Life course determinants of cardiovascular ageing

Around one in two men and one in three women suffer a cardiovascular event sometime during life, making cardiovascular disease (CVD) a major cause of mortality and morbidity. Heart failure is of increasing importance because of improvements in the prevention and treatment of acute clinical events such as heart attack. Although clinical disease becomes evidence at older ages, the presence of plaque in the arteries is already present by young adulthood and progresses through life. Hence there is increasing interest in the use of measures of changes taking place before disease as tools to predict future clinical events and target treatment.||The overall aim of this programme is to investigate how exposures over the life course are associated with cardiovascular structure and function and the development of disease. The MRC National Survey of Health and Development, a birth cohort study of men and women born in 1946 and followed up ever since, is collecting a comprehensive set of measures of the structure and function of the heart and arteries. Evaluations of this type will be critical to understanding whether risk factor modification from a much earlier age than is routine in current clinical practice could yield benefits for CVD prevention. |

Approximately one in two men and one in three women suffer a cardiovascular event at sometime during life, making cardiovascular disease (CVD) a major cause of mortality and morbidity. Atrial fibrillation and heart failure are assuming increasing importance as clinical end-points in CVD, due to improvements in primary prevention and treatment of acute clinical events. Although clinical complications of atherosclerosis manifest in later life, atheroma is already present by young adulthood and progresses through life so there is increasing interest in the use of non-invasive measures of subclinical disease as tools to predict future clinical events and target therapies.||The overall aim of this programme is to evaluate the impact of exposures over the life course on cardiovascular structure and function and the development of disease. To do this we are collecting a comprehensive set of measures of arterial and cardiac structure and function as well as repeating measures of cardiovascular risk factors already measured at younger ages. Evaluations of this type will be critical to understanding whether risk factor modification from a much earlier age than is routine in current clinical practice could yield benefits for CVD prevention. ||The main objectives of this programme are to use the MRC National Survey of Health and Development:||To assess the influence of the life course exposure to established CVD risk factors (such as blood pressure and smoking) on arterial and cardiac structure and function, and on preclinical disease ||To investigate whether factors of less certain causal relevance, such as early growth and development and life circumstances, have effects on these outcomes, or modify the impact of the established risk factors on these outcomes.||To study the inter-relationships between the different CVD measurements and establish the range of normality in the UK population aged 60-64 years. Diastolic dysfunction, a condition accounting for an increasing proportion of patients with heart failure, is of particular interest.||To identify genetic factors that predict cardiovascular risk, function and preclinical disease in order to gain better insight into causal mechanisms. For example, to examine the effect on carotid atheroma of common genetic variants with established effects on LDL-cholesterol concentration, to test the hypothesis that carotid atheroma reflects arterial changes on the causal pathway leading to clinical disease. ||To evaluate the role of CVD in the decline of physical and cognitive capability