Our unique, long-running Prospective Urban and Rural Epidemiological (PURE study) involves studying 225,000 participants in detail, and 500,000 with simple information, from more than 1,000 urban and rural communities in 27 high, middle and low-income countries.
PURE is investigating the impact of modernization, urbanization, and globalization on health behaviours, how risk factors develop and influence cardiovascular disease, diabetes, lung diseases, cancers, kidney disease, brain health, and injuries.
Working with universities in 26 countries, early findings from PURE have demonstrated that a large proportion of patients who can benefit from proven and simple therapies did not receive them, especially if they were from poorer countries. Therefore, the large differences in death rates between the poor and the rich countries were likely due to differences in health care, rather than differences in risk factors. This identifies practical opportunities to improve health by the greater provision of simple but effective treatments.PURE Overview - Download PDF
Executive Director; Senior Scientist
Salim Yusuf is an internationally renowned cardiologist and epidemiologist, whose work over 40 years has substantially influenced prevention and treatment of cardiovascular disease. Born in India, medically qualified at St. John’s Medical College, Bangalore in 1976, he received a Rhodes Scholarship and obtained a DPhil from Oxford, during which he (along with Richard Peto, Rory Collins and Peter Sleight) initiated the concepts of large, simple trials, and meta-analysis. He proposed the concept of combination drug treatment for prevention of CVD to achieve large reductions in CVD with a single pill (now called the polypill concept), but more importantly has been evaluating the concept through large randomized trials.
He leads several global studies involving more than 60 countries in every inhabited continent of the world aimed at enhancing knowledge about the biological, behavioural and societal causes, consequences, and approaches to the control of heart diseases, and strokes through large multi-country programs such as INTERHEART, INTERSTROKE, and PURE.
He holds a Heart and Stroke Foundation of Ontario Research Chair and has received (among others) the Lifetime Research Achievement award of the Canadian Cardiovascular Society; the Paul Wood Silver Medal of the British Cardiac Society; the European Society of Cardiology gold medal, the clinical Research Prize of the American Heart Association and the International Award and the Braunwald Lecture of the American College of Cardiology. He has been inducted into the Royal Society of Canada and the Canadian Medical Hall of Fame; been appointed as an Officer of the Order of Canada, and received the Canada Gairdner Wightman Award in 2014. He has received four honorary doctorates, and is among the top 20 most cited health researchers in history.
Salim Yusuf has published more than 1,000 articles in refereed journals, rising to the second most cited researcher in the world for 2011. He has mentored more than 120 scientists, several of whom are in leadership positions across the globe. He has been President of the World Heart Federation (2015-2016), where he initiated several programs (the Emerging Leaders program, road maps for CVD control and a course for training primary care practitioners in CVD prevention) aimed at halving the CVD burden globally within a generation. The World Heart Federation has recognized his contributions by naming the program the Salim Yusuf Emerging Leaders Programme.
He is a Distinguished University Professor of Medicine, and Executive Director of the Population Health Research Institute, McMaster University and Chief Scientist, Hamilton Health Sciences.
Darryl Leong is a Scientist at PHRI, Director of the McMaster University and Hamilton Health Sciences Cardio-Oncology Program, Associate Professor, Department of Medicine (Cardiology), McMaster University, and Staff Cardiologist at Hamilton Health Sciences. He has methodological expertise in clinical epidemiology and clinical trials, and content expertise in physical frailty, echocardiography, and cardio-oncology. His research is supported by the CIHR, and he has published more than 150 manuscripts including all the leading internal medical and cardiovascular journals.
He graduated from the University of Adelaide Medical School with Deans Listing and Honours for academic excellence, completed his cardiology training, Doctor of Philosophy, Master of Public Health, and Master of Biostatistics degrees at the University of Adelaide in Australia, and completed a post-doctorate fellowship in cardiovascular imaging at the Leiden University Medical Centre in The Netherlands, before re-locating to Canada.
Andrew Mente is a Principal Investigator for the Epidemiology program at PHRI, and Assistant Professor in the Department of Health Research Methods, Evidence, and Impact at McMaster University. He’s working in the ongoing Population Urban and Rural Epidemiological (PURE) study, interested in the role of essential minerals (sodium, potassium, calcium, magnesium) and dietary fatty acids in cardiovascular diseases in populations around the world.
He has received a Research Fellowship from the Heart and Stroke Foundation of Canada, and a Research Early Career Award from Hamilton Health Sciences, and has published more than 45 papers and two book chapters. Andrew received his doctoral degree in Epidemiology from the University of Toronto, and completed his post-doctoral training in cardiovascular epidemiology at McMaster University.
Mahshid Dehghan is an Investigator for the Nutrition Epidemiology program at PHRI, and the nutrition lead of the Population Urban and Rural Epidemiological (PURE) study and the INTERSTROKE study. Her main interests are the development of methods to measure dietary intake of individuals around the world, and understanding the impact of dietary factors in the cause and prevention of cardiovascular disease and cancer. She has published 39 papers and 2 book chapters.
She holds two Masters of Clinical Nutrition and Health Research Methodology, received her doctoral degree in Clinical Nutrition from Newcastle University, England, and completed post-doctoral training in Nutrition Epidemiology at McMaster University.
Philip Joseph’s research interests include cardiovascular prevention, global health, heart failure, and cardiac imaging. He is the principal investigator for the PURE-AF substudy, and the SPECT-MINS study, an investigator in the PURE study, and the G-CHF registry. He is also the project officer for the TIPS-3 study. He has published more than 30 peer-reviewed scientific papers.
