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Fifty years ago, in the fall of 1973, in the rural Louisiana town of Bogalusa, a groundbreaking study began that would change the world’s understanding of heart disease.
The Bogalusa Heart Study, which tracked the health of the town’s children into adulthood, was the first to find that heart disease begins in childhood.
This community-wide study pioneered a new approach to pediatrics by demonstrating that high blood pressure and high cholesterol in children do not improve with age without intervention, potentially leading to future hypertension and heart disease. One of the longest-running interracial health studies in the world, it was also one of the first to identify race-based health disparities between black and white participants.
“This study has had a global impact on medicine and has left an enormous legacy in public health,” said Lidia Bazzano, principal investigator of the Bogalusa Heart Study and director of the Center for Lifespan Epidemiology Research in the Tulane University School of Public Health and Tropical Medicine. “We’ll never have a clinical trial that proves that early childhood interventions lead to improvements 40 to 50 years later. This is the best evidence we have, and we don’t know if we’ll ever see a study like this again.”
This fall, Tulane University is celebrating 50 years of groundbreaking research from the Bogalusa Heart Study and looking ahead to what the next 50 years of this work can accomplish.
The Bogalusa Heart Study, in collaboration with researchers from Louisiana State University’s Pennington Biomedical Research Center and Mary Bird Perkins Cancer Center, received a $14.5 million grant from the National Institute on Aging in 2019 to investigate whether high blood sugar in childhood leads to poor brain health later in life.
Bazzano said he believes Bogalusa, with its current middle-aged participants, can “do for brain health in the next 50 years what we did for heart health in the last 50 years.”
“It all starts with the heart,” says Bazzano, “and the brain is one of the first places the blood leaves the heart, so it makes sense to explore how vascular aging affects the brain.”
Early results showed that participants who performed poorly on neuropsychological tests previously exhibited more risk factors for heart disease. Brain scans of middle-aged participants showed white matter brain lesions in those who had slightly higher blood sugar levels as young adults. These lesions, called white matter hyperintensities, indicate that not enough oxygen and nutrients are reaching the brain’s smallest blood vessels and are associated with decreased cognitive function.
Researchers are also working to identify blood biomarkers for dementia, in the hope that in the future, a blood test may be able to identify dementia risk.
“Just like we don’t think heart disease starts in childhood, we don’t think dementia starts in early middle age,” Bazzano said. “This could have a revolutionary impact on the field.”
The Bogalusa Heart Study has enrolled more than 16,000 participants since it was started by pediatric cardiologist and Tulane graduate Dr. Gerald Berenson, and the data collected continues to be important for research on nutrition, childhood obesity and genetic risk factors.
The longevity of the Bogalusa Heart Study is due in large part to the dedication of its researchers, but its historic achievements may have ended long ago if the research had not become so deeply rooted in the community.
Bogalusa native and former police chief Joe Culpepper was 11 years old when he first began undergoing health screenings with 5,000 other children in 1973. A long white trailer loaded with lab equipment arrived at his elementary school. Researchers put the students into groups and fitted them with colorful wool bracelets. Their blood pressure was taken, their weight was measured, their blood was drawn.
Testing continued for several years, but Culpepper never expected the global impact his findings would have.
“I still go for testing, one of my brothers is still actively involved, some of our friends from Baton Rouge come back to Bogalusa from time to time to participate, and my sister-in-law now runs the lab,” Culpepper says. “We’re all very proud of this research, and we hope that the medical knowledge we gain from a lifetime of studying people like us will make things better for children yet to come.”
Two of the current employees at the Bogalusa Heart Lab are former participants in the study. Another, Phyllis Cothern, has been working as a research technician for 10 years, succeeding her mother, who began working on the study when the pilot project was underway in 1972. Cothern’s two daughters and granddaughter are now study participants.
“We depend on the community and the community depends on us. The extent to which this research has benefited the community is overwhelming and I am honored to be part of its legacy,” Cothern said.
Joe Culpepper was 11 years old when he began participating in the Bogalusa Heart Study. Fifty years later, he’s still getting screened. (Photo by Sabry Hill)
