CClinicalTrials.gg
RecruitingNCT03225586PUREUpdated Jan 31, 2024

Prospective Urban Rural Epidemiology Study

An observational study in Cardiovascular Diseases, Risk Factor, Cardiovascular and Health Behavior, sponsored by Population Health Research Institute. Recruiting at 34 sites in 25 countries. Open to participants aged 35 Years to 70 Years. Per ClinicalTrials.gov, last updated 2024-01-31.

Sponsored by Population Health Research Institute · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
200,000
Ages
35 Years to 70 Years
Sex
All
01

Study summary

To examine the impact of health determinants at the individual (e.g. health related behaviors) and societal level (e.g. environmental factors, health related policy, quality of health systems) on health outcomes (e.g. death, non-communicable disease development) across a range of socioeconomic and health resource settings. Additional components of this study will examine genetic factors for non-communicable diseases. This will be examined both through a cross sectional component, and prospectively (cohort component).

Read the detailed description
  1. To examine the relationship between societal influences and prevalence of risk factors and chronic noncommunicable diseases. Societal determinants are measured by an index of measures from each of the 4 domains of interest: built environment, food and nutrition policy, psychosocial/socioeconomic factors, and tobacco.
  2. To examine the relationship between societal determinants and incidence of chronic noncommunicable disease events (e.g. cardiovascular disease, cancer) and on changes in rates of selected risk factors (e.g. smoking)
  3. To examine the relationship between health related behaviors (e.g. diet, physical activity, smoking, alcohol) and health outcomes (e.g. death, non-communicable diseases)
  4. The quality of health systems across a diverse range of health resource settings, and how this impacts health outcomes
  5. Genetic factors for non-communicable diseases
02

Conditions studied

  • Cardiovascular Diseases
  • Risk Factor, Cardiovascular
  • Health Behavior
  • Environmental Exposure
  • Lung Diseases
  • Cancer
  • Injuries
  • Renal Disease
  • Communicable Disease

Keywords

  • Non-communicable Diseases, Risk Factors
03

Who can participate

Ages eligible
35 Years to 70 Years
Sexes eligible
All
Sampling method
Non-probability sample

Study population

Adults aged 35 to 70 years from communities in low-, middle-, and high-income regions of the world representing various levels of development and encompassing great sociocultural diversity.

Inclusion criteria

  • consenting adults between 35-70 years of age

Exclusion criteria

Exclusion Criteria:

  • none
04

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
200,000 participants (estimated)
Patient registry
No
Biospecimen retention
Samples with dna

