Icelandic Heart Association - main areas of activity

1. Hjartavernd
Icelandic Heart Association

2. The Icelandic Heart Association
• A non-profit organisation - charity -
founded 1964
• Three lines of work
 Epidemiological studies
 Information to the public
 Cardiovascular risk clinic

3. 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

5. 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

7. 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

9. 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

10. The AGES Reykjavik Study
Age 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 Institute
National Institute of Neurological Disorders and Stroke

11. Systems studied
• Cardiovascular
• Brain
• Bone
• Body composition
• In 3 visits

12. Informed consent
1.MEDICATION
2.EXCLUSION CRITERIA
RECEPTION
COGNITION 1
Motor function
TUG
6 m WALK
ISOMETRIC CHAIR
GRIP STRENGTH
BALANCE
REFRESHMENTS
VISIT 1
UNDRESS
DRESS
Measurements
HEIGHT/WEIGHT
WAIST CIRC.
BONE DENSITY HEEL
EAR CHECK
ECG
BLOOD PRESSURE
BIOIMPEDENCE
BLOOD DRAW
Questionnaire 1
HAND PHOTO
SPIROMETRY
Take home:
1.Food list
2.Vial for urine
3.Vials for saliva

13. RECEPTION
BRING
1.food list
2.urine sample
2.saliva sample
MRI
BRAIN
CT
SPINE
HIPS
THIGH
HEART
US
CAROTIDS
HEART
COGNITION 2
REFRESHMENTS
Questionnaire 2
VISIT 2
UNDRESS
DRESS

14. Exit interview
Memory Clinic
NEUROLOGIST
PROXY INTERVIEW
VISIT 3
Depression test
Reception
REFRESHMENTS
Eyes
a. Acuity
b. Tonometry
c. Retinal photo
Hearing

15. AGES Reykjavik Study
• Recruitment started in September 2002
• Ended January 2006

16. AGESII Reykjavik Study
• Follow-up study
• Recruitment started in April 2007
• Two visits
• Ended October 2011
• 3411 participants

17. 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

18. 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)

19. AGES Offspring
• Offspring of AGES participants
• Control group recruited 2012
• 526 participants
• Offspring of parents with Alzheimers
disease
• 430 participants

20. 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)

21. Risk assessment
• Hjartarannsókn does the assessment
• Uses the risk calculator áhættureiknir
Hjartaverndar based on the epidemiological
research

22. 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