| Citation | Distinguished for the deveopment and application of laboratory techniques in epidemiological and clinical investigations in coronary heart disease. Meade established highly significant associations of fibrinogen and factor VII activity (and of low fibrinolytic activity) with the incidence of the disease. He demonstrated that the well-known effect of smoking on the risk of coronary diseaes is mediated mainly through increaased fibrinogen. He demonstrated the association of fibrinogen concentrations with restriction fragment length polymorphisms and the influence of physiological variations in fibrinogen concentration on platelet aggregation. Factor VII activity was strongly influenced by dietary fat intake and was a determinant of thrombin production. These observations constitute the basis for large-scale thrombosis-prevention trials of warfarin at substantially lower levels of anti-coagulation than previously employed. Meade is recognised as the leading medical epidemiologist on the thrombotic component of coronary heart disease. His outstanding contribution has been in his use of epidemiological correlations to develop hypotheses capable of experimental testing. This is demonstrated by his health services research, which has set a national standard by a rigorous scientific approach that has provided answers to questions about numerous troublesome ailments where treatment pre viously relied on ill founded beliefs. |