Groups and cohorts

  • Adults

    Between 35 to 70 years of age at time of enrollment

05

What researchers measure

Primary outcomes

  1. incident cardiovascular disease

    cardiovascular death, stroke, myocardial infarction, heart failure

    Time frame: mean follow up of 10 years

Secondary outcomes

  1. incident cancer

    total and cause specific cancers

    Time frame: mean follow up of 10 years

  2. Incident COPD

    development of COPD

    Time frame: mean follow up of 10 years

  3. Incident Asthma

    development of asthma

    Time frame: mean follow up of 10 years

  4. Pneumonia

    hospitalization for pneumonia

    Time frame: mean follow up of 10 years

  5. Respiratory outcomes

    change in pulmonary function test

    Time frame: mean follow up of 10 years

  6. All Cause Hospitalizations

    All cause hospitalizations

    Time frame: mean follow up of 10 years

  7. Kidney disease

    end stage renal disease, dialysis, transplant, changes in renal function

    Time frame: mean follow up of 10 years

  8. All cause and cause specific mortality

    death from all causes, and cause specific deaths

    Time frame: mean follow up of 10 years

  9. incident diabetes

    development of diabetes

    Time frame: mean follow up of 10 years

  10. obesity

    development of obesity, change in BMI

    Time frame: mean follow up of 10 years

  11. hypertension

    development of hypertension and changes in blood pressure

    Time frame: mean follow up of 10 years

  12. incident injuries

    assessing fatal and non-fatal injuries due road traffic accidents and falls

    Time frame: mean follow up of 10 years

06

Study locations

34 of 34 sites recruiting
  • Estudios Clinicos Latinoamerica ECLA
    Rosario, Santa Fe, Argentina
    Recruiting
  • Independent University, Bangladesh
    Dhaka, Bangladesh
    Recruiting
  • Dante Pazzanese Institute of Cardiology
    São Paulo, Brazil
    Recruiting
  • Simon Fraser University
    Vancouver, British Columbia, Canada
    Recruiting
  • Population Health Research Institute
    Hamilton, Ontario L8L2X2, Canada
    • Sandy Trottier · Contact · sandy.trottier@phri.ca · 905-521-2100
    • Koon Teo, MB, PhD · Principal investigator
    Recruiting
  • University of Ottawa
    Ottawa, Ontario K1H8L6, Canada
    Recruiting
  • Université Laval Institut universitaire de cardiologie et de pneumologie de Québec
    Quebec City, Quebec, Canada
    Recruiting
  • Universidad de La Frontera
    Temuco, Chile
    Recruiting
  • State Key Laboratory of Cardiovascular Disease, Fuwai Hospital
    Beijing, China
    Recruiting
  • Fundacion Oftalmologica de Santander - FOSCAL
    Floridablanca, Santander, Colombia
    Recruiting
  • St John's Research Institute
    Bangalore, Karnataka, India
    Recruiting
  • Health Action by People
    Thiruvananthapuram, Kerala, India
    Recruiting
  • Eternal Heart Care Centre and Research Institute
    Jaipur, Rajasthan, India
    Recruiting
  • Madras Diabetes Research Foundation
    Chennai, Tamil Nadu, India
    Recruiting
  • Post Graduate Institute of Medical Education and Research (PGIMER)
    Chandigarh, India
    Recruiting
  • Isfahan University of Medical Sciences
    Isfahan, Iran, Islamic Republic of
    Recruiting
  • Research Institute of Cardiology & Internal Diseases
    Almaty, Kazakhstan
    Recruiting
  • Kyrgyz Society of Cardiology, National Center of Cardiology and Internal Disease
    Bishkek, Kyrgyzstan
    Recruiting
  • Universiti Teknologi MARA, UCSI Universiti
    Kuala Lumpur, Malaysia
    Recruiting
  • University Kebangsaan Malaysia
    Kuala Lumpur, Malaysia
    Recruiting
  • Aga Khan University
    Karachi, Pakistan
    Recruiting
  • Birzeit University, Birzeit
    Ramallah, Palestinian Territory, occupied
    Recruiting
  • Universidad Peruana Cayetano Heredia
    Lima, Peru
    Recruiting
  • University of Philippines, Section of Adult Medicine & Medical Research Unit
    Manila, Philippines
    Recruiting
  • Wroclaw Medical University & Department of Internal Medicine
    Wrocław, Poland
    Recruiting
  • Research Institute for Complex Issues of Cardiovascular Diseases
    Kemerovo, Russian Federation
    Recruiting
  • King Saud University
    Riyadh, Saudi Arabia
    Recruiting
  • School of Public Health, University of the Western Cape
    Bellville, South Africa
    Recruiting
  • North-West University
    Potchefstroom, South Africa
    Recruiting
  • Sahlgrenska University Hospital/Östra Hospital
    Göteborg, Sweden
    Recruiting
  • Pamoja Tunaweza Women Center
    Moshi, Tanzania
    Recruiting
  • Istanbul Medeniyet University
    İstanbul, Turkey
    Recruiting
  • Dubai Medical University
    Dubai, United Arab Emirates
    Recruiting
  • University of Zimbabwe College of Health Sciences
    Harare, Zimbabwe
    Recruiting
07

