Vascular events, such as heart attack or stroke are largely preventable. The challenge for researchers is to identify which factors – social, biological or health interventions – are associated with missed prevention and developing strategies for patients, families and clinical teams to reduce the likelihood of further vascular conditions. 

Studying patterns of multiple long-term vascular conditions

In this study, public health and multimorbidity researchers at ARC South London are undertaking an observational study of populations in Lambeth and Southwark, linking multiple sources of health data. The aim is to map the causes of multiple long-term vascular conditions (MLTVCs), and patterns of morbidity linked to both physical and mental health outcomes. 

If we can understand the relationships between the characteristics of a population, vascular disease, physical and mental health, and the success of attempts to prevent and control disease, we may be able to reduce the burden of multiple long-term vascular conditions on health systems and society, and improve people’s health.

Dr Abdel Douiri, reader in medical statistics at King’s College London, and project lead

Aims of the project

Analysing health data for Lambeth and Southwark’s diverse population, the researchers aim to: 

  • Pilot MLTVCs data collection in Lambeth and Southwark, building on a local stroke register and routine national cardiovascular outcomes research data
  • Link these data with primary care data, developing a platform to estimate the progression from one long-term vascular condition to MLTVCs and factors (eg quality of care, socio-economic and demographic factors) influencing clusters of morbidities
  • Estimate the effects of MLTVCs on physical and mental outcomes.

If the team can identify common clusters and patterns of MLTVCs and related physical and mental health outcomes, they can use this information to inform better clinical decision making, helping to develop new prognostic tools and linking these to electronic health systems. 

Dr Douiri, says: "We want, for example, to identify patient groups that are not treated appropriately for hypertension or secondary prevention after stroke with antithrombotic therapy and why this may have happened. We also aim to estimate compliance with treatment, frequency of follow-up and missed opportunities to assess vascular risk and prevent adverse events."

Data sources

The researchers will use longitudinal population-based patient data from the South London Stroke Register, data from National Institute Cardiovascular Outcomes Research, London heart attack audit, Hospital Episode Statistics and the Office for National Statistics mortality register. They will also use data from Lambeth DataNet, a database of electronic health records, which is linked to the Clinical Records Interactive Search system at South London and Maudsley NHS Trust.

This study will inform the most efficient and effective methods of integrating data, how to estimate the data’s provenance and how these innovations can ultimately be used to support clinical decision making to prevent and manage MLTVCs. 

This project was adopted by the ARC South London and is funded by Guy's & St Thomas' Charity. It is expected to finish in 2022.