A Model for Ischaemic Heart Disease and Stroke I: The Model

T. Chatterjee, A. S. Macdonald and H. R. Waters

Annals of Actuarial Science, 2008, vol. 3, issue 1-2, 45-81

Abstract: We construct a stochastic model of an individual's lifetime that includes diagnosis with ischaemic heart disease and stroke and also the development of the major risk factors for these conditions: hypercholesterolaemia, hypertension, diabetes and obesity. Smoking, another major risk factor, is treated deterministically. Mathematically, the model is a continuous time, finite state space Markov process, with the individual's age playing the rôle of time. The model is parameterised using data from the Framingham Heart Study, with parameter values adjusted so that the model is appropriate for UK conditions in the early 21st century. The model has been designed so that it can be used to quantify the effects of: (i) trends, in particular increasing prevalence of obesity. (ii) changes in behaviour, in particular smoking patterns, and (iii) treatments, in particular statins for hypercholesterolaemia. These applications are covered in two accompanying papers.

Date: 2008
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