The Bogalusa Heart Study is the longest and most detailed study of a biracial (black-white) population of children in the world. The focus is on understanding the early natural history of coronary artery disease and essential hypertension. It is the only major program studying a total and geographically well-defined, biracial, and semi-rural community.
The most impressive accomplishments of the Bogalusa Heart Study can be summarized as follows:
• Observations clearly show that the major etiologies of adult heart disease, atherosclerosis, coronary heart disease, and essential hypertension begin in childhood. Documented anatomic changes occur by 5 to 8 years of age.
• C V risk factors can be identified in early life. Methods to study C V risk factors are now developed, and normative values from a large biracial (black-white) population (approximately 10,000 individuals) are available for comparison.
• The levels of risk factors in childhood are different than those in the adult years. Levels change with growth phases, i.e. in the first year of life, during puberty and adolescence, in the transition to young adulthood and in adulthood. National Institute on Aging is now funding observations related to aging and longevity.
• Autopsy studies show atherosclerotic lesions in the aorta and coronary vessels, and changes in the kidney vasculature relate strongly to clinical C V risk factors, clearly indicating atherosclerosis and hypertension begin in early life. Imaging studies of the heart, carotid and femoral arteries are extending these findings.
• Gender and race contrasts are a major contribution to the research findings. It is well known blacks have more and a severer form of hypertension, more diabetes, white males early coronary artery disease, and women show a lag in the development of heart disease. Subtle changes of aging are reflecting a life long burden of C V risk factors.
• Environmental factors are significant and influence dyslipidemia, hypertension, and obesity. Those that are controllable include diet, exercise, and cigarette smoking.
• Lifestyles and behaviors that influence C V risk are learned and begin early in life. Healthy lifestyles should be adopted in childhood, because they are critical to modulation of risk factors later in life. Primary care physicians, pediatricians and cardiologists can play a major leadership role in the prevention of adult heart diseases beginning in childhood. Physicians are encouraged to obtain risk factor profiles on children, along with a family history of heart disease.