University of Minnesota

Hugh Tunstall-Pedoe, MD

Born: 1939

Professor Tunstall-Pedoe, Englishman, educated at Cambridge and trained in Guy’s Brompton and London Hospitals, became interested in coronary disease and sudden death while a cardiac registrar. His interest, and a temporary disability, coincided with the ambition of pioneer epidemiologist Jerry Morris and with WHO plans in 1969, to create a cardiac register in the central hamlets of London. The challenges and education around this surveillance project and from its base in the London School of Hygiene and Tropical Medicine launched Hugh’s lifetime work in CVD prevention research. A crowning contribution has been his role in the international CVD surveillance MONICA Program of WHO, the major publication of which he edited.

He early embraced quantitative approaches to CVD issues of the time, noting: “What happened in the coronary care units [needed to be put] into a community perspective; you had to have the same denominator for both. This was very educational for me and for others because so many clinical statements are based on nebulous denominators.”

Tunstall-Pedoe combines keen analysis with pragmatism and directness in the way he approaches questions. For example, “If we were able to reduce the coronary incidence, the specific coronary incidence in men to what it is in women, we would have achieved a miracle. We would have said we had prevented disease and no one would have denied that. So I think lifetime risk is a totally different story. And, in fact, what happened to coronary disease after the Second World War in many industrialized countries was that coronary disease invaded the younger age groups whereas it had always been there probably in the older ones.”

And sometimes the directness is seen in how Hugh deals with colleagues in public debate: “I went to a debate at the Oxford Union […] not actually an official University thing. It was funded by a drug company and it […] was on the subject: ‘Risk factors were best left alone.’ What I said was the question in 1980, was not whether to leave risk factors alone, but the most effective method of changing them. And I [said I] thought that the motion of the debate was typically British. Because I said it combined extreme arrogance with impotence!”

Tunstall-Pedoe now directs the MRC unit in epidemiology in Dundee and the Scottish Heart Health Study. (HB)

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