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The Whitehall study is a 40-year follow-up for cause-specific mortality of 19,000 men who worked in the civil service in central London in 1968-1970. It is a collaborative study between CTSU, London School of Hygiene and Tropical Medicine and University College London Medical School. Repeat questionnaires were obtained from 8500 surviving participants in 1997. Repeat measures of blood pressure, body weight, height and a blood sample were obtained on 5400 (77% of respondents) in 1997. Currently, about 15,000 (~70%) of the cohort have died and cardiovascular disease (CVD) accounts for half of all deaths.

The study has provided important information on changes in CVD risk factors between middle and old age and on the long-term within-person variability in CVD risk factors between middle and old age. Moreover, differences in in old age of plasma biomarkers, including lipids, biomarkers of inflammation (CRP, fibrinogen and albumin), cystatin C, 25-hydroxyvitamin D and plasma phospholipid fatty acids also strongly predict mortality from CVD in old age.

The age-standardised mortality ratios from CVD in the UK have declined steadily over the last few decades and we are using the prolonged follow-up of the Whitehall study to understand such changes.  We are assessing how secular trends in CVD mortality rates are reflected in age-specific patterns of sub-types of CVD over the last 4 decades.  In addition, preliminary work on risk scores, combining the effects of established CVD risk factors predict 14-year differences in life expectancy. Hence, current work is also addressing the importance of classical CVD factors for lifetime risk of CVD and life expectancy.

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