Icelandic Heart Association

Hjartavernd

Icelandic Heart Association

The Icelandic Heart Association

• A non-profit organisation - charity - founded 1964

• Three lines of work Epidemiological studies Information to the public Cardiovascular risk clinic

The Icelandic Heart Association

• In 1967 founded a Research Institute and started a prospective study

• Participants: all individuals resident in the Reykjavik area who

were born between 1907 – 1935 a total of around 30,000

About 20,000 have participated at one or more stage

• The Reykjavik study

The Reykjavik Study

• Repeated measurements of risk factors mainly for cardiovascular disease

• Supplementary data such as birth weight and school records

• Verified endpoints, MI registry• Serum samples frozen and stored from

all stages

Risk factor calculator, web based

• Built on data from the Reykjavik study using CVD information

• people can enter their measured values height, weight, cholesterol, HDL, Triglycerides,

smoking status etc• and see their risk of developing CVD over the

next 10 years compared to their peers• can then see how things change if they

change their risk factors

The Reykjavik Study - next step

• A continuum of the Reykjavik Study• Participants aged between 67 and 95 years• Examined 5,764 individuals over a 3½ year

period • Making use of available data and obtaining

extensive phenotypes for epidemiological and genetic studies of healthy aging

• The AGES Reykjavik study

The AGES Reykjavik StudyAge Gene/Environment Susceptibility(AGES)Reykjavik Study

A collaborative project between the Icelandic Heart Association and National Institute on Aging

Later add on:National Eye Institute, National Institute on Deafness and Other Communication

Disorders, National Heart, Lung and Blood InstituteNational Institute of Neurological Disorders and Stroke

Systems studied

• Cardiovascular• Brain• Bone • Body composition

• In 3 visits

Informed consent1.MEDICATION2.EXCLUSION CRITERIA

RECEPTION

COGNITION 1

Motor function TUG6 m WALKISOMETRIC CHAIRGRIP STRENGTHBALANCE

REFRESHMENTS

VISIT 1

UNDRESS

DRESS

MeasurementsHEIGHT/WEIGHTWAIST CIRC.BONE DENSITY HEELEAR CHECKECGBLOOD PRESSUREBIOIMPEDENCEBLOOD DRAW

Questionnaire 1HAND PHOTOSPIROMETRYTake home:1.Food list2.Vial for urine3.Vials for saliva

RECEPTIONBRING1.food list2.urine sample2.saliva sample

MRIBRAIN

CTSPINEHIPSTHIGHHEARTUS

CAROTIDSHEART

COGNITION 2

REFRESHMENTS

Questionnaire 2

VISIT 2

UNDRESS

DRESS

Exit interview

Memory ClinicNEUROLOGISTPROXY INTERVIEW

VISIT 3Depression test

Reception

REFRESHMENTS

Eyesa. Acuityb. Tonometryc. Retinal photoHearing

AGES Reykjavik Study

• Recruitment started in September 2002• Ended January 2006

AGESII Reykjavik Study

• Follow-up study• Recruitment started in April 2007• Two visits• Ended October 2011• 3411 participants

AGES Reykjavik study

• More than 12000 variables obtained for each individual

• The AGES Reykjavik study gives us an opportunity to examine subclinical disease by extensive and accurate measurements.

• In particular interesting by using imaging in epidemiology

Áhættuþáttakönnun Hjartaverndar - REFINE

• Started 2006 ongoing• Risk Evaluation For INfarct Estimates Reykjavik study • Random population based cohort from greater Reykjavik

area.• 20 to 70 years old. Mean age about 48.• Carotid ultrasound for CIMT and plaque assessment• Loingitudinal measurements (REFINELO, REFLOCT)

AGES Offspring

• Offspring of AGES participants• Control group recruited 2012• 526 participants• Offspring of parents with Alzheimers

disease• 430 participants

DNA

• Isolated from whole blood since 1996• OFFGEN, OFFGENT8

Exome chip (Texas)• AGES:

1500 snp panel (2300) (Illumina) GWAS 3219 (NIA) Exome chip 2983 (Texas) APOE (HV) Various SNPs (HV,KBiosciences)

Risk assessment

• Hjartarannsókn does the assessment

• Uses the risk calculator áhættureiknir Hjartaverndar based on the epidemiological research

Risk Assessment

• Examinations and nurse´s interview• Interview with specialist (2nd visit)• Endurance test if necessary• Læknisviðtal 20 mínútur

Characteristics of CHD Results evaluated Risk calculator reiknivél Advice regarding risk factors Advice for further research Treatment started if necessary