Participating Studies

Abdominal Aortic Aneurysm Screening Program

This study is a large randomised controlled trial of screening for AAA in men living in Perth, Western Australia aged 65-83 years, who were not resident in a nursing home. A response fraction of 70.5% was obtained with 12,203 men attending one of five clinics between April 1996 and December 1998. In addition to an ultrasound scan of the abdominal aorta, each man was asked to complete a questionnaire covering demographic details, medical, family, and occupational history, and selected aspects of diet and current lifestyle. Height, weight, blood pressure and circumference at the waist and hips were also recorded. It has been found that AAA shares some but not all of the risk factors of other arterial disease. Participants in the AAA Program are currently being followed up in the Health In Men Study (HIMS) to determine their outcomes in the long-term. The HIMS concerns several major health issues in the older population, and will address a series of unanswered questions as well as testing some novel hypotheses. Both these projects make use of Western Australia's unique electronic health data systems, its stable population, its relative isolation and the strong "research culture" in the local community.

Australia Longitudinal Study of Ageing (ALSA)

The Australian Longitudinal Study of Ageing (ALSA) is Australia's first multi-dimensional population based study of human ageing. The general purpose of the ALSA study is to gain further understanding of how social, biomedical and environmental factors are associated with age related changes in health and well-being of persons aged 70 years and over. Emphasis is given in the overall study to defining and exploring the concept of health and successful ageing. The research has a number of specific objectives.

These include:

  • determination of levels of health and functional status of an older population and to track the changes in these characteristics over time;
  • identification of factors which promote and maintain health and well being in an ageing population;
  • identification of risk factors for major morbid conditions and social, behavioural and other problems among an ageing population;
  • analysis of the effects on transitions in health and functional status of age, gender, different patterns of co-morbidity, availability and nature of informal and formal support arrangements, social and economic circumstances, health care provision and utilisation and other variables of interest;
  • assessment of the effects of disease processes on functional status and the demand for health care services and both informal and formal long term care;
  • examination of the patterns of the need for and the utilisation of informal and formal sources of long-term care as they relate to social support networks, economic and housing conditions, care giving arrangements and the availability of appropriate services; and
  • examination of mortality outcomes in the light of changes in health and functional status, medical interventions, self-assessed health, social networks, and individual characteristics.

The breadth and scope of ALSA are unusual, even by comparison with longitudinal studies of ageing conducted in other countries. The inclusion of both survey and clinical components makes it possible to link objective clinical measures with details of the lifestyle, attitudes and personal histories of respondents. With the added dimension of repeated observations over time, ALSA provides a richness of data not available in previous Australian studies, and promises to substantially increase our understanding of the quality of life of older Australians.

The initial baseline data collection for ALSA began in 1992 with information being collected for 2087 participants. Components of this first Wave included a comprehensive personal interview, a home based assessment of physiological functions; self completed questionnaires and additional clinical studies.

Reinterviews of participants have since been carried out annually, with Wave 6 (a full reassessment) was completed in April 2001.

Funding has now been provided through an National Health and Medical Research Council (NHMRC) grant for a seventh wave of data collection for ALSA commencing in September 2003 that will provide for a further full follow-up (interview and physical assessments) and a specific exploration of significant life transitions and the impact of these in physical health, social and psychological terms on participants.

The longitudinal data collected in the course of the ALSA study comprises the most comprehensive longitudinal data base yet assembled on ageing Australians and the findings of the ALSA are directly relevant to policy formulation and planning of health and social services for an ageing population.

Researchers have cited the Australian Longitudinal Study of Ageing in over 200 publications including book chapters, journals, conference proceedings and theses.

Aito Town Study

The baseline survey was conducted through 1980 to 1983 to investigate the factors associated with the cardiovascular death in a representative sample of the adult population (40 to 64 years) of Aito town in the rural area of Shiga prefecture in Japan. All residents were invited to the health check-up during the survey. 1,743 participants were enrolled, with a response rate of 76 percent for the initial examination. The cohort was followed for the death due to stroke and coronary heart disease through the review of death records. There is 18 years of follow-up for analyses.

