Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): Objectives and Design

TLDR

In low‑ and middle‑income countries, chronic non‑communicable diseases are rising amid rapid demographic, epidemiologic, and nutritional transitions, yet data on their incidence, social determinants, and risk factors remain scarce. ELSA‑Brasil seeks to generate comprehensive information on the development and progression of clinical and subclinical chronic diseases, particularly cardiovascular disease and diabetes. The study enrolled 15,105 civil servants from five universities and one research institute, conducting a 2008–2010 baseline examination that included interviews, clinical and anthropometric assessments, glucose tolerance testing, urine collection, ECG, carotid intima‑media thickness, echocardiography, pulse‑wave velocity, hepatic ultrasound, retinal photography, heart‑rate variability analysis, and will maintain a biobank and annual telephone surveillance with a follow‑up exam in 2012–2013.

Abstract

Although low- and middle-income countries still bear the burden of major infectious diseases, chronic noncommunicable diseases are becoming increasingly common due to rapid demographic, epidemiologic, and nutritional transitions. However, information is generally scant in these countries regarding chronic disease incidence, social determinants, and risk factors. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) aims to contribute relevant information with respect to the development and progression of clinical and subclinical chronic diseases, particularly cardiovascular diseases and diabetes. In this report, the authors delineate the study’s objectives, principal methodological features, and timeline. At baseline, ELSA-Brasil enrolled 15,105 civil servants from 5 universities and 1 research institute. The baseline examination (2008–2010) included detailed interviews, clinical and anthropometric examinations, an oral glucose tolerance test, overnight urine collection, a 12-lead resting electrocardiogram, measurement of carotid intima-media thickness, echocardiography, measurement of pulse wave velocity, hepatic ultrasonography, retinal fundus photography, and an analysis of heart rate variability. Long-term biologic sample storage will allow investigation of biomarkers that may predict cardiovascular diseases and diabetes. Annual telephone surveillance, initiated in 2009, will continue for the duration of the study. A follow-up examination is scheduled for 2012–2013.