References and documents

Publications

  • Dehghan M, Al Hamad N, Yusufali A, Nusrath F, Yusuf S, Merchant AT. Development of a semi-quantitative food frequency questionnaire for use in United Arab Emirates and Kuwait based on local foods. Nutr J. 2005 May 27;4:18. doi: 10.1186/1475-2891-4-18. PubMed 15921524 ↗
  • Merchant AT, Dehghan M, Chifamba J, Terera G, Yusuf S. Nutrient estimation from an FFQ developed for a Black Zimbabwean population. Nutr J. 2005 Dec 13;4:37. doi: 10.1186/1475-2891-4-37. PubMed 16351722 ↗
  • Merchant AT, Dehghan M. Food composition database development for between country comparisons. Nutr J. 2006 Jan 19;5:2. doi: 10.1186/1475-2891-5-2. PubMed 16423289 ↗
  • Vaz M, Bharathi AV, Thomas T, Yusuf S, Kurpad AV. The repeatability of self reported physical activity patterns in rural South India. Asia Pac J Clin Nutr. 2009;18(1):71-5. PubMed 19329398 ↗
  • Dehghan M, del Cerro S, Zhang X, Cuneo JM, Linetzky B, Diaz R, Merchant AT. Validation of a semi-quantitative Food Frequency Questionnaire for Argentinean adults. PLoS One. 2012;7(5):e37958. doi: 10.1371/journal.pone.0037958. Epub 2012 May 25. PubMed 22662256 ↗
  • Dehghan M, Martinez S, Zhang X, Seron P, Lanas F, Islam S, Merchant AT. Relative validity of an FFQ to estimate daily food and nutrient intakes for Chilean adults. Public Health Nutr. 2013 Oct;16(10):1782-8. doi: 10.1017/S1368980012004107. Epub 2012 Sep 21. PubMed 22995762 ↗
  • Dehghan M, Lopez Jaramillo P, Duenas R, Anaya LL, Garcia RG, Zhang X, Islam S, Merchant AT. Development and validation of a quantitative food frequency questionnaire among rural- and urban-dwelling adults in Colombia. J Nutr Educ Behav. 2012 Nov-Dec;44(6):609-13. doi: 10.1016/j.jneb.2010.10.001. Epub 2011 Jul 7. PubMed 21737352 ↗
  • Khatib R, Schwalm JD, Yusuf S, Haynes RB, McKee M, Khan M, Nieuwlaat R. Patient and healthcare provider barriers to hypertension awareness, treatment and follow up: a systematic review and meta-analysis of qualitative and quantitative studies. PLoS One. 2014 Jan 15;9(1):e84238. doi: 10.1371/journal.pone.0084238. eCollection 2014. PubMed 24454721 ↗
  • Teo K, Chow CK, Vaz M, Rangarajan S, Yusuf S; PURE Investigators-Writing Group. The Prospective Urban Rural Epidemiology (PURE) study: examining the impact of societal influences on chronic noncommunicable diseases in low-, middle-, and high-income countries. Am Heart J. 2009 Jul;158(1):1-7.e1. doi: 10.1016/j.ahj.2009.04.019. PubMed 19540385 ↗
  • Chow CK, Lock K, Teo K, Subramanian SV, McKee M, Yusuf S. Environmental and societal influences acting on cardiovascular risk factors and disease at a population level: a review. Int J Epidemiol. 2009 Dec;38(6):1580-94. doi: 10.1093/ije/dyn258. Epub 2009 Mar 4. PubMed 19261658 ↗
  • Bharathi AV, Kurpad AV, Thomas T, Yusuf S, Saraswathi G, Vaz M. Development of food frequency questionnaires and a nutrient database for the Prospective Urban and Rural Epidemiological (PURE) pilot study in South India: methodological issues. Asia Pac J Clin Nutr. 2008;17(1):178-85. PubMed 18364343 ↗