Akabane Study

In 1985, all residents living in the town of Akabane town in Aichi Prefecture, Japan were invited to participate in this study. The size of the cohort is 1,828 and the response rate when the study recruitment ended was 77.6%. The age of participants ranged from 40 to 69 years with 55.7% of them being female. It has a median follow-up of 11 years.

Anzhen 02 Cohort Study

This study commenced in 1992 in China and has a cohort size is 4,154 with the age of participants ranging from 34 to 65 years. 51% of participants are female and the median follow-up is 3 years.

Beijing Aging Study

This study commenced in Beijing, China in 1992. The cohort size is 3,257 with 51% female and an age range of 55 to 97 years. It has a median follow-up of 4.8 years.

Beijing Anzhen Cohort Study

The Beijing Anzhen Cohort Study was originally part of the Beijing Hypertension Survey. The sample was selected from Docheng, Xicheng, Changyang, Xuanwu, and Haidian districts of Beijing. A random sample resident committee was selected first, and then a random sample of households was selected again. This group comprised of a cohort of 7,260 men and women aged over 35 years in 1991, and followed up in 1996 for the occurrence of coronary heart disease, stroke and death through the review of hospital and death records. The cohort was followed up to 1999 and 5 years of follow-up are used for analyses.

Beijing Steelworkers Study

The study population consisted of employees of a steel factory in Beijing, China. The study commenced in 1970 and has a median follow-up 27.9 years and the age of participants range from 20 to 86 years. 11.7% of participants are female.

Busselton Health Study

The cohort consisted of the adult community of the town of Busselton in Western Australia (1,923 men and 1,968 women) who participated in cross-sectional health surveys every three years over the period 1966-81. Baseline assessment included cardiovascular risk factor measurements. Mortality follow-up data is available to 31 December 1994. Please see: http://bsn.uwa.edu.au for further information and a comprehensive list of publications pertaining to this study.

Canberra-Queanbeyan Longitudinal Study of the Elderly

The Canberra Longitudinal Study is a large epidemiological survey of mental health and cognitive functioning in a community based sample living in or near or in Canberra, Australia. The study was planned in 1988-1989 and the initial wave of interviews was carried out in 1990-1991. Subsequent waves were carried out in 1994, 1998 and 2002. The study aimed to investigate the epidemiology of cognitive decline, dementia and depressive disorders/symptoms over time and to identify factors influencing the course of cognitive decline and depression. Risk factors of interest assessed included psychological variables such as mental activity, cognitive style, social support and biological ones, such as genetic polymorphisms, blood pressure, reaction time and grip strength. Of particular interest was the co-occurrence of depression and dementia, an issue that remains at the forefront of psychiatric epidemiology. Participants in the community sample were people aged 70 years or older living in the Canberra/Queanbeyan region in 1990. A sample of 945 people was recruited from the community via the Electoral Roll. Approximately 60% of those approached eligible participated. The sample was stratified by age and sex. Interviews were sought from both the participant and an informant, and trained lay interviewers undertook interviews. In addition to the community sample, the study also recruited a sample of individuals living in nursing homes and over sampled individuals aged 90 years of age and over. Wave 2 of the community study was undertaken 3.6 years later (interwave contact interval ranged from 3.3 to 4.2 years) and Wave 3 a mean of 4.0 years later (range 3.7 to 4.4 years). A sample of 638 participants was interviewed at Wave 2 (approximately 65% of the previous sample) and 379 participants at Wave 3 (approximately 60%) of Wave 2 sample). Of the original sample, 21.9% were no longer living at Wave 2 and, of the Wave 2 sample, 26.2% at Wave 3 were deceased. Refusal rates were low, being less than 10% for those able to be contacted at subsequent waves.

