Institute of Epidemiology & Health Care


British Regional Heart Study (BRHS)

The British Regional Heart Study (BRHS) is a long-term cohort investigating the causes of cardiovascular disease (CVD) in men and seeking to understand the effect of co-morbidities on CVD & ageing.  The BRHS provides a geographically and socially representative cohort for the prospective investigation of CVD in British men spanning over four decades. Established in 1978-80, with 7735 male participants, the BRHS study has benefited from four repeated assessments of the men at ages in middle (40-59 years) and later life (60-79, 72-91 and 79-98 years). Participants have been followed up at four life stages for a wide range of health outcomes, including all-cause mortality and CVD morbidity, physical disability and frailty using GP records and participant questionnaires. This unique ageing cohort with extensive phenotyping, genotyping and detailed follow-up will contribute and allow us to study healthy cardiovascular ageing including prevention of CVD, heart failure, stroke, diabetes and related disabilities (frailty, dementia) in older age and to add to our understanding of the biological ageing process on CVD risk.


Research from the BRHS provides scientific-based evidence and knowledge for clinical guidelines and policy in the management and prevention of CVD. Our research goes beyond CVD prevention and tries to look at strategies to improve the health of older people generally.  We are looking at reducing co-morbidity related to CVD, such as frailty and dementia.  Our recent research has...

  • identified several determinants of heart failure including adverse socioeconomic factors, airway obstruction, nutritional status and excessive sleep. 
  • established the importance of body composition  (obesity and sarcopenia) in CVD.
  • identified dietary and physical activity and sedentary patterns  as well as trajectory patterns from middle-age to older age associated with CVD risk and mortality. 
  • investigated how CVD risk is related to health challenges in later life including mobility limitation, frailty, cognitive impairment, oral health and hearing impairment.
  • pioneered the use of  scoring systems for estimating risk of major cardiovascular events, draws attention to the value of regular moderate physical activity in the prevention of cardiovascular disease and the role of overweight and obesity in the origin of cardiovascular disease and diabetes mellitus. It continues to examine the role of many of the 'newer' risk factors for cardiovascular disease and provides material for the estimation of trends in the incidence and prevalence of coronary heart disease.


British Regional Heart Study cohort profile

Three key papers detailing the cohort profile have been published (see below).  These papers provide a description of the study and the follow-up over forty years.

  1. The British Regional Heart Study 1975-2004. Walker M, Whincup PH, Shaper AG. International Journal of Epidemiology, Volume 33, Issue 6, December 2004, Pages 1185–1192, https://doi.org/10.1093/ije/dyh295
  2. Cohort Profile Update: The British Regional Heart Study 1978–2014: 35 years follow-up of cardiovascular disease and ageing. Lennon LT, Ramsay SE, Papacosta O, Shaper AG, Wannamethee SG, Whincup PH. International Journal of Epidemiology, Volume 44, Issue 3, June 2015, Pages 826–826g, https://doi.org/10.1093/ije/dyv141
  3. Cohort Profile Update: The British Regional Heart Study 1978–2018: 40 years of follow-up of older British men. Kimble R, McLellan G, Lennon LT , Papacosta AO, Mathers JC, Wannamethee SG, Whincup PH,  Ramsay SE. International Journal of Epidemiology, 2022, 1–8.   https://doi.org/10.1093/ije/dyac122



The study has been funded by major grants from:  British Heart Foundation (BHF), Medical Research Council (MRC), The Dunhill Medical Trust and National Institute for Health Research (NIHR)