2009 Distinguished Scientist Lecture—Highlights of Hormones and Heart Disease: Forty Years in Forty Minutes: The Rancho Bernardo Study
The Rancho Bernardo Study began in 1972 as one of 12 Lipid Research Clinic Prevalence Studies sponsored by the National Heart Institute. Each site was allowed to select its own epidemiologist, who could then select a cohort of 5000 to 6000 individuals. I was given the great opportunity to choose the San Diego LRC cohort. I chose Rancho Bernardo for several reasons, of which perhaps the most important was that it was a new town with many “old people” over the age 50 years. Beyond any expectation, Rancho Bernardo is now in its fortieth year of continuous funding from the NIH, plus intermittent and critically important additional grants to junior faculty and visiting scholars from the American Heart Association.
In the beginning, I knew little about cohort studies or heart disease epidemiology. I did know that heart disease had 6 accepted risk factors: age, male sex, cholesterol, smoking, blood pressure, and diabetes. Every clinician knew male sex was a strong heart disease risk factor, but clinical studies of sex differences were few. The LRC had not planned to study diabetes, which “belonged to another institute,” but I managed to add fasting glucose and 2 pages about noncholesterol risk factors, including diabetes, to the baseline 2-page questionnaire. During the next 40 years, that small beginning allowed me and many new colleagues the opportunity to try to understand the interface between sex differences in coronary heart disease and diabetes.
This talk summarizes cardiovascular insights based on epidemiological data from the Rancho Bernardo Study. I am grateful to the many scholars at diverse levels of training who began their careers using Rancho Bernardo data and the many who continue to do so.