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Capital Iron and Steel Company Study (CISC)

This cohort study is a survey on risk factors of coronary heart disease among male workers in the Capital Iron and Steel Company of Beijing, China. A total of 5,298 men over 18 years of age enrolled in 1974, 1979 and 1980 and were followed up at the end of 2001 (the first time was in 1987 and the second in 1993). The response rate for the three separate cohorts ranged from 94% - 97%. Participants were free of coronary heart disease in the follow up study. Examinations at baseline consisted of age, smoking and drinking habits, blood pressure measurements, body weight and height, a resting electrocardiogram and exercise test and total cholesterol levels. The participants were followed up for an average of 20.8 years. Ten papers have been published from this study including the incidence and mortality rate of coronary heart disease and stroke. The results of this prospective study have confirmed established risk factors such as age, blood pressure, total cholesterol, body mass index and smoking as independent predictors of coronary heart disease, and showed that appropriate intervention and modification of those traditional risk factors especially prevention and control of hypertension, management of hypercholesterolemia and cessation smoking can lead to a decrease in coronary events such as myocardial infarction in the Chinese population.

Capital Iron and Steel Company Hospital Cohort (CISCH)

This study was initiated in 1992 in China. The cohort size is 2,169 and the age of participants range from 34 to 64 years with 51% female. It has a median follow-up of 3.3 years.

Civil Service Workers Study

This study is a prospective cohort study of Civil Service Workers in Nagoya, Japan. In 1989, baseline information was collected by a self-administered questionnaire, and 18,450 workers were followed up to March 31 1995. All deaths observed during active service were identified and date of retirement was also recorded. Among 5,352 male workers aged 40 to 54, 11 committed suicide during follow-up period of 5 years. Analyses were carried out using Cox's proportional hazard model, controlling for age.

East Beijing Cohort Study

The population sample originated in the East district of Beijing in 1979 and was selected through cluster sampling. The cohort size is 1,135 and the age of subjects ranged from 20 to 84 years with 51% female. It has a median follow-up of 17 years.

Electrical Generating Authority of Thailand Study (EGAT)

In 1985, male and female employees of the Electricity Generating Authority of Thailand based at the company's head plant in Nonthaburi, aged between 35 and 54 years, took part in a cardiovascular risk factor survey. Volunteers completed a self-administered questionnaire, underwent a physical examination, provided fasting blood samples and underwent an oral glucose tolerance test. Twelve years later, in 1997, a follow-up survey was conducted and causes of death were determined for those subjects known to have died. Changes in levels of vascular risk factors over 12 years, and the associations of baseline risk factors with vascular mortality, were calculated. The 1985 survey recruited 3499 volunteers (average age 43 years) of whom 23% were female. In 1997, 2,967 (85%) of the study participants were resurveyed, and vital status was determined for 3,318 (95%). The primary aim of these analyses was to describe 12-year changes in vascular risk factors in this cohort of subjects. A secondary aim was to determine the associations between baseline risk factors levels and the risk of vascular death.

Fangshan Cohort Study

This study commenced in 1991 in Fangshan, China and has a cohort size of 2,597 with 66% female. The age range of participants is from 34 to 86 years and has a median follow-up of 3.6 years.

Fletcher Challenge Heart and Health Study

The purpose of this prospective observational study was to determine the relationship of sociodemographic factors, psychological factors and several factors measured in blood, with the risk of coronary heart disease in a New Zealand population. The participants were recruited from two sources - the Fletcher Challenge Group and individuals listed on the general electoral roll for the Auckland region and consisted of a total size of 10,529 participants. Baseline and follow-up risk factor data were obtained from a questionnaire, blood samples and a simple physical exam. Outcome data on deaths and hospitalisations due to coronary heart disease was obtained through hospital linkage records. The study commenced in 1992.

Guangzhou Occupational Cohort Study

The aim of this study was to compare the mortality risk of smoking and overall occupational exposure in factory workers and drivers in Guangzhou, China. Baseline data on smoking and occupational exposure of 82,159 workers aged 30+ were retrieved from medical records established in 1988-92. Vital status and causes of death were followed through 1998.