  • Iqbal R, Ajayan K, Bharathi AV, Zhang X, Islam S, Soman CR, Merchant AT. Refinement and validation of an FFQ developed to estimate macro- and micronutrient intakes in a south Indian population. Public Health Nutr. 2009 Jan;12(1):12-8. doi: 10.1017/S1368980008001845. Epub 2008 Mar 7. PubMed 18325134 ↗
  • Chow CK, Lock K, Madhavan M, Corsi DJ, Gilmore AB, Subramanian SV, Li W, Swaminathan S, Lopez-Jaramillo P, Avezum A, Lear SA, Dagenais G, Teo K, McKee M, Yusuf S. Environmental Profile of a Community's Health (EPOCH): an instrument to measure environmental determinants of cardiovascular health in five countries. PLoS One. 2010 Dec 10;5(12):e14294. doi: 10.1371/journal.pone.0014294. PubMed 21170320 ↗
  • Mir H, Buchanan D, Gilmore A, McKee M, Yusuf S, Chow CK. Cigarette pack labelling in 12 countries at different levels of economic development. J Public Health Policy. 2011 May;32(2):146-64. doi: 10.1057/jphp.2011.3. Epub 2011 Mar 3. PubMed 21368847 ↗
  • Yusuf S, Islam S, Chow CK, Rangarajan S, Dagenais G, Diaz R, Gupta R, Kelishadi R, Iqbal R, Avezum A, Kruger A, Kutty R, Lanas F, Lisheng L, Wei L, Lopez-Jaramillo P, Oguz A, Rahman O, Swidan H, Yusoff K, Zatonski W, Rosengren A, Teo KK; Prospective Urban Rural Epidemiology (PURE) Study Investigators. Use of secondary prevention drugs for cardiovascular disease in the community in high-income, middle-income, and low-income countries (the PURE Study): a prospective epidemiological survey. Lancet. 2011 Oct 1;378(9798):1231-43. doi: 10.1016/S0140-6736(11)61215-4. Epub 2011 Aug 26. PubMed 21872920 ↗
  • Gasevic D, Vukmirovich I, Yusuf S, Teo K, Chow C, Dagenais G, Lear SA. A direct assessment of "obesogenic" built environments: challenges and recommendations. J Environ Public Health. 2011;2011:161574. doi: 10.1155/2011/161574. Epub 2011 Nov 15. PubMed 22174727 ↗
  • Corsi DJ, Subramanian SV, McKee M, Li W, Swaminathan S, Lopez-Jaramillo P, Avezum A, Lear SA, Dagenais G, Rangarajan S, Teo K, Yusuf S, Chow CK. Environmental Profile of a Community's Health (EPOCH): an ecometric assessment of measures of the community environment based on individual perception. PLoS One. 2012;7(9):e44410. doi: 10.1371/journal.pone.0044410. Epub 2012 Sep 4. PubMed 22973446 ↗
  • Dehghan M, Ilow R, Zatonska K, Szuba A, Zhang X, Mente A, Regulska-Ilow B. Development, reproducibility and validity of the food frequency questionnaire in the Poland arm of the Prospective Urban and Rural Epidemiological (PURE) study. J Hum Nutr Diet. 2012 Jun;25(3):225-32. doi: 10.1111/j.1365-277X.2012.01240.x. Epub 2012 Mar 6. PubMed 22390143 ↗
  • Teo K, Lear S, Islam S, Mony P, Dehghan M, Li W, Rosengren A, Lopez-Jaramillo P, Diaz R, Oliveira G, Miskan M, Rangarajan S, Iqbal R, Ilow R, Puone T, Bahonar A, Gulec S, Darwish EA, Lanas F, Vijaykumar K, Rahman O, Chifamba J, Hou Y, Li N, Yusuf S; PURE Investigators. Prevalence of a healthy lifestyle among individuals with cardiovascular disease in high-, middle- and low-income countries: The Prospective Urban Rural Epidemiology (PURE) study. JAMA. 2013 Apr 17;309(15):1613-21. doi: 10.1001/jama.2013.3519. PubMed 23592106 ↗
  • Chow CK, Teo KK, Rangarajan S, Islam S, Gupta R, Avezum A, Bahonar A, Chifamba J, Dagenais G, Diaz R, Kazmi K, Lanas F, Wei L, Lopez-Jaramillo P, Fanghong L, Ismail NH, Puoane T, Rosengren A, Szuba A, Temizhan A, Wielgosz A, Yusuf R, Yusufali A, McKee M, Liu L, Mony P, Yusuf S; PURE (Prospective Urban Rural Epidemiology) Study investigators. Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries. JAMA. 2013 Sep 4;310(9):959-68. doi: 10.1001/jama.2013.184182. PubMed 24002282 ↗
  • Corsi DJ, Subramanian SV, Chow CK, McKee M, Chifamba J, Dagenais G, Diaz R, Iqbal R, Kelishadi R, Kruger A, Lanas F, Lopez-Jaramilo P, Mony P, Mohan V, Avezum A, Oguz A, Rahman MO, Rosengren A, Szuba A, Li W, Yusoff K, Yusufali A, Rangarajan S, Teo K, Yusuf S. Prospective Urban Rural Epidemiology (PURE) study: Baseline characteristics of the household sample and comparative analyses with national data in 17 countries. Am Heart J. 2013 Oct;166(4):636-646.e4. doi: 10.1016/j.ahj.2013.04.019. Epub 2013 Jul 27. PubMed 24093842 ↗
  • Duong M, Islam S, Rangarajan S, Teo K, O'Byrne PM, Schunemann HJ, Igumbor E, Chifamba J, Liu L, Li W, Ismail T, Shankar K, Shahid M, Vijayakumar K, Yusuf R, Zatonska K, Oguz A, Rosengren A, Heidari H, Almahmeed W, Diaz R, Oliveira G, Lopez-Jaramillo P, Seron P, Killian K, Yusuf S; PURE-BREATH Study Investigators. Global differences in lung function by region (PURE): an international, community-based prospective study. Lancet Respir Med. 2013 Oct;1(8):599-609. doi: 10.1016/S2213-2600(13)70164-4. Epub 2013 Sep 10. PubMed 24461663 ↗
  • Mahajan R, Malik M, Bharathi AV, Lakshmi PV, Patro BK, Rana SK, Kumar R. Reproducibility and validity of a quantitative food frequency questionnaire in an urban and rural area of northern India. Natl Med J India. 2013 Sep-Oct;26(5):266-72. PubMed 25017832 ↗
  • Mente A, O'Donnell MJ, Dagenais G, Wielgosz A, Lear SA, McQueen MJ, Jiang Y, Xingyu W, Jian B, Calik KB, Akalin AA, Mony P, Devanath A, Yusufali AH, Lopez-Jaramillo P, Avezum A Jr, Yusoff K, Rosengren A, Kruger L, Orlandini A, Rangarajan S, Teo K, Yusuf S. Validation and comparison of three formulae to estimate sodium and potassium excretion from a single morning fasting urine compared to 24-h measures in 11 countries. J Hypertens. 2014 May;32(5):1005-14; discussion 1015. doi: 10.1097/HJH.0000000000000122. PubMed 24569420 ↗
  • Lear SA, Teo K, Gasevic D, Zhang X, Poirier PP, Rangarajan S, Seron P, Kelishadi R, Tamil AM, Kruger A, Iqbal R, Swidan H, Gomez-Arbelaez D, Yusuf R, Chifamba J, Kutty VR, Karsidag K, Kumar R, Li W, Szuba A, Avezum A, Diaz R, Anand SS, Rosengren A, Yusuf S; Prospective Urban Rural Epidemiology (PURE) study. The association between ownership of common household devices and obesity and diabetes in high, middle and low income countries. CMAJ. 2014 Mar 4;186(4):258-66. doi: 10.1503/cmaj.131090. Epub 2014 Feb 10. Erratum In: CMAJ. 2014 Apr 1;186(6):453. PubMed 24516093 ↗
  • Mente A, O'Donnell MJ, Rangarajan S, McQueen MJ, Poirier P, Wielgosz A, Morrison H, Li W, Wang X, Di C, Mony P, Devanath A, Rosengren A, Oguz A, Zatonska K, Yusufali AH, Lopez-Jaramillo P, Avezum A, Ismail N, Lanas F, Puoane T, Diaz R, Kelishadi R, Iqbal R, Yusuf R, Chifamba J, Khatib R, Teo K, Yusuf S; PURE Investigators. Association of urinary sodium and potassium excretion with blood pressure. N Engl J Med. 2014 Aug 14;371(7):601-11. doi: 10.1056/NEJMoa1311989. PubMed 25119606 ↗
  • O'Donnell M, Mente A, Rangarajan S, McQueen MJ, Wang X, Liu L, Yan H, Lee SF, Mony P, Devanath A, Rosengren A, Lopez-Jaramillo P, Diaz R, Avezum A, Lanas F, Yusoff K, Iqbal R, Ilow R, Mohammadifard N, Gulec S, Yusufali AH, Kruger L, Yusuf R, Chifamba J, Kabali C, Dagenais G, Lear SA, Teo K, Yusuf S; PURE Investigators. Urinary sodium and potassium excretion, mortality, and cardiovascular events. N Engl J Med. 2014 Aug 14;371(7):612-23. doi: 10.1056/NEJMoa1311889. Erratum In: N Engl J Med. 2014 Sep 25;371(13):1267. PubMed 25119607 ↗
  • Yusuf S, Rangarajan S, Teo K, Islam S, Li W, Liu L, Bo J, Lou Q, Lu F, Liu T, Yu L, Zhang S, Mony P, Swaminathan S, Mohan V, Gupta R, Kumar R, Vijayakumar K, Lear S, Anand S, Wielgosz A, Diaz R, Avezum A, Lopez-Jaramillo P, Lanas F, Yusoff K, Ismail N, Iqbal R, Rahman O, Rosengren A, Yusufali A, Kelishadi R, Kruger A, Puoane T, Szuba A, Chifamba J, Oguz A, McQueen M, McKee M, Dagenais G; PURE Investigators. Cardiovascular risk and events in 17 low-, middle-, and high-income countries. N Engl J Med. 2014 Aug 28;371(9):818-27. doi: 10.1056/NEJMoa1311890. PubMed 25162888 ↗
  • Batool S, O'Donnell M, Sharma M, Islam S, Dagenais GR, Poirier P, Lear SA, Wielgosz A, Teo K, Stotts G, McCreary CR, Frayne R, DeJesus J, Rangarajan S, Yusuf S, Smith EE; PURE Study Investigators. Incidental magnetic resonance diffusion-weighted imaging-positive lesions are rare in neurologically asymptomatic community-dwelling adults. Stroke. 2014 Jul;45(7):2115-7. doi: 10.1161/STROKEAHA.114.005782. Epub 2014 Jun 12. PubMed 24923720 ↗
  • Chow CK, Corsi DJ, Lock K, Madhavan M, Mackie P, Li W, Yi S, Wang Y, Swaminathan S, Lopez-Jaramillo P, Gomez-Arbelaez D, Avezum A, Lear SA, Dagenais G, Teo K, McKee M, Yusuf S. A novel method to evaluate the community built environment using photographs--Environmental Profile of a Community Health (EPOCH) photo neighbourhood evaluation tool. PLoS One. 2014 Nov 4;9(11):e110042. doi: 10.1371/journal.pone.0110042. eCollection 2014. PubMed 25369366 ↗
  • Smith EE, O'Donnell M, Dagenais G, Lear SA, Wielgosz A, Sharma M, Poirier P, Stotts G, Black SE, Strother S, Noseworthy MD, Benavente O, Modi J, Goyal M, Batool S, Sanchez K, Hill V, McCreary CR, Frayne R, Islam S, DeJesus J, Rangarajan S, Teo K, Yusuf S; PURE Investigators. Early cerebral small vessel disease and brain volume, cognition, and gait. Ann Neurol. 2015 Feb;77(2):251-61. doi: 10.1002/ana.24320. PubMed 25428654 ↗
  • Mayhew AJ, Lock K, Kelishadi R, Swaminathan S, Marcilio CS, Iqbal R, Dehghan M, Yusuf S, Chow CK. Nutrition labelling, marketing techniques, nutrition claims and health claims on chip and biscuit packages from sixteen countries. Public Health Nutr. 2016 Apr;19(6):998-1007. doi: 10.1017/S1368980015000658. Epub 2015 Mar 30. Erratum In: Public Health Nutr. 2016 Apr;19(6):1145. doi: 10.1017/S1368980015002098. PubMed 25818889 ↗
  • Rosengren A, Teo K, Rangarajan S, Kabali C, Khumalo I, Kutty VR, Gupta R, Yusuf R, Iqbal R, Ismail N, Altuntas Y, Kelishadi R, Diaz R, Avezum A, Chifamba J, Zatonska K, Wei L, Liao X, Lopez-Jaramillo P, Yusufali A, Seron P, Lear SA, Yusuf S. Psychosocial factors and obesity in 17 high-, middle- and low-income countries: the Prospective Urban Rural Epidemiologic study. Int J Obes (Lond). 2015 Aug;39(8):1217-23. doi: 10.1038/ijo.2015.48. Epub 2015 Apr 14. PubMed 25869608 ↗
  • Leong DP, Teo KK, Rangarajan S, Lopez-Jaramillo P, Avezum A Jr, Orlandini A, Seron P, Ahmed SH, Rosengren A, Kelishadi R, Rahman O, Swaminathan S, Iqbal R, Gupta R, Lear SA, Oguz A, Yusoff K, Zatonska K, Chifamba J, Igumbor E, Mohan V, Anjana RM, Gu H, Li W, Yusuf S; Prospective Urban Rural Epidemiology (PURE) Study investigators. Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study. Lancet. 2015 Jul 18;386(9990):266-73. doi: 10.1016/S0140-6736(14)62000-6. Epub 2015 May 13. PubMed 25982160 ↗
  • Gupta R, Islam S, Mony P, Kutty VR, Mohan V, Kumar R, Thakur JS, Shankar VK, Mohan D, Vijayakumar K, Rahman O, Yusuf R, Iqbal R, Shahid M, Mohan I, Rangarajan S, Teo KK, Yusuf S. Socioeconomic factors and use of secondary preventive therapies for cardiovascular diseases in South Asia: The PURE study. Eur J Prev Cardiol. 2015 Oct;22(10):1261-71. doi: 10.1177/2047487314540386. Epub 2014 Jun 18. PubMed 24942224 ↗
  • Smyth A, Teo KK, Rangarajan S, O'Donnell M, Zhang X, Rana P, Leong DP, Dagenais G, Seron P, Rosengren A, Schutte AE, Lopez-Jaramillo P, Oguz A, Chifamba J, Diaz R, Lear S, Avezum A, Kumar R, Mohan V, Szuba A, Wei L, Yang W, Jian B, McKee M, Yusuf S; PURE Investigators. Alcohol consumption and cardiovascular disease, cancer, injury, admission to hospital, and mortality: a prospective cohort study. Lancet. 2015 Nov 14;386(10007):1945-1954. doi: 10.1016/S0140-6736(15)00235-4. Epub 2015 Sep 17. PubMed 26386538 ↗
  • Savell E, Gilmore AB, Sims M, Mony PK, Koon T, Yusoff K, Lear SA, Seron P, Ismail N, Calik KB, Rosengren A, Bahonar A, Kumar R, Vijayakumar K, Kruger A, Swidan H, Gupta R, Igumbor E, Afridi A, Rahman O, Chifamba J, Zatonska K, Mohan V, Mohan D, Lopez-Jaramillo P, Avezum A, Poirier P, Orlandini A, Li W, McKee M, Rangarajan S, Yusuf S, Chow CK. The environmental profile of a community's health: a cross-sectional study on tobacco marketing in 16 countries. Bull World Health Organ. 2015 Dec 1;93(12):851-61G. doi: 10.2471/BLT.15.155846. PubMed 26668437 ↗
  • Lamelas PM, Mente A, Diaz R, Orlandini A, Avezum A, Oliveira G, Lanas F, Seron P, Lopez-Jaramillo P, Camacho-Lopez P, O Donnell MJ, Rangarajan S, Teo K, Yusuf S. Association of Urinary Sodium Excretion With Blood Pressure and Cardiovascular Clinical Events in 17,033 Latin Americans. Am J Hypertens. 2016 Jul;29(7):796-805. doi: 10.1093/ajh/hpv195. Epub 2015 Dec 18. PubMed 26683344 ↗
  • Khatib R, McKee M, Shannon H, Chow C, Rangarajan S, Teo K, Wei L, Mony P, Mohan V, Gupta R, Kumar R, Vijayakumar K, Lear SA, Diaz R, Avezum A, Lopez-Jaramillo P, Lanas F, Yusoff K, Ismail N, Kazmi K, Rahman O, Rosengren A, Monsef N, Kelishadi R, Kruger A, Puoane T, Szuba A, Chifamba J, Temizhan A, Dagenais G, Gafni A, Yusuf S; PURE study investigators. Availability and affordability of cardiovascular disease medicines and their effect on use in high-income, middle-income, and low-income countries: an analysis of the PURE study data. Lancet. 2016 Jan 2;387(10013):61-9. doi: 10.1016/S0140-6736(15)00469-9. Epub 2015 Oct 20. PubMed 26498706 ↗
  • Mente A, Dagenais G, Wielgosz A, Lear SA, McQueen MJ, Zeidler J, Fu L, DeJesus J, Rangarajan S, Bourlaud AS, De Bluts AL, Corber E, de Jong V, Boomgaardt J, Shane A, Jiang Y, de Groh M, O'Donnell MJ, Yusuf S, Teo K. Assessment of Dietary Sodium and Potassium in Canadians Using 24-Hour Urinary Collection. Can J Cardiol. 2016 Mar;32(3):319-26. doi: 10.1016/j.cjca.2015.06.020. Epub 2015 Jun 25. PubMed 26454468 ↗
  • Li W, Gu H, Teo KK, Bo J, Wang Y, Yang J, Wang X, Zhang H, Sun Y, Jia X, He X, Zhao X, Cheng X, Li J, Rangarajan S, Chen C, Yusuf S, Liu L; PURE China Investigators. Hypertension prevalence, awareness, treatment, and control in 115 rural and urban communities involving 47 000 people from China. J Hypertens. 2016 Jan;34(1):39-46. doi: 10.1097/HJH.0000000000000745. PubMed 26630211 ↗
  • Raina P, Sohel N, Oremus M, Shannon H, Mony P, Kumar R, Li W, Wang Y, Wang X, Yusoff K, Yusuf R, Iqbal R, Szuba A, Oguz A, Rosengren A, Kruger A, Chifamba J, Mohammadifard N, Darwish EA, Dagenais G, Diaz R, Avezum A, Lopez-Jaramillo P, Seron P, Rangarajan S, Teo K, Yusuf S; PURE Investigators. Assessing global risk factors for non-fatal injuries from road traffic accidents and falls in adults aged 35-70 years in 17 countries: a cross-sectional analysis of the Prospective Urban Rural Epidemiological (PURE) study. Inj Prev. 2016 Apr;22(2):92-8. doi: 10.1136/injuryprev-2014-041476. Epub 2015 Oct 28. PubMed 26512093 ↗
  • Leong DP, Teo KK, Rangarajan S, Kutty VR, Lanas F, Hui C, Quanyong X, Zhenzhen Q, Jinhua T, Noorhassim I, AlHabib KF, Moss SJ, Rosengren A, Akalin AA, Rahman O, Chifamba J, Orlandini A, Kumar R, Yeates K, Gupta R, Yusufali A, Dans A, Avezum A, Lopez-Jaramillo P, Poirier P, Heidari H, Zatonska K, Iqbal R, Khatib R, Yusuf S. Reference ranges of handgrip strength from 125,462 healthy adults in 21 countries: a prospective urban rural epidemiologic (PURE) study. J Cachexia Sarcopenia Muscle. 2016 Dec;7(5):535-546. doi: 10.1002/jcsm.12112. Epub 2016 Apr 12. PubMed 27104109 ↗
  • Dagenais GR, Gerstein HC, Zhang X, McQueen M, Lear S, Lopez-Jaramillo P, Mohan V, Mony P, Gupta R, Kutty VR, Kumar R, Rahman O, Yusoff K, Zatonska K, Oguz A, Rosengren A, Kelishadi R, Yusufali A, Diaz R, Avezum A, Lanas F, Kruger A, Peer N, Chifamba J, Iqbal R, Ismail N, Xiulin B, Jiankang L, Wenqing D, Gejie Y, Rangarajan S, Teo K, Yusuf S. Variations in Diabetes Prevalence in Low-, Middle-, and High-Income Countries: Results From the Prospective Urban and Rural Epidemiological Study. Diabetes