine how effective treatments are in a population. Information can be used to determine whether there are specific sub-populations that either don’t respond to treatment, or get additional benefit. Population studies can also show whether socio-economics is associated with health, or even whether where you live makes a difference.
In 1992, Dr. Yusuf became director of cardiology at McMaster University where he developed one of the world’s most renowned programmes in heart research. He continues to instigate and coordinate large, international trials, ones with names such as HOPE, OASIS and CURE.
Dr. Yusuf was the brain behind the INTERHEART study which included over 30,000 people in 52 countries. This important study revealed there are nine key risk factors that substantially increase people’s risk for heart attack. Importantly, the study found that these risk factors are common to people around the world. The risk factors are: high cholesterol, elevated blood pressure, elevated glucose, abdominal obesity, poor diet, stress, lack of exercise, and smoking, and lack of moderate consumption of alcohol.
The study showed genetics and environment did not play as big a role in risk as these nine modifiable risk factors. INTERHEART had a huge impact globally, placing great emphasis on prevention. He is following this with a study of 150,000 people in 17 countries aimed at why risk factors develop in the first place.
It takes many talented and skilled people to do these important studies, and Dr. Yusuf enjoys being in a position to teach other people the needed skills and pass on his knowledge. He won several national and international awards recognizing his contributions. He was the first Canadian to receive the Gold Medal from the European Society of Cardiology, and the first Canadian to receive the research prize of the American Heart Association.
Dr. Yusuf’s research is funded by the Canadian Institutes of Health Research, The Heart and Stroke Foundation, the National Institutes of Health, industry, recently the European Union and Wellcome Trust.