Hisayama Study

This prospective cross-sectional study was initiated in 1961 to elucidate the incidence and mortality of cardiovascular disease and their risk factors among residents of Hisayama Town on Kyushu Island, in Japan. A total of 1,618 subjects aged 40 years free from stroke and myocardial infarction were selected in the screening examination (with a participation rate of 90%). This cohort was followed up by repeated health examinations every 2-5 years. In this study, study-team physicians performed physical and neurological examinations on a majority of the subjects who developed stroke and collected clinical information. Furthermore, morphological examinations by autopsy and/or brain imaging were performed on more than 90% of the stroke subjects. The cohort is still being followed and 26 years of follow-up are used for analyses.

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(20) Hong Kong Study

The Hong Kong study on "Health, health risk and quality of life in the Chinese elderly cohort"

This territory-wide population-based study began in 1990 with the aim of investigating the relation between social, physical, lifestyle and health factors on a multiple of health outcomes in a cohort of elderly Chinese aged 70 years and over. The cohort, comprising 2032 subjects, was selected by stratified random sampling from a registered list of all recipients of old age and disability allowances in Hong Kong. The Old Age Allowance list covers over 90% of elderly people age 70 years and over, since eligibility is by age alone, independent of income. The disability allowance list covers the subjects who may be receiving additional social welfare support. Subjects were stratified by age and sex so that there would be 300 subjects in the 70-74 and 75-79 age group in each sex and 150 subjects in the 80-84, 85-89 and = 90+ age groups in each sex. After the baseline face-to-face interview, the cohort was followed with telephone interview at 18 months, face-to-face interview at 36 months and further periodic telephone interviews over time. Death certificates were searched to ascertain the mortality status of participants. This territory-wide population-based study began in 1990 with the aim of investigating the relation between social, physical, lifestyle and health factors on a multiple of health outcomes in a cohort of elderly Chinese aged 70 years and over. The cohort, comprising 2032 subjects, was selected by stratified random sampling from a registered list of all recipients of old age and disability allowances in Hong Kong. The Old Age Allowance list covers over 90% of elderly people age 70 years and over, since eligibility is by age alone, independent of income. The disability allowance list covers the subjects who may be receiving additional social welfare support. Subjects were stratified by age and sex so that there would be 300 subjects in the 70-74 and 75-79 age group in each sex and 150 subjects in the 80-84, 85-89 and = 90+ age groups in each sex. After the baseline face-to-face interview, the cohort was followed with telephone interview at 18 months, face-to-face interview at 36 months and further periodic telephone interviews overtime. Death certificates were searched to ascertain the mortality status of participants.

Health and social predictors of morbidity and mortality in an elderly Chinese cohort in Shatin

A cohort of 1,054 subjects aged 70 years and above were recruited from Shatin New Town in Hong Kong. The cohort was selected by stratified systematic sampling from multiple sources. These were the Old Age Allowance Scheme (where the only criteria were years or above and having resided in Hong Kong for at least 5 years), social centers for the elderly, and homes and hostels for the aged. This was done in order to include subjects with different levels of baseline characteristics, e.g., social support. Forty percent of the sample was recruited through the Old Age Allowance Scheme. Subjects who came to the Social Welfare Department of the Shatin District for periodic review during the study period were recruited into the study while those not yet due for review were recruited through a one-in-five systematic sample. Another 30 percent of the sample was recruited through social centers for the elderly, and the remaining 30 percent came from hostels and homes for the elderly. Four of the six social centers in Shatin were selected randomly and then a systematic sampling of one in three listed persons was used in the four centers for the recruitment of subjects. Twenty-nine percent of the subjects were thus residents of old age homes and hostels; and the others were free-living subjects residing in the community. Among the community subjects, about one-quarter were living in sheltered housing. Men accounted for 29 percent of the sample. The mean age of the subjects was 76.6 years (standard deviation = 5.8), with a range from 70 to 100 years.
Baseline data on a number of social, demographic, and biologic variables were obtained from personal interviews at the homes of the subjects with the use of standard questionnaires. The subjects were re-interviewed at 6 and 12 months by telephone to obtain information on morbidity and mortality (97 percent of the subjects had access to a telephone). Home visits were made to those who could not be contacted by telephone. Another home interview was conducted at 24 months to collect more detailed information on the health status or mortality outcome of the subjects.

