Epidemiology Assignment 2022

Running Head: EPIDEMIOLOGY
Epidemiology
Name of Student:
Name of University:
Author Note:

Epidemiology1
1.
a) The necessary components of heart attack based on the diagram provided includes-
Male gender, High Cholesterol, High blood pressure, Smoking, Diabetes,
unhealthy diet, older age, being inactive and overweight.
b) Four candidates that contribute to heart attack includes high cholesterol, high blood
pressure, smoking and male gender. This is because the artery becomes hardened
with cholesterol deposition and it becomes difficult for the heart to pump blood to
the arteries. And smoking damages the lining of the arteries and builds up fatty
material deposition in the arteries narrowing them. And males are more at risk to
heart diseases because of traditional risk issues.
c) The person F is at highest risk of a heart attack first amongst the 7 different people
considered in the cohort study.
d) The systematic review and meta-analysis by Bravi et al (2017) proves the
following-
Seria
l No.
Criteria Evaluation
1. Experimental
evidence
This meta-analysis had a lot of literature review of coffee
promoting reduction in HCC and CLD which includes 15
effective studies that included 3414 cases of
hepatocellular carcinoma and 1463 cases of chronic liver
disease. The meta-analysis shows that 34% and 38%
reduction in the risk of hepatocellular carcinoma and
chronic liver disease respectively for individual who
regularly intake coffee in comparison to non derinkers or
occasional drinkers
2. Temporality The studies revealed that intake of coffee helps in
reduction of the probability of liver cancer and chronic
liver diseases. The relative risk for individual who drink
coffee frequently is 0.50 and 0.35 for HCC and CLD
respectively.
3 Strength of
association
A large number of cases with liver cancer and CLD that
was included (12 studies on HLC and 6 studies on CLD)
as well as the several studies that considered the

Epidemiology2
categories like intake of coffee guided the research to
explore factors like the levels of the coffee consumption
and the different population involved in that were the
main strengths of the meta-analysis.
4 Dose
response
The relative risk for HCC was 0.66, 0.72 and 0.50 for
regular drinkers, occasional drinkers and frequent
drinkers respectively. The relative risks for the increased
consumption of one cup per day was 0.85. The
summative RR for CLD was 0.62 for regular drinkers, it
was 0.72 for occasional drinkers and 0.35 for frequent
drinkers and the relative risk for an increment of one cup
for one day was 0.74.
5 Biological
plausibility
A strong oxidative activity is maintained by coffee. This
activity prevents the proliferation of liver carcinoma cells
(Bamia et al., 2015). This effect of protection by intake of
coffee can be observed among health concerned
population and also in patients suffering chronic liver
diseases, it is also observed that the intake of coffee also
prevents liver cirrhosis. It reduces the serum level of
enzymes glutamyl transferase and aminotransferase
which are indicators of hepatic disorders (Kennedy et al.,
2017).
6 Consistency The relative risk was 0.66 based on the Asian and
European studies. The studies showed related risk rates
though in those countries the consumption of coffee was
low.
e) It can be concluded from the provided research article that coffee helps in
preventing liver cancer with the fact that the antioxidative characteristic of coffee