We owe a lot to the residents of the small community of Bogalusa, Louisiana, and a dedicated physician whose work has greatly advanced our knowledge about the natural history of heart disease and hypertension. For over three decades, renowned cardiologist Gerald Berenson and his team of researchers have conducted the world's longest-running study of cardiovascular risk factors in children, adolescents, and young adults living in a diverse, free-standing, and biracial community. And in the process, the Bogalusa Heart Study has yielded invaluable insights into risk factors now considered common knowledge.
"We have an unprecedented wealth of knowledge about the lifestyle, dietary habits, and cardiovascular risk factors of this population," noted Dr. Berenson, director of the Tulane Center for Cardiovascular Health and founder of the study. "Very clearly, adult heart disease, hypertension, type 2 diabetes, and obesity begin in childhood. We know how to study risk factors in children, and we have an understanding that lifestyles begin in childhood. Most of all, we've learned the importance of prevention. As the majority of the population grows older, study of the aging process and longevity becomes increasingly important from a public-health perspective."
In 1972, with funding from the National Heart, Lung, and Blood Institute of the NIH, Berenson's team began tracking the health histories of the over 17,000 children and young adults who have become part of the study. Using a multidisciplinary approach, researchers began analyzing blood samples, measuring blood pressure, assessing height and weight, and interviewing the children and parents about food and lifestyle choices--yielding a vast treasure of data that have been included in over 700 publications and numerous books.
"Our initial study screened about 4,000 children to age 14," Berenson says. "We found high cholesterol levels even in preschool children. The object of this project was to study all the kids that we could in Bogalusa to make a complete community study--one of only two in the country that I am aware of. What makes Bogalusa unique is that we have a biracial community, with 35 percent African-American participants. Thirty years ago, we knew that there were gender and racial contrasts, and our study now supports that finding. The African-American population tends to have higher blood pressure and diabetes, while young to middle-aged white men tend to express early coronary disease."
Dr. Berenson's findings prove even more relevant today in light of the dramatic increase in obesity among youth and adults. While many adults believe overweight children are simply passing through a "phase" and will eventually outgrow youthful obesity, studies suggest a much different conclusion. Bogalusa researchers have found evidence of coronary heart disease and arteriosclerosis in very young children. Unfortunately, early patterns tend to persist throughout life. Of importance, risk tactors like obesity, bad cholesterol (LDL), and even high blood pressure are predictive of adult levels.
"Looking at height and weight, we see that overweight children tend to be obese in adulthood," Dr. Berenson explains. "The message from Bogalusa is: our population has an epidemic of obesity, an epidemic of coronary artery disease. Kids are getting fatter, and there is much less exercise. Much of it relates to the pace of modern society, the availability of food, changes in diet, and increased inactivity."
The ongoing study also demonstrates that risk factors emerge in groups, leading to more serious chronic diseases later in life. …