He is a fellow of the Royal College of Physicians and Surgeons of Canada, with certification in both internal medicine and cardiology. obtained his B.A.Sc at McMaster University in 2000, and his M.D. at Western University in 2004. His internal medicine (2004-2007) and cardiology (2007-2010) residencies were completed at the University of Ottawa. Subsequently, he completed additional clinical training in Nuclear Cardiology at McMaster University (2013), a M.Sc. in Health Research Methodology at McMaster (2010-13), and a post-doctoral research fellowship in PET imaging at Harvard University (2015).
Sathish Thirunavukkarasu, an Investigator at PHRI, has received the Hamilton Health Sciences’ New Investigator Fund. His main research interests are to investigate the risk factors associated with chronic diseases, specifically diabetes and cardiovascular disease, and develop effective and cost-effective strategies for the prevention of these diseases, with a particular focus on low- and middle- income countries. He is an investigator on the PURE study at PHRI. He is also interested in implementation science and translation of evidence into clinical and public health practice. Sathish has published 61 research articles, including in some high impact factor journals such as The Lancet Diabetes & Endocrinology, Nature Reviews Endocrinology, Diabetes Care, PLoS Medicine, and BMC Medicine. His research papers have received more than 4100 citations. His Google Scholar h-index is 18 and i10-index is 24.
Sathish received his Medical Degree and a Master’s Degree in Public Health from India and a PhD in Diabetes Epidemiology from the University of Melbourne in Australia. After completing two years of Post-Doctoral training in diabetes research at Nanyang Technological University in Singapore and Imperial College London, he joined PHRI in April 2019.
Harry Klimis is a Clinical and Research Fellow at PHRI and McMaster University, supervised by Darryl Leong and Salim Yusuf. His training features an integrated cardio-oncology research and clinical program dedicated to understanding the evolution of cardiovascular risk factor patterns in healthy populations and people with cancer, and their association with CVD and mortality. Harry is an investigator in the RADICAL-PC and SCHOLAR-2 studies, and will be working on the PURE study.
Harry is an Australian cardiologist and completed both his MBBS and PhD at the University of Sydney. His research has primarily focused on primary prevention of cardiovascular disease and digital health interventions. Other research interests include cardio-oncology and echocardiography.
After working as a cardiologist for more than 10 years in Japan, Ryo Naito is now a Research Fellow at PHRI, joining the PURE study team. His research interests include preventive cardiology, heart failure, and ischemic heart disease.
MyLinh Duong is a respirologist at Hamilton Health Sciences, and Associate Professor, Department of Medicine, McMaster University. Her research interests include respiratory epidemiology, and understanding the environmental and social determinants of lung development and lung function. She is the respiratory lead for a number of PHRI’s population-based studies including PURE, FAMILY and the global heart failure registry, G-CHF.
She obtained her medical degree, specialist and sub-specialist training in Internal Medicine, Sleep Medicine and Respiratory Medicine at the University of Adelaide, Australia. This was followed by a research fellowship in the areas of airway inflammation, asthma and COPD at the Firestone Clinic and McMaster University, Canada, where she obtained a Master’ degree in Health Research Methodology and Epidemiology.
Eric Smith is a Professor of Clinical Neurosciences, and the Katthy Taylor Chair in Vascular Dementia in the Department of Clinical Neurosciences, University of Calgary, and Hotchkiss Brain Institute, and a member of the Calgary Stroke program. His research program has three main components: Population studies of brain health, using neuroimaging to identify predictors of cognitive impairment and decline; biomarker studies in patients with cognitive impairment, Alzheimer’s disease and cerebral amyloid angiopathy; and quality improvement and health outcomes research in patients with stroke and intracerebral hemorrhage. His research has been funded by the Canadian Institutes for Health Research, Heart and Stroke Foundation of Canada, Alberta Innovates – Health Solutions, Canadian Stroke Network, and the U.S. National Institute of Neurological Disorders and Stroke.
He received his MD degree from McGill University in 1998 and completed a residency in Neurology at Massachusetts General Hospital and Brigham and Women’s Hospital, teaching hospitals of Harvard Medical School. A one-year fellowship in Stroke and Vascular Neurology was completed at Massachusetts General Hospital in 2003. He earned a Master of Public Health degree (MPH) from the Harvard School of Public Health in 2005.
Isabelle Johansson is a Research Fellow at PHRI, supervised by Salim Yusuf, and McMaster University where she is pursuing a Masters in Health Research Methodology, clinical epidemiology. Her main research interests are in heart failure, diabetes, global health, and cardiovascular disease prevention. At PHRI, she is an Investigator in the G-CHF-study and the PURE study. Isabelle was in the 2019 cohort of the World Heart Federation Salim Yusuf Emerging Leaders Programme, focusing on reducing the burden of heart failure globally.
She obtained her M.D. from the Karolinska Institutet Medical University, Stockholm, Sweden in 2014 and has completed two out five years of clinical training in a residency in family medicine. She completed her Ph.D. in medical sciences at the Karolinska Institutet, Department of Medicine in 2017 where she studied epidemiological aspects of heart failure in combination with diabetes. Isabelle was part of the European Society of Cardiology task force writing the guidelines for the management of diabetes and cardiovascular disease presented in September 2019.
Sumathy Rangarajan has been Program Director, Global Health, since 2016, preceded by many years’ service at PHRI in other roles. She oversees the PURE study team, as well as the INVICTUS rheumatic AF treatment trial, the CANPWR pediatric weight management registry, and others.
She holds both a Bachelor of Science Degree and a Master of Science degree from Pune University in India.
Senior Research Coordinator
Maha Mushtaha has been employed by the Population Health Research Institute since 2011, working currently in the global health research group on the following studies: PURE, SCHOLAR-2 and TIMING. She has experience with site and database management of large, international observational studies as well as investigator-initiated clinical trials.
She holds a Bachelor of Science Degree from McMaster University and a Biotechnology Diploma from Mohawk College.
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