Karachi: Pakistan's first comprehensive study on heart disease risk, which suggests that the roots of cardiovascular conditions are planted during adolescence and young adulthood, is set to reshape the understanding of heart health in the country. The study, published in Progress in Cardiovascular Diseases, highlights a shift from viewing heart disease as a middle and older age issue, to considering earlier life stages as critical periods for intervention.
According to Aga Khan University, the study, titled 'Longitudinal study of cardiovascular-kidney-metabolic syndrome risk assessment among adolescents and young adults (10-45 years) in Pakistan (LIFECARD)', is a pioneering effort to track the progression of heart and metabolic health over time in young populations. The research, led by AKU researchers with both national and international collaborators, began enrolling participants in November 2024 at a peri-urban site in Karachi and later at a rural site in Matiari, with full enrolment anticipated by late 2026.
Pakistan's high heart disease rates in South Asia are primarily informed by snapshot studies. LIFECARD seeks to provide a longitudinal perspective by following adolescents aged 10-20 and adults aged 21-45 over at least a decade. This approach aims to uncover how risk factors for cardiovascular, kidney, and metabolic conditions develop and interact over time. The study balances participant enrolment by sex, enhancing its capacity to explore sex-specific risk variations.
The research addresses a significant gap in the current understanding of health risks in Pakistan, a nation with a median age of around 21 years. As the young population ages, chronic disease prevalence is expected to rise. Early identification and prevention of risk factors through lifestyle changes and early treatment present a crucial opportunity to mitigate future health burdens.
LIFECARD's integrated research model stands out by examining interconnected health issues—heart disease, diabetes, obesity, and kidney problems—as part of the cardiovascular kidney metabolic syndrome. This comprehensive approach accounts for a range of influencing factors, such as diet, physical activity, pollution, stress, and genetics, offering a holistic view of disease development.
As the study progresses, it will provide insights into the prevalence and progression of health risks, the onset of harmful conditions like high blood pressure, and the most perilous risk combinations. Additionally, it will probe less-studied areas, including early artery damage, pollution exposure, mental health effects, pregnancy-related risks, and genetic-environment interactions.
Dr. Salim S. Virani, the Principal Investigator and Professor of Medicine at AKU, emphasizes the study's goal of not just identifying risks but informing actionable interventions at critical life stages. The findings are expected to guide early screening, community prevention programs, and policy initiatives, particularly those addressing air quality, while serving as a model for similar contexts in low- and middle-income countries.
By focusing on early risk factors, LIFECARD aims to transform Pakistan's heart health challenge from an impending crisis into an opportunity for early action, potentially improving health outcomes for future generations.