Today, epidemiology has moved beyond the study of infections alone and has contributed to the link between rubber workers and bladder cancer [5], asbestos exposure and mesothelioma [62], ultraviolet radiation and skin cancer [41], and most notably, from the British Doctors study, tobacco in the etiology of lung cancer [17]. Epidemiology

is defined as the study of distribution and determinants of health-related Vemurafenib states and the use of such studies to address health-related problems. The main aim of the science is to discover potential causal relationships, which may be further tested with appropriate modifications to remove the possible trigger and assess the potential benefits. In 1965, Austin Bradford Hill detailed criteria for assessing evidence of causation (Table 1) [25]. It is important to stress that these are nothing more than a series of tests to apply to a hypothesis to determine its relative strength; they do not form a checklist that if all criteria are met, causality is proven. At this point, it is important to distinguish between true epidemiological studies and population-based mechanistic studies. Epidemiological studies are primarily designed to reveal relationships between exposures to substances,

such as alcohol selleck chemical and smoking, to outcomes, such as cardiovascular events or death. This contrasts with the larger population-based studies that are aimed at determining and measuring physiological or pathological processes, and exploring their relationships with morbidity, mortality, or surrogates thereof. The

utility of large populations Florfenicol and statistical methods established in epidemiology often results in these microvascular mechanistic studies being referred to as “epidemiological.” These large-scale studies have considerable overlap with epidemiology, notably in the application of the Bradford-Hill criteria of causation, study designs (Table 2), and statistical modeling to account for other known mechanistic processes and potential confounding, however, have the important distinction that these are exploring relationships between structure and/or function within one microvascular beds and outcomes, without looking directly at the impact of external influences. Cardiovascular disease, encompassing, but not limited to, atherosclerotic coronary artery disease, stroke, peripheral vascular disease, and hypertensive target organ damage, is the biggest cause of premature death and disability in the developed world [74], and much work has been performed to better understand its etiology. Despite this, much of the variance in these disease processes remains unexplained [75]. Furthermore, the exact mechanisms associating, for example, hypertension and atherosclerosis are unclear. A greater understanding of these etiopathogenic mechanisms may allow further drug development or nonpharmacological interventions to be applied to populations.