Huashan Study

The study originated in 1992 to investigate the factors associated with the development of coronary heart disease in a representative sample of the adult population of Jin-an district, Shanghai, China. A random sample of households was selected, with a response rate of 91.5% for the initial examination. This group comprised the cohort aged 35-74 years examined in 1992 and recalled for clinic examinations every 3 years. The cohort was followed for the occurrence of coronary heart disease and death through the monitoring and review of hospital and death records.

The Kinmen Neurological Disorders Survey (KINDS)

The study originated in 1993 to investigate the factors associated with the development of stroke, dementia, Parkinson's disease, migraine, essential tremor, and depression in an adult population of Kinmen, Taiwan. All the registered residents aged 50 years in the two townships (Kin-Hu and Kin-Cheng) were the target population of this cohort. From 5,061 targeted subjects, a total of 3,915 (77.4%) comprising 1,966 men and 1,949 women, participated in the baseline study. The study was based on a door-to-door survey. The first survey period spanned 1 year and 48 days, (from August 1 1993 to September 17 1994). The 3,915 participants were monitored for 3 years from May 26 1996 to December 6 1997. For deceased subjects, we reviewed death certificates for all deaths in the study area to identify those with stroke. The cohort is not followed now.

Korean Medical Insurance Corporation Study (KMIC)

Konan Health and Nutrition Study

The purpose of this cross-sectional study was to evaluate associations between unfavourable factors and low blood cholesterol in non-Western populations. A self-administered questionnaire concerning health characteristics and a nutritional survey, using a continuous 48-hour dietary record, was conducted on a stratified population sample of 461 and 571 females aged 20 to 79 years (the response rate when the study recruitment ended was 63.8%), in a rural Japanese population - the town of Konan. Blood pressure and cholesterol measurements were also taken. The study commenced in 1987.

Melbourne Collaborative Cohort Study

The Melbourne Collaborative Cohort Study (HEALTH 2000) is a longitudinal study that began in the early 1990s to investigate prospectively the role of diet and other lifestyle factors in causing common chronic diseases including cancer, cardiovascular disease and diabetes. It was also designed to investigate possible interactions between common chronic disease and common genetic variants. The distinguishing feature of the Melbourne study is the ethnic diversity of the local population. Between 1990 and 1994, 41,500 people, (24,500 women and 17,000 men) aged 40-69 volunteered to take part in a 20-year prospective study. The cohort is made up of 69% Australian born and 11% Greek, 13% Italian born and 7% UK born migrants. Participants provided information via a self-administered dietary questionnaire and interview administered questions. In addition a number of body measurements were taken and a blood sample was stored. Passive and active follow up has continued since recruitment through the collection of additional data via a self-administered questionnaire (1995-98) and record linkage with the state death and cancer registers. Contact with participants has also been maintained through the distribution of newsletters. Commencing in 2003, the cohort will be invited to attend a study centre to repeat the baseline measures.

Miyama Cohort Study

The baseline survey was conducted from 1988 to 1989 to investigate the relationship between lifestyle and mortality. All inhabitants aged 40 to 79 years were invited to participate in the study from Miyama Village, Wakayama Prefecture in Japan. A total of 1,369 inhabitants responded to the survey with a response rate of 89%. The cohort was followed for the occurrence of death through the monitoring and review of death records. The cohort is still being followed, and 8 years of follow-up are used in analyses.

National Heart Foundation Risk Factor Prevalence Survey 1989

This study was part of a series of surveys conducted by the National Heart Foundation of Australia in 1980, 1983 and 1989. It was designed to obtain national information on biomedical and behavioural risk factors in Australia and to monitor trends over time. The survey collected information from a sample of around 22,000 adults living in capital cities in Australia between May/June and December of the survey year.

