Abstract
The Hamburg City Health Study (HCHS) is a large, prospective, long-term, population-based cohort study and a unique research platform and network to obtain substantial knowledge about several important risk and prognostic factors in major chronic diseases. A random sample of 45,000 participants between 45 and 74 years of age from the general population of Hamburg, Germany, are taking part in an extensive baseline assessment at one dedicated study center. Participants undergo 13 validated and 5 novel examinations primarily targeting major organ system function and structures including extensive imaging examinations. The protocol includes validate self-reports via questionnaires regarding lifestyle and environmental conditions, dietary habits, physical condition and activity, sexual dysfunction, professional life, psychosocial context and burden, quality of life, digital media use, occupational, medical and family history as well as healthcare utilization. The assessment is completed by genomic and proteomic characterization. Beyond the identification of classical risk factors for major chronic diseases and survivorship, the core intention is to gather valid prevalence and incidence, and to develop complex models predicting health outcomes based on a multitude of examination data, imaging, biomarker, psychosocial and behavioral assessments. Participants at risk for coronary artery disease, atrial fibrillation, heart failure, stroke and dementia are invited for a visit to conduct an additional MRI examination of either heart or brain. Endpoint assessment of the overall sample will be completed through repeated follow-up examinations and surveys as well as related individual routine data from involved health and pension insurances. The study is targeting the complex relationship between biologic and psychosocial risk and resilience factors, chronic disease, health care use, survivorship and health as well as favorable and bad prognosis within a unique, large-scale long-term assessment with the perspective of further examinations after 6 years in a representative European metropolitan population.
Highlights
ObjectivesWithin the last decades, a change in the disease pattern has been observed
In addition to the change in disease patterns a change in diagnostic abilities and personalized treatment opportunities has occurred
The city is mostly urban, but has some rural areas and a large harbor contributing to the environmental exposures of the population. 839,389 persons are older than 45 years and in 2017 approximately 90,000 persons moved away
Summary
The majority of the ageing populations in industrialized parts of the world will survive acute events and move into survivorship living with one or more of the following conditions, e.g., cardiovascular and neurovascular disease, cancer, respiratory diseases, diabetes [1] This change is mostly explained by better diagnostics leading to identification of disease at an earlier stage and to the development of more effective treatments of these diseases. Observational studies have changed practice of medicine and lifestyle for millions of people [4], e.g., the Framingham Heart Study, which for the first time identified risk factors for cardiovascular events [4] The conditions for those who survived these diseases were only a minor part of the agenda. Identification of factors supporting life in survivorship of major chronic diseases
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