Combining longitudinal cohort studies to examine cardiovascular risk factor trajectories across the adult lifespan

Abstract

We introduce a statistical framework for combining data from multiple large longitudinal cardiovascular cohorts to enable the study of long-term cardiovascular health starting in early adulthood. Using data from seven cohorts belonging to the Lifetime Risk Pooling Project (LRPP), we present a Bayesian hierarchical multivariate approach that jointly models multiple longitudinal risk factors over time and across cohorts. Because few cohorts in our project cover the entire adult lifespan, our strategy uses information from all risk factors to increase precision for each risk factor trajectory and borrows information across cohorts to fill in unobserved risk factors. We develop novel diagnostic testing and model validation methods to ensure that our model robustly captures and maintains critical relationships over time and across risk factors. Our modeling reveals substantial age-related variation in risk factor trajectories, with patterns that differ across life stages, subgroups, and cohorts, thereby highlighting key periods for cardiovascular prevention and monitoring. Keywords: Bayesian hierarchical models; Missing data; Model validation; Multiple imputation; Random effects.