A 10-year Isfahan cohort on cardiovascular disease as a master plan for a multi-generation non-communicable disease longitudinal study: methodology and challenges

A 10-year longitudinal population-based study entitled Isfahan Cohort Study (ICS) was conducted in 2001-2011 with cardiovascular disease (CVD) as the primary outcome. We considered ICS as a master plan for a multi-level non-communicable disease (NCD) study named Isfahan Cohort Study 2 (ICS2). ICS2 is a multi-generation 10-year cohort study with new goals and outcomes that have been started in 2013, recruiting a sub-sample of ICS (n = 1487) and a new recruited sample (n = 1355) aged 35 years and over, all living in urban and rural areas of two counties in central Iran. In addition, 2500 of participant's adult children were selected randomly, as well as 1000 of their grandchildren. The aim of ICS2 is to detect the incidence of some NCDs including CVD, cancers, and diabetes and to identify the impact of their behavioral, metabolic, environmental, and genetic risk factors. In addition, studying lifestyle behaviors in three generations in a hierarchical manner of parents, their children and grandchildren in ICS2 will improve our knowledge on other determinants such as epigenetics of NCDs.