Cardiovascular (CV) diseases, largely driven by high blood pressure (BP), are a major global health issue. Recognizing the early roots of CV diseases, this research introduces a multidisciplinary approach to BP across life course. Combining novel genetic, epigenetic, and life-course epidemiological methodologies, the study is strategically divided into four aims using data from the Cardiovascular Risk in Young Finns Study (aims 1 & 3), the Special Turku Coronary Risk Factor Intervention Project (STRIP) (Aim 2), and the MULTIEPIGEN cohort (Aim4).

Aim 1: Assessment of natural BP (normal, elevated, hypertensive) transition across various life stages, offering a perspective on the longitudinal impact of BP fluctuations on CV risk. Comparing cumulative BP measurements and BP change rates, enhancing our predictive capabilities for future CV events based on BP trajectories. Our novel approach seeks to establish how BP exposure at various life stages associates with CV events, identifying critical periods where BP is most strongly associated with future CV risks, thereby pinpointing potential optimal windows for targeted CV prevention.

Aim 2: In an unprecedented approach, this aim evaluates the long-term effects of early-life interventions on BP patterns. We also investigate predictors of individual responses, underscoring the potential for personalized BP management starting in infancy.

Aim 3: This aim delves into unexplored areas by examining the life-stage specific effects of BP-associated genetic risk scores and their interplay with lifestyle factors during youth. It evaluates the predictive power of these genetic factors for CV events independent of traditional BP measurements, offering novel insights into the genetic basis of CV disease.

Aim 4: A pioneering exploration into the transmission of BP traits and the role of epigenetics across generations, this aim aims to unravel the complex mechanisms of BP heritability and regulation, a significant leap in understanding familial and epigenetic aspects. Altogether, this multi-faceted approach provides the best evidence on life-course BP and CV risk and paves the way for revolutionary changes in BP management and CV risk prevention, potentially transforming clinical practices and policy guidelines.