Globally cardiovascular diseases (CVD) account for about 18 million deaths each year, including 4 million in China. In recent decades, death rates from CVD have declined significantly in most Western populations, but increased steadily in China. Previous work in CKB has confirmed the importance of conventional risk factors such as smoking, blood pressure, blood lipids and diabetes for CVD in Chinese adults, but also highlighted many unexplained differences in the incidence of CVD types and subtypes both between Chinese and Western populations, and within different regions of China.
Building on our previous research, we plan to continue to study the causal relevance of conventional and novel non-genetic and genetic risk factors in the aetiology of CVD and CVD types and to clarify biological mechanisms underlying these associations.
Our ongoing and planned work includes the following objectives:
- to collect additional information from medical records to characterise subtypes of ischaemic heart disease (IHD), heart failure and pulmonary heart disease to enhance our understanding of risk factors, natural history and prognosis of CVD types;
- to develop risk scores for the prediction of CVD, IHD and stroke types (including ischaemic stroke subtypes) and assess their relevance for guiding the implementation of population and high-risk strategies for the prevention of CVD;
- to examine, the causes and consequences of heart rate variability, left ventricular hypertrophy, arrhythmias and ischaemic changes and their predictive value for incident IHD and other CVDs using the available ECG records in CKB and genetic data;
- to investigate the associations of novel proteomic markers with risk of IHD and to identify novel biomarkers for risk prediction and potentially modifiable targets for treatment and prevention of IHD;
- to compare the genetic architecture of CVD in Europeans with that in Chinese adults and to evaluate the utility of polygenic risk scores derived in Europeans for Chinese adults.
To address these research questions, we will also use data from other biobanks (e.g. UK Biobank) and will participate in worldwide genetic consortia (e.g. CARDIoGRAMplusC4D, Polygenic Score Catalogue and GIGASTROKE).