Map | Collaboration | Key research aims | Summary table

During the 1970s it became evident that the development of atherosclerosis, the major cause of heart attack and stroke, commenced in childhood. That this process was likely to be influenced by the same risk factors that predicted cardiovascular disease in adults was anticipated at that time, and was subsequently shown to be correct.

Over the following two decades, investigators in several countries initiated cohort studies to gain insights into these risk factors through childhood, and their relationship with cardiovascular disease, as participants aged into early and middle adulthood.





By 2002, the possibility of linking data collected in childhood through adulthood to future cardiovascular disease (CVD) events was becoming a realistic focus in several of these large cohorts – the intention being to look at the separate effects of childhood and adult risk factors on the occurrence of CVD. However, because the cohorts were still relatively young, an extended follow-up period would be necessary to accumulate sufficient cardiovascular disease events to address key questions in any individual cohort. The idea of pooling data from these large cohorts arose. Initially the Young Finns, the CDAH, the Bogalusa, and the Muscatine studies were approached to participate. Through the increased power this would provide, the follow-up period to ascertain sufficient early cardiovascular disease events could be reduced. Detailed examination revealed that all four studies had included similar lifestyle and biological risk factors, among them the major cardiovascular disease risk factors – blood pressure, serum lipids, and adiposity measures, permitting pooling or meta-analysis involving these factors across studies.

Researchers associated with each cohort agreed to proceed with establishing a formal consortium ultimately named: the International Childhood Cardiovascular Cohort (i3C) Consortium. This Consortium brought together international researchers involved in the four long-standing cohort studies, as well as experts in epidemiology, pediatric cardiology, statistical genetics, and other disciplines. Although the Consortium initially consisted only of the largest four cohorts that had undertaken measurement of major cardiovascular disease risk factors in childhood and had followed them through adulthood. As the capacity of the Consortium and the extent of its network developed, other similar studies were identified. These were the Princeton Lipid Research Clinics Study, two Minneapolis Childhood Cohort Studies, and the National Heart, Lung, and Blood Institute Growth and Health Study (NGHS).

The ongoing i3C Outcomes Study (funded by the National Institutes of Health (NIH)) is the first longitudinal cohort study designed to locate large numbers of adults from i3c cohorts with detailed biological, physical, and socioeconomic measurements obtained in childhood and with a longitudinal harmonized data base. This main focus of this study is to: 1) identify incident CV endpoints using self-reported morbidity validated by adjudication of medical records; and 2) identify decedents using the National Death Index and adjudicate cause of death for deceased participants. Therefore, the i3C Outcomes Study has significant potential for clarifying the relation between childhood levels of CV risk factors and development of adult CV disease, with an acknowledged public health goal of establishing evidence-based preventive guidelines that can be introduced during childhood.


Key research aims

Altogether over 40,000 children were examined in the collaborating cohorts. The total number of participants with major cardiovascular disease risk factors measured at least once in childhood and at least once in adulthood is approximately 10,000. Therefore, the i3C Consortium offers the potential to extend our knowledge about the childhood origin of adult cardiometabolic diseases and will focus on, but not be limited to, three key research areas: 1) Follow-up of CVD morbidity and mortality, 2) Genetic data collection and analyses, 3) Continued assessment of non-invasive vascular measures.




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