Tom Meade, who has died aged 86, pioneered the field of cardiovascular epidemiology. His research, spanning five decades, gave medical science a vastly improved understanding of the biology of blood and the circulatory system, opening the door for targeted new heart disease treatments.
By the early 1960s, heart disease was the leading cause of death in many countries, with the culprit widely believed to be atheroma (fatty deposits inside the arteries), brought on by high cholesterol and a fatty diet. But in 1965, Meade, a researcher at the Medical Research Council (MRC), read something he described as “a real eye-opener”. His boss, the pre-eminent epidemiologist Jerry Morris, wrote that while the numbers of men dying aged 50-69 had surged since 1908, analysis of autopsy reports showed that the numbers dying with coronary atheroma had decreased. Meade wondered if other factors were in play, and what role blood might have in heart disease. He wanted to investigate.
In 1970, he became director of the newly created MRC Epidemiology and Medical Care Unit at Northwick Park in Harrow, north-west London. He set up the Northwick Park heart trial in 1972 with 3,900 volunteers, who were mostly workers at the nearby Heinz factory. Among other things, Meade and his team wanted to study fibrinogen and Factor VII (proteins in the blood essential for clot formation, but too much of which can make blood “sticky” and liable to clot inappropriately).
The trial found fibrinogen levels are linked to heart disease, and one of the reasons smoking is a risk factor for heart disease is that it raises fibrinogen levels. The findings pointed to the need for fibrinogen-lowering drugs. They also found high levels of Factor VII increased heart disease risk, which posed the question – what might lower it? In 1983 Meade’s thrombosis prevention trial began, which took 5,500 high-risk individuals and gave them aspirin, warfarin, a combination of the two, or a placebo. Of the four groups, those on the combination fared best, with heart attacks reduced by more than a third.
Recruits for the thrombosis prevention trial came through the MRC GP Research Framework, a network of GP practices around Britain. Meade directed many trials through this network, not just on blood circulation, but also on blood pressure, incontinence, back pain, stroke rehabilitation and other topics. Chiropractic was considered a quack science, but Meade’s trial in 1990 comparing it with standard treatment for low back pain found it to be more effective.
It was compulsory to retire from the MRC at 65, so in 2001 Meade stepped down as director. He was glad, as the administrative demands had become steadily more onerous, but was keen to retain an academic foothold somewhere to continue his research. After a five-week campervan holiday in Australia, he became an emeritus professor of epidemiology at the London School of Hygiene and Tropical Medicine, with, to his wry amusement, pay of £10 a month to formalise the agreement.
As well as his own work, he also chaired the LSHTM research ethics committee and was the co-author of an overview of trials into aspirin to prevent heart disease, which also found it valuable in preventing bowel and other cancers.
Meade stayed at the LSHTM for more than 15 years and was able to do a 30-year follow-up of his Northwick Park heart trial. One finding was that having a respiratory infection made people more susceptible to having a heart attack. Knowing there is this link has prompted officials to encourage uptake of flu vaccinations in vulnerable groups.
Born in Oxford, Tom was the son of Margaret (nee Wilson), a committed Quaker, and James Meade, a distinguished economist and Nobel laureate. Tom was the eldest of four children, with three sisters, Charlotte, Bridget and Carol. In 1940 the second world war was still in its “phoney” stage, so the family went on holiday in France (from Geneva, where James was serving with the League of Nations), but rapidly turned for Britain with the Germans advancing behind them. After days waiting on the French coast they were rescued by a tramp steamer and taken to Barry in Wales.
His mother then took the children to the US for safety, and his father pressed a copy of Rudyard Kipling’s Jungle Book into Tom’s hands, with an inscription. It was a memento should they never meet again. Meade’s mother did not like being away from the UK, however, and they returned in 1942, a perilous crossing, with masts of sunken ships just visible as they sailed into home waters.
In 1949, Meade won a scholarship to Westminster school in London, where in 1953 he took part in an ancient rite at Queen Elizabeth’s coronation. (The scholars were the first to greet the new monarch with Vivat Regina.) In 1950 he had his appendix out and, although he excelled at classics, seeing a hospital at close quarters inspired him to read medicine. He studied at Christ Church, Oxford, and Bart’s hospital in London, where he qualified in 1962.
Meade originally wanted to join the prison medical service and to that end worked for 18 months as a junior doctor at Littlemore hospital, a mental health facility in Oxford. However, he had become increasingly interested in public health, and decided to work for Morris at the Medical Research Council.
In 1962 Meade married Liz Perks, a social worker, and the couple went on to have three children: Richard, Helen and Rebecca. They went to India in 1969 for a year (with their London house let to the king of Tonga) so that Meade could study the epidemiology of leprosy at the Schieffelin research laboratory in Karigiri.
The family lived in Highgate, north London, and when in 1979 Haringey council shut the borough’s schools for several weeks in response to a caretakers’ strike, Meade sued the council in a case that reached the court of appeal, by which time the schools were open again. Modest yet principled, Meade was happy to accept appropriate accolades: in 1996 he was elected a fellow of the Royal Society and in 1997 received the Balzan prize for epidemiology. In 1994 he was appointed CBE, although he was always uneasy about the honours system. When he heard that the head of the MRC, Colin Blakemore, was not getting a knighthood, as was customary with that position, he handed back his CBE in protest; Blakemore’s knighthood came in 2014. When several of the congregation stayed away from his granddaughter’s confirmation in disapproval of female priests, Meade was so incensed that he left the Church of England and became a Quaker.
In middle age, Meade took up running, completing a marathon, and for decades had an allotment in Highgate. He and Liz moved into a flat in Highgate in 2016 and his health gradually began to falter.
He is survived by Liz and their children and eight grandchildren, and by his sisters.
