Abstract
The first population-based cohort study in Uppsala with the aim to study cardiovascular disease was initiated in 1970 (ULSAM). This cohort of 2300 middle-aged men has since then been followed in a longitudinal fashion for almost 50 years. This study has been followed by the PIVUS study, investigating 1000 men and women at ages 70, 75, and 80. A very detailed examination has also been performed in 500 subjects aged 50 years, the POEM study. In recent years, a high-throughput study conducted in 13000 subjects has also been performed, named EpiHealth. Uppsala also collects data in 5,000 subjects in the nationwide SCAPIS study. Taken together, these cardiovascular-oriented studies constitute a very rich source for cardiovascular epidemiological research in Uppsala. This review summarizes the design of these studies and highlights some of the important results published based on data from these studies.
Highlights
Framingham Heart Study (FHS) was initiated in 1948 to study the natural course of cardiovascular disease (CVD) and its risk factors
It was recognized that coronary heart disease mainly was a disease of men, and only men were included
Inspired by these two milestone studies in the USA and in Sweden, Hans Hedstrand and co-workers at the Department of Medicine at Uppsala University Hospital initiated in 1970 a cohort study of 2,322 men all aged 50 years that was later named ‘the Uppsala Longitudinal Study of Adult Men’ [1]
Summary
Framingham Heart Study (FHS) was initiated in 1948 to study the natural course of cardiovascular disease (CVD) and its risk factors. Apart from traditional CVD risk factors, an oral glucose tolerance test (OGTT) with insulin determinations was performed together with the hyperinsulinemic euglycemic clamp that allowed an evaluation of both insulin secretion and sensitivity This is still the largest effort in a single study to characterize these two major determinants of diabetes development. The major strength of the ULSAM study is the many reexaminations performed, which allows for collection of longitudinal trends of measured variables as well as for collection of incident cases of a number of diseases, CVD, over more than 40 years. In addition to the traditional CV risk factors, an extensive imaging program is performed, including CT coronary angiography, CT scanning of lungs and abdomen for visceral/subcutaneous adipose tissue and liver fat (including ‘inflamed adipose tissue’ determinations), as well as ultrasound for carotid artery atherosclerosis (and MRI if carotid plaques are found). Having access to several cohorts makes it possible to replicate findings in one sample in another study, an important task to ascertain the validity of novel research findings
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