Newcastle Study

A population-based observational study of men and women aged 21 to 77 years in the Hunter Region of New South Wales, Australia. The study was conducted to assess the impact of risk-factor modification and increased drug therapy on the trends in major coronary events. The study ran from 1983 to 1994 with a cohort size of 5,958 and a median follow-up of 11.1 years. A stratified random sampling method was used to select participants. Surveys were conducted in 1983 (68% response rate), 1988/89 (64% response rate) and 1994 (63% response rate).

Ohasama Study

The Ohasama Study is a prospective cohort study among individuals aged 40 years or older living in Ohasama town, Iwate Prefecture in northern Japan. It was initiated in 1988 to investigate and compare the associations between casual/home/ambulatory blood pressure values and mortality/morbidity. Over 1,500 representative subjects with measured casual/home/ambulatory blood pressures have been followed-up. Previous findings demonstrated that home/ambulatory blood pressures were more strongly related to prognosis than was casual blood pressure. Furthermore, home/ambulatory blood pressure monitoring had several unique prognostic parameters, such as diminished nocturnal decline in blood pressure, short-term variability in blood pressure, morning/evening blood pressure ratio, etc. This prospective cohort study would reveal the prognostic significance of home/ambulatory blood pressures, thus leading to better detection, prevention and treatment of hypertension.

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Perth Risk Factors Survey (Perth MONICA)

The Perth Cohort consists of five cohorts of persons invited to individual Risk Factor Prevalence Surveys conducted in Perth, Western Australia during the years 1978/79, 1980, 1983, 1989 and 1994. The studies aimed to investigate the prevalence within the population of possible risk factors for coronary disease. In all but the first cohort the participants were randomly selected adults from the Western Australian Electoral Roll. In the 1978/79 survey, only 1-in-5 participants was randomly selected from the Western Australian Electoral Roll while the rest were self-referred volunteers. Ages ranged from 18 to 90 years. The recruitment area in 1978/79, 1980 and 1983 was bounded by a 16 km radius from the Perth city centre. The 1980 and 1983 surveys included only people aged 25-64, while the 1989 and 1994 surveys covered the whole metropolitan area and age-groups 20-69 years. The combined cohort contains 10,376 responders from a total of 12,563 invited, 5,349 men and 5027 women. The cohorts have been followed for up to 20 years to mid 1999 for death and coronary events by review of death and hospital records. A further Risk Factor Prevalence Survey was conducted in 1999. Data from this cohort will contribute to the combined study, which will be followed up again to the end of 2002.

Saitama Cohort Study

This prospective cohort study commenced in 1986 among residents (mostly older than 40 years) in a town of Yoshimi in Saitama Prefecture, Japan. An epidemiological survey was done in a total of 8,552 persons with a self-administered questionnaire that covered 90 lifestyle factors. Of all individuals who completed the survey, 3625 cohort members gave peripheral-blood samples at health-screening checks between 1986 and 1990. Blood pressure data were also collected at this time. All blood samples were collected between 1 pm and 3 pm after strict fasting of more than 12 hours and were used for immunological and biochemical assays including measurement of serum lipids and lipoproteins and other various components, NK activity of peripheral-blood lymphocytes, CD4/CD8 T cells, and blastformation of lymphocytes in the presence of mitogen. A follow-up survey on cancer incidence and death from all causes among the participants in the study is being carried out.

Seven Cities Cohort Study

A community based intervention trial was initiated in seven Chinese cities in 1987 with the overall goal to evaluate the effectiveness of an intervention aimed at reducing multiple risk factors for stroke. Subjects underwent a survey at baseline consisting of a physical and neurological examination and a questionnaire/interview, (which included questions on smoking and drinking status). In May 1987 in each of 7 the cities, 2 geographically separated communities with a registered population of about 10,000 each were selected as either intervention or control communities. In each community, a cohort containing about 2,700 subjects (35 years old) free of stroke was sampled, and a survey was administered to obtain baseline data and screen the eligible subjects for intervention. In each city, a program of treatment for hypertension, heart disease, and diabetes was instituted in the intervention cohort (approximately 2,700) and health education was provided to the full intervention community (approximately 10,000). A follow-up survey was conducted in 1990. Comparisons of intervention and control cohorts in each city were pooled to yield a single summary. A total of 18,786 subjects were recruited to the intervention cohort and 18,876 to the control cohort from 7 cities. After 3.5 years, 174 new stroke cases had occurred in the intervention cohort and 253 in the control cohort. The 3.5-year cumulative incidence of total stroke was significantly lower in the intervention cohort than the control cohort.

