# Combining longitudinal cohort studies to examine cardiovascular risk factor trajectories across the adult lifespan and their association with disease

> **NIH NIH R01** · NORTHWESTERN UNIVERSITY · 2021 · $609,963

## Abstract

PROJECT SUMMARY/ABSTRACT
The development of clinical cardiovascular disease (CVD) is a process that occurs across the lifespan, beginning
early in life and spanning late into life as clinical event rates increase. Much of our understanding of the impact
of cardiovascular risk factors comes from studies examining the association between risk factor levels measured
at a single point in time, often in middle age, with incident disease over the short- to intermediate-term. However,
risk factor levels in young adulthood are signiﬁcantly associated with the development of CVD later in life and
our recent work has demonstrated that not only the levels at speciﬁc ages, but also cumulative exposures and
long-term trajectories in cardiovascular health are signiﬁcantly related to the risk for subsequent CVD. Therefore,
a life course approach is critical in order to understand how cardiovascular risk factors develop and impact an
individual's risk for CVD events later in life. Yet there is no single study that has collected detailed phenotypic
data spanning young adulthood through old age on a broadly representative sample of the U.S. population.
 In response to NOT-HL-19-712: Innovative Data Evaluation and Analysis to Health, we propose to de-
velop a statistical framework for combining longitudinal risk factors and clinical outcomes data from multiple
cohort studies to create a “synthetic cohort” enabling the study of long-term cardiovascular health starting in
early adulthood. The investigative team of this proposal has pooled the data from 20 community-based CVD
cohorts through the Lifetime Risk Pooling Project (LRPP), which now has >11 million person-years of follow-
up data on repeated measures of CVD risk factors, detailed information about medication use (including blood
pressure- and cholesterol-lowering therapy), nearly 100% follow-up for vital status, and detailed CVD event adju-
dication. Few cohorts in the LRPP cover the entire adult lifespan; therefore, we propose to view risk factors and
outcomes at ages not included in each cohort study as missing data, and to use multiple imputation to ﬁll in these
unobserved measurements to facilitate analysis. The overall goal of this project is to identify and measure
the characteristics of CVD risk factor trajectories across the adult lifespan that are most amenable to
intervention. Measuring these characteristics can help identify critical periods for intervention, more precisely
deﬁne thresholds for known risk factors, elucidate the role of lifestyle behaviors, explain differences in health
among populations, and promote CVD prevention strategies at younger ages. Our speciﬁc aims are: 1) Develop
and validate a statistical framework for imputing unobserved CVD risk factors and events across the lifespan
using data from the LRPP; 2) Inform treatment strategies by identifying clinically relevant features of longitudi-
nal risk factor trajectories that are associated with CVD outcomes; 3) Leverage the work...

## Key facts

- **NIH application ID:** 10279399
- **Project number:** 1R01HL158963-01
- **Recipient organization:** NORTHWESTERN UNIVERSITY
- **Principal Investigator:** Michael J Daniels
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $609,963
- **Award type:** 1
- **Project period:** 2021-06-15 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10279399

## Citation

> US National Institutes of Health, RePORTER application 10279399, Combining longitudinal cohort studies to examine cardiovascular risk factor trajectories across the adult lifespan and their association with disease (1R01HL158963-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10279399. Licensed CC0.

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