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Reader and Consultant Cardiologist

Dr David Wald is an Interventional Cardiologist with an interest in the prevention of cardiovascular disease. His clinical-academic aims are to bridge the interventional and preventive approaches to cardiovascular disease which are often viewed as distinct. He is co-ordinating a proposed randomised trial to assess the value of coronary angioplasty in preventing future coronary heart disease events among patients receiving angioplasty to treat an acute myocardial infarction.

He conducted a randomised trial which showed the minimum fully effective dose of folic acid for serum homocysteine reduction. He was awarded the BMA Brackenbury Research Prize for this work. He has been adviser to the Food safety Authority of Ireland in helping them reach a decision on dietary fortication with folic acid. Together with Malcolm law and Joan Morris he quantified the relationships between homocysteine, coronary heart disease, stroke and thromboembolic disease using meta-analyses of observational and genetic epidemiological studies. This was important because it specified the expected effect of folic acid intake on cardiovascular disease prevention. This, in turn, showed how even the largest randomised trials of folic acid supplementation were underpowered to show the expected effect.

Together with Nicholas Wald and Jonathan Bestwick he showed that screening for familial hypercholesterolaemia, by serum cholesterol measurement, is effective if done in early childhood after the first year of life. The finding underpins a novel “child-parent” population screening strategy that screens children and their parents within the same programme. He is assessing imaging techniques like carotid ultrasound and CT scanning in screening for coronary heart disease to determine their value in medical practice.

He coordinates the Polypill Prevention Programme, a novel service that adopts the Polypill approach in coronary heart disease and stroke prevention. With Nicholas Wald and Malcolm Law he collaborates in the development and proposed trials of the Polypill itself.

Selected Publications

  1. Wald DS, Bestwick J, Wald NJ. Child-parent screening familial hypercholesterolaemia; a screening proposal based on a meta-analysis. BMJ 2007;335:599-603
  2. Wald DS, Law MR, Morris J. Homocysteine and Cardiovascular disease: evidence on causality from a meta-analysis. BMJ 2002;325:1202-6
  3. Wald DS, Bishop L, Law MR et al. Randomised Trial of folic acid supplementation on serum homocysteine levels. Arch Intern Med 2001;161(5):695-700
  4. Wald DS, Law M, Morris J. Mortality rates from Hypertrophic cardiomyopathy in England & Wales: clinical and public health implications. Int J Cardiol 2004;97:479-484
  5. Wald DS, Wald NJ, Morris J, Law M. Folic acid, homocysteine and cardiovascular disease; judging causality in the face if inconclusive trial evidence. 2006 BMJ 333;1114-1117
  6. Wald DS, Law MR, Morris J. The dose-response relation between serum homocysteine and cardiovascular disease: implications for treatment and screening. European Journal of Cardiovascular Prevention & Rehabilitation 2004,11:250-253
  7. Sambu N, Wald DS, Seddon M, Simpson IA. Undertreatment of coronary heart disease in patients undergoing coronary artery bypass surgery. Heart 2006;92;697-698
  8. Wald DS, Morten G, Iosson N, Curzen N. Long term continuation with cardiovascular drug treatment in patients with coronary heart disease. Annals of Pharmacotherapy 2007;41: 1644-1647
  9. Wald NJ, Law MR, Morris J, Wald DS. Quantifying the effect of folic acid on the prevention of neural tube defects. Lancet 2001; 358(9298):2069-73
  10. Wald DS, Law MR, Wald NJ, Morris J. Homocysteine and Ischaemic Heart Disease. In Coronary Heart Disease Epidemiology, 2nd edition 2005, eds Marmot and Elliot, Oxford University Press
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Centre for Environmental and Preventive Medicine, Wolfson Institute of Preventive Medicine, Barts and The London, Charterhouse Square, London EC1M 6BQ Tel: 020 7882 3850 Fax: 020 7882 6270