Shanghai Factory Workers Study

The aim of this prospective observational study was to examine the relationship between serum cholesterol concentration and mortality (from coronary heart disease and from other causes) of employees in over 10 factories in urban Shanghai. The total number of participants was 9,334 with a median follow-up of 14 years. The age range of participants at baseline ranged from 30 to 80. After baseline surveys, some participants were re-surveyed 3 years later, while another 3,550 participants were re-surveyed 5 years later.

Shibata Cohort Study

The aim of this prospective study was to examine stroke risk factors in Japan. The cohort composed of rural free-living residents aged 40 years or older of the Akadani-Ijimino district in Shibata City, Niigata Prefecture who have been followed up since 1977. The response rate for the initial examination at baseline was 85% of 1,182 males and 93% of 1,469 females.

Shigaraki Town Study

This 1991 cross-sectional study was undertaken to investigate the association of electrocardiographic (ECG) ischaemic abnormalities with ischaemic heart disease (IHD) risk factors in a Japanese population (the town of Shigaraki). Resting ECGs of 1201 subjects (572 men and 629 women, aged 30 to 89 years), were coded independently by two coders according to the Minnesota Code. Blood pressure (BP) was recorded using a standard sphygmomanometer, and non-fasting serum total cholesterol and high-density lipoprotein cholesterol were measured. Codes 1.1 and 1.2 were classified as myocardial infarction and codes 1.3, 4.1-4.4, 5.1-5.3 and 7.1 were classified as ischaemic. Prevalence of ECG with evidence of IHD (IHD ECG) was defined as myocardial infarction and ischaemic together. Levels of risk factors were compared between subjects with IHD ECG and those without IHD ECG. Multiple logistic regression analysis was used to ascertain the associations between IHD ECG and risk factors.

Shirakawa Study

The Shirakawa study originated in 1969 to investigate the factors associated with the development of cerebral stroke and ischaemic heart disease in a representative sample of the adult population of Shirakawa Town located 70 kilometers north of Nagoya City between Tokyo and Osaka. All registered residents were invited for a health check-up, with a response rate of 88.4% for the initial examination. This group comprised the cohort of 6,537 aged 20 - 64 years examined during the 2-year period 1969-1970. The participants with a need of medical care were re-examined in 1971-1972, and the participants with a minor abnormality were re-examined in 1973-1974 among the original cohort. Since 1975 the residents aged 20, 30, 40, 50, 55, 60, 64 years were examined every summer, and the residents of 45 years since 1980, and those of 35 years were also invited, with the highest response rate of 92.9% in 1983 and the lowest of 84.1% in 1976. The cohort was followed for the occurrence of cerebral stroke and ischaemic heart disease and death through the monitoring and review of hospital, death, and health insurance records in the town office. The cohort is still being followed.

Singapore National Health Survey 1992

The purpose of the 1992 Singapore National Health Survey was to determine the distribution of major non-communicable diseases and their risk factors, including the prevalence of diabetes and dyslipidaemia, in Singapore. The NHS '92 was conducted between September and November 1992 at six community centres distributed around Singapore Island. A total of 4,915 individuals were randomly selected from a sample of all household units in Singapore, obtained form the Department of Statistics' National Database on dwellings in Singapore. The characteristics of the selected sample conformed to that of the resident population. Systematic sampling, followed by disproportionate stratified sampling by ethnic groups was used to select the sample for the survey. The final number of respondents was 3,568, giving a response rate of 72.6%. Measurements were made from fasting blood specimens for lipids, insulin and glucose. All subjects were given an oral glucose tolerance test (OGTT), except those with Diabetes on oral hypoglycemic medications or insulin. Anthropometric measurements were made (height/weight to calculate BMI and hip/waist to calculate WHR) as well as blood pressure.

