Study Title
Investigation of Cardiovascular Health and Risk Factors Among the Diverse and Contemporary Population in London (the TOGETHER Study): Protocol for Linking Longitudinal Medical Records.
Principal Investigator
Kanika Dharmayat, Maria Woringer, Nikolaos Mastellos, Della Cole, Josip Car, Sumantra Ray, Kamlesh Khunti, Azeem Majeed, Kausik K Ray, Sreenivasa Rao Kondapally Seshasai.
Affiliation
Imperial College London, St George's University of London, University of Cambridge, University of Leicester.
Start Date
January 2019.
End Date
Data collection anticipated to end by 2020.
Study Objective
To quantify and characterize the burden of cardiovascular disease (CVD) risk factors across diverse ethnic and sociodemographic groups in London, and to develop and validate bespoke risk prediction models using linked electronic health records (EHRs).
Short Abstract
This study aims to address the gaps in understanding of cardiovascular health across diverse ethnic populations in London by linking longitudinal medical records from the NHS Health Check program with secondary care data. The study will develop tailored CVD risk prediction tools to inform public health policy and improve healthcare delivery across ethnic groups.
Study Design
The study is designed as a large-scale cross-sectional observational study with subsequent prospective CVD ascertainment through longitudinal follow-up of linked EHR data.
Population
Approximately 200,000 individuals attending NHS Health Checks in general practices across London, particularly from ethnically diverse groups.
Sample Size
200,000 individuals across London (estimate based on the NHS Health Check program data from 2009 to 2018).
Inclusion Criteria
Adults aged 40–74 years without pre-existing cardiovascular disease, diabetes, or hypertension attending NHS Health Checks.
Exclusion Criteria
Individuals with pre-existing CVD, diabetes, or hypertension.
Intervention/Exposure
Routine clinical data collected through NHS Health Checks linked with secondary care data (e.g., hospital admissions, mortality data).
Outcome Measures
- Incidence of cardiovascular disease
- Cardiovascular risk factor burden across ethnic groups
- Validation and development of new CVD risk prediction models.
Funding Source
Supported by the National Institute for Health Research (NIHR) and an unrestricted investigator-initiated grant from Regeneron Pharmaceuticals.
Collaborating Institutions
Imperial College London, St George's University of London, University of Cambridge, University of Leicester.
Ethics Approval
Approved by the East Scotland Research Ethics Committee (Ref: 17-ES-0104) and Health Research Authority.
Publication Status
Protocol published in JMIR Research Protocols, 2020.
Keywords
Cardiovascular health, risk factors, electronic health records, NHS Health Check, ethnic diversity, longitudinal study.
Data Collection Methods
Routine clinical data from NHS Health Checks will be linked to hospital and mortality records to provide comprehensive information on CVD risk factors and outcomes across multiple ethnic groups.
Primary Data Availability
Data will be available for research purposes upon request, subject to relevant approvals.
Contact Information
Kanika Dharmayat, Imperial College London,