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Functional Trajectories and Cardiovascular Ageing

Which factors from across the life course promote good adult cardiovascular function and prevent disease onset, and which increase vulnerability to accelerated decline?  

 

Research programme: Functional Trajectories and Cardiovascular ageing 

Programme leader: Professor Rebecca Hardy

MRC Studentship: Ahmed Elhakeen

Other LHA scientists: Dr Will Johnson, Professor Diana KuhProfessor Marcus Richards, Dr Mai Stafford (Programme Leader Track)

External collaborators:


Understanding the pathways to cardiovascular (CV) ageing is important: although deaths from heart and circulatory disease are falling, cardiovascular disease (CVD) remains the main cause of death in the UK. Ageing of the CV system, through its impact on physical and mental functioning in older people, also impairs quality of life and the ability of individuals to carry out the tasks of everyday life. Obesity and blood pressure are two of the major modifiable risk factors for CVD. While the obesity epidemic has prompted concerns over the health effects of early onset obesity, there is also a growing recognition that blood pressure history should be taken into account when considering CVD risk. The purpose of this programme is to provide evidence on timing and type of intervention which may prevent or delay the onset of disease, extend the healthy lifespan and improve wellbeing and quality of life in older age. This programme addresses the MRC strategic research priority for 2009-14 to improve the chances of living a long and healthy life.

This programme investigates biological and social factors from across the life course that influence CV function in later life using data from the MRC National Survey of Health and Development, and other cohort studies. It builds on previous work which has shown how birth weight, childhood and adolescent growth, age at puberty and adult changes in body size are related to CV risk factors, such as blood pressure and cholesterol. We have also shown how life course influences, from genetics to lifetime socioeconomic position, influence body size and blood pressure trajectories and have conducted inter-cohort comparisons of blood pressure through the MRC cross-unit collaboration: Function Across the Life Course (FALCon).  Cross cohort comparisons of biological structure and function is currently being continued through the ESRC/MRC funded project CLOSER (Cohort and Longitudinal Studies Enhancement Resource). 


Main objectives

This research programme focuses on questions which make the best use of unique life course data to address the causes and consequences of CV ageing and disease. The new set of measures of arterial and cardiac structure and function, collected at 60-64 years, provide detailed information on the presence of pre-clinical changes in the CV system. We carry out research across four related themes:

  • the predictors of life course body size trajectories, including predictors of healthy trajectories, and their impact on CV ageing and CVD;
  • the predictors of adult BP and life course resting heart rate (RHR) trajectories, including predictors of healthy trajectories, and their impact on CV ageing;
  • the biological pathways and mechanisms underlying CV ageing and relationships with ageing of other body systems and, in the longer term, the predictive power of the vascular and cardiac phenotypes and life course CV risk factors on CHD and heart failure;
  • the social and behavioural causes and, in the longer term, consequences of CV ageing.

This programme has the potential to have a major impact in regard to refinement of clinical guidelines for the management of CVD risk by providing evidence on early identification and better targeted treatment.


Key Publications:

 


Wills AK, Lawlor DA, Matthews F, Aihie Sayer A, Bakra E, Ben-Shlomo Y, Benzeval M, Brunner E, Cooper R, Kivimaki M, Kuh D, Muniz-Terrera G, Hardy R. Life course trajectories of systolic blood pressure using longitudinal data from UK cohorts. PLoS Medicine 2011; 8(6): e1000440.

This paper describes life course trajectories in SBP using the novel approach of modelling multiple longitudinal cohorts from different periods of the life course. It was published in a high ranking general medical journal, was one of the “most viewed” articles in the week it was published, and was reported on in the BMJ. It provides evidence on which to base future research on the importance of the midlife rise in BP.

Wills AK, Hardy RJ, Black S, Kuh D. Trajectories of overweight and body mass index in adulthood and blood pressure at age 53: the 1946 British Birth Cohort study. Journal of Hypertension 2010; 28: 679-686.
As well as showing the importance of BMI across adulthood and high BP, this paper illustrated the extent of tracking in BMI across adulthood. This finding was covered widely in the media. The paper also outlined, for the first time, the different approaches to the modelling of BMI across adulthood; approaches which have been applied in subsequent NSHD papers.

Hardy R, Wills AK, Wong A, Elks CE, Wareham NJ, Loos RJF, Kuh D, Ong KK. Life course variations in the associations between FTO and MC4R gene variants and body size. Human Molecular Genetics 2010; 19: 545-52.
This was one of the first studies to investigate the longitudinal changes in the association between gene variants identified as associated with adult BMI. We showed associations varied with age. We have published two subsequent papers using a similar approach.

Hardy R, Lawlor DA, Black S, Mishra GD, Kuh D. Age at parenthood and coronary heart disease risk factors at age 53 years in men and women. Journal of Epidemiology and Community Health 2009; 63: 99-105.
This is one of the few papers to investigate the impact of age at parenthood on CV risk factors in men as well as women as a way of distinguishing social and lifestyle effects of childrearing and the biological effects of pregnancy.

Li L, Hardy R, Kuh D, Lo Conte R, Power C. Child-to-adult BMI and height trajectories: a comparison of two British birth cohorts. American Journal of Epidemiology 2008; 168: 1008-1015.
This paper illustrated that the 1958 cohort had a faster rate of BMI gain in early adulthood than the 1946 cohort and had on average a greater BMI by mid-life. It raises important questions about future trends for mortality and morbidity, particularly in cohorts who experienced the obesity epidemic in childhood.

 

For a full list of publications from 2007-2012 please click here.


For more recent publications please look on our findings page which can be found by clicking here.

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