Singapore Thyroid and Heart Study

The purpose of the Singapore Thyroid and Heart Study was to examine cardiovascular risk factors to see how they might explain differences in cardiovascular disease mortality among Chinese, Malays, and Indians in the Republic of Singapore. The study design was a population based cross-sectional survey. Stratified systematic sampling of census districts, reticulated units, and houses was used. The proportions of Malay and Indian households were increased to improve statistical efficiency, since about 75% of the population is Chinese. Subjects were recruited from all parts of the Republic of Singapore. 2,143 subjects aged 18 to 69 years were recruited (representing 60.3% of persons approached). Data on cardiovascular risk factors were collected by questionnaire. Measurements were made of blood pressure, serum cholesterol, low and high-density lipoprotein cholesterol, fasting triglycerides and plasma glucose. The study ran from 1982 to 1984.

Six Chinese Cohorts Study

The six cohorts consisted of farmers from villages/workshops of Shanxi, Shaanxi, Guangxi, Jiangsu provinces and minors of Hebei province and fishermen from Zhejiang in China. The participants were selected using cluster-sampling methods. The study ran from 1982 to 1985. The age of participants ranged from 35 to 59 years with a total cohort size of 30,560 (15,723 men and 14,837 women). All causes of death were documented.

Tanno - Soubetsu Study

This study commenced in 1977 to investigate the cause of cardiovascular diseases and hypertension amongst a representative sample of adults in Japan. The examination districts are a small north town (Tanno) and a small south town (Soubetsu) town in Hokkaido, Japan. In 1996, residents of these two towns were randomly selected on the basis of the 'inhabitants account book' for the initial examination. Prognosis, onset of diabetes mellitus and hypertension and the progress of arterial sclerosis of these participants have been observed annually for 25 years.

Tianjin Study

The Tianjin Study originated in China and has a cohort size of 9,334, with a median follow-up of 6.1 years. The age range of participants is from 35 to 98 years with 51.3% of them being female. The study commenced in 1984.

The Cardiovascular Disease Risk Factors Two-Township Study (CVDFACTS)

The Cardiovascular Disease Risk Factors Two-Township Study (CVDFACTS) is an ongoing longitudinal study of the risk factors and pathogenesis of cardiovascular disease in two Taiwanese townships of Chu-Dung (a Hakka community) and Pu-Tzu (a Fukienese community). Among the 3,357 subjects who were aged at least 20 years, free of hypertension, and had complete data at baseline, 2,374 subjects were followed. The average duration of follow-up was 3.23 years with a follow-up rate of 71%. Data regarding smoking, alcohol consumption, health and socioeconomic background, blood pressure, and body mass index were collected. Clinical and haemostatic profiles were also assessed.

Xi'an Study

This study is a prospective study on smoking and mortality in a population of employees in a machinery factory in Xi'an, China. The study started in 1976 and has a cohort size of 1,696 (1,124 men and 572 women), with a median follow-up of 19.5 years. The age range of participants ranges from 35 to 73 years.

Yunnan Tin Miner Cohort Study

The Yunnan Tin Miner Cardiovascular Study originated in 1992 to investigate the factors associated with the development of coronary heart disease in a representative sample of the adult population of Yunnan tin mine workers. A sample of workers was selected, with a response rate of 79% for the initial examination. This group comprised the cohort of 6,583 men and women aged 36 - 75 years (average age 54) examined during the 10-year period 1992 - 2001 and recalled for health examinations every 2-5 years. The cohort was followed for the occurrence of cardiovascular disease and death through the monitoring and review of hospital and death records. The cohort is still being followed, and 10 years of follow-up are used in analyses.

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