Cardiovascular Health

Around one in two men and one in three women suffer a cardiovascular (CV) event (such as a heart attack or stroke) sometime during life, making cardiovascular disease (CVD) a major cause of mortality and morbidity. With improvements in primary prevention and treatment of acute clinical events, other manifestations of CVD such as atrial fibrillation (abnormal heart rhythm) and heart failure are assuming increasing importance.

Questions relating to CVD were asked in 1982, 1989, 1999, 2006-10, 2014-16 and 2022-24.

In adult life, blood pressure was measured at 36¹⁾, 43, 53²⁾, 60-64 69³⁾ and 77 years. Blood pressure at 53 and 60-64 years was measured twice, while the survey member was seated and after five minutes of rest. At age 69 it was measured three times under the same conditions. At age 77 blood pressure was measured twice standing – once at 1 minute after standing and then at 3 minutes after standing.

At each age, the final blood pressure reading was used for analysis unless it was unavailable, when a previous measure was used. This was done for both SBP and DBP.

At each interview survey members were also asked whether they had taken any prescribed medicines or tablets for high blood pressure in the last year.

Variable names for the main blood pressure measurements can be seen below.

As a child, the school doctor examination recorded whether there was any irregularities in the study member’s heart beat or murmurs at each of the four examinations conducted (in 1952, 1953, 1957 and 1961). A record was also made if the study member had received any treatment for heart trouble in these examinations. In 1957 and 1961 the doctors were specifically asked if the study member showed any signs of rheumatic heart disease.

In 1982 and 1989, study members were asked if they or their mother or father had ever had heart trouble.

In 1999, 2006-10 and 2014-16, the questions separated heart attacks from other heart trouble (such as coronary thrombosis, myocardial infarction, valvular disease, aortic stenosis, ischaemic heart disease, tachycardia, palpitations or heart murmur).

In 1982, study members were asked if they or their mother or father had ever had a stroke.

In 1989 more detailed questions about strokes were asked including the age of their first and their most recent stroke, whether they had consulted a doctor and whether they were taking any medication. In 1999 this information was updated to cover the period 1989 to 1999.

Longitudinal variables have been derived to show if the study member had a ‘diagnosed stroke’, an undiagnosed stroke or never had a stroke.

In 1999, 2006-10, and 2014-16, study members were asked if they had ever had a heart attack and if so how many, who had diagnosed it, as well as the age of the first and most recent heart attack.

In 2022-24, study members were asked “since your 68th birthday have you been told by a doctor that you have had a heart attack (myocardial infarct/coronary thrombosis)?”, how many heart attacks they had since 68^th birthday and the date of the first of these.

Longitudinal variables covering all years up to 2016 have been derived to show doctor diagnosis of the most common CV conditions over the life course to date. The conditions covered are:

• Angina
• High blood pressure
• Diabetes (see standalone topic guide)
• Heart failure
• Heart attack (MI)
• Stroke

The Rose Angina battery of questions was asked in 1989 and 1999. There are three scales derived: stage 1, stage 2 and a combined variable.

Stage 1 Rose Angina

• If Study member has ever had any pain or discomfort in their chest then all of the following conditions must be met:
• The pain must be in the Sternum (upper and middle) or Sternum (lower), left anterior chest or the left arm;
• They must get the pain when walking uphill or in a hurry but not when walking at an ordinary pace on the level;
• That pain is relieved in 10 minutes or less when they stand still.

Stage 2 Angina

• If Study member has ever had any pain or discomfort in their chest then all of the following conditions must be met:
• The pain must be in the Sternum (upper and middle) or Sternum (lower), left anterior chest or the left arm;
• They must get the pain when walking at an ordinary pace on the level;
• That pain is relieved in 10 minutes or less when they stand still.

Overall Rose Angina

• This is the sum of stage 1 and 2.

In 1999, 2006-10, and 2014-16 study members were asked directly if they had been told by a doctor that they had angina. For 1999 and 2014-16, they were subsequently asked at what age they were diagnosed, what medication they took and how often they consulted a doctor. For 2022-24, study members were asked “since your 68^th birthday have you been told by a doctor that you have angina?” and the age when they were told.

Diagnostic Intermittent claudication questions were asked in 1999, and the relevant variables derived.

Intermittent claudication is defined by

• getting pain in either leg on walking combined with the leg pain not beginning when standing still or sitting
• the pain being felt in the calf
• the pain being present when walking uphill or in a hurry or pain being felt when walking at an ordinary pace on the level
• and the pain not disappearing whilst walking
• the study member stops or slows down when pain felt whilst walking,
• and the pain is relieved when standing still in less than 10 minutes

As part of the 2006-10 data collection, wave 2 and 3 of Insight 46 and MyoFit46, a number of cardiological scans and other measurements were performed, including ECG, Heart Rate Variability (HRV), Pulse Wave Velocity / Analysis (PWV/PWA), ECHO and IMT. A great deal of data resulted from these investigations, so please search Skylark and then contact us if you wish to use these specialist datasets.

Further information on the cardiometabolic Health research programme is available on the public LHA website.