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Title: Aragon workers' health study - design and cohort description

Author
item CASASNOVAS, JOSE - Aragon Institute
item ALCALDE, VICTOR - General Motors
item CIVEIRA, FERNANDO - Aragon Institute
item GUALLAR, ELISEO - National Center For Cardiovascular Research(CNIC)
item IBANEZ, BORJA - National Center For Cardiovascular Research(CNIC)
item JIMENEZ-BORREGUERO, JESUS - National Center For Cardiovascular Research(CNIC)
item LACLAUSTRA, MARTIN - National Center For Cardiovascular Research(CNIC)
item LEON, MONTSERRAT - National Center For Cardiovascular Research(CNIC)
item ORDOVAS, JOSE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item POCOVI, MIGUEL - University Of Zaragoza
item SANZ, GINES - National Center For Cardiovascular Research(CNIC)
item FUSTER, VALENTIN - National Center For Cardiovascular Research(CNIC)

Submitted to: BioMed Central - Cardiovascular Disorders
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 5/23/2012
Publication Date: 6/19/2012
Citation: Casasnovas, J.A., Alcalde, V., Civeira, F., Guallar, E., Ibanez, B., Jimenez-Borreguero, J., Laclaustra, M., Leon, M., Ordovas, J.M., Pocovi, M., Sanz, G., Fuster, V. 2012. Aragon workers' health study - design and cohort description. BioMed Central - Cardiovascular Disorders. 12(1):45.

Interpretive Summary: We designed the Aragon Workers' Health Study (AWHS) to characterize the factors associated with metabolic abnormalities and subclinical hardening of the arteries in a middle aged population in Spain free of clinical cardiovascular disease. The objective of this paper is to describe the study design, aims and baseline characteristics of the 5,400 General Motors workers participating in the AWHS. Study participants will undergo annual clinical exams and laboratory assays, and baseline and triennial collection of biological materials for biobanking and cardiovascular imaging exams (carotid, femoral and abdominal ultrasonography, coronary calcium score, and ankle-arm blood pressure index). Participants will have follow-up for 10 years. So far, the baseline data from the AWHS show a high prevalence of cardiovascular risk factors and of subclinical hardening of the arteries. Follow-up of this cohort will allow the assessment on the progression of subclinical hardening of the arteries and the link of disease progression to traditional and emergent risk factors.

Technical Abstract: Spain, a Mediterranean country with relatively low rates of coronary heart disease, has a high prevalence of traditional cardiovascular risk factors and is experiencing a severe epidemic of overweight/obesity. We designed the Aragon Workers' Health Study (AWHS) to characterize the factors associated with metabolic abnormalities and subclinical atherosclerosis in a middle aged population in Spain free of clinical cardiovascular disease. The objective of this paper is to describe the study design, aims and baseline characteristics of participants in the AWHS. Longitudinal cohort study based on the annual health exams of 5,400 workers of a car assembly plant in Figueruelas (Zaragoza, Spain). Study participants were recruited during a standardized clinical exam in 2009-2010 (participation rate 95.6%). Study participants will undergo annual clinical exams and laboratory assays, and baseline and triennial collection of biological materials for biobanking and cardiovascular imaging exams (carotid, femoral and abdominal ultrasonography, coronary calcium score, and ankle-arm blood pressure index). Participants will be followed-up for 10 years. The average (SD) age, body mass index, and waist circumference were 49.3 (8.7) years, 27.7 (3.6) kg/m2and 97.2 (9.9) cm, respectively, among males (N = 5,048), and 40.8 (11.6) years, 24.4 (3.8) kg/m2, and 81.9 (9.9) cm, among females (N = 351). The prevalence of overweight, obesity, current smoking, hypertension, hypercholesterolemia, and diabetes were 55.0, 23.1, 37.1, 40.3, 75.0, and 7.4%, respectively, among males, and 23.7, 8.3, 45.0, 12.1, 59.5, and 0.6%, respectively, among females. In the initial 587 study participants who completed all imaging exams (94.5% male), the prevalence of carotid plaque, femoral plaque, coronary calcium score greater than 1 to 100, and coronary calcium score greater than 100 was 30.3, 56.9, 27.0, and 8.8%, respectively. 67.7% of study participants had at least one plaque in the carotid or femoral arteries. Baseline data from the AWHS show a high prevalence of cardiovascular risk factors and of subclinical atherosclerosis. Follow-up of this cohort will allow the assessment of subclinical atherosclerosis progression and the link of disease progression to traditional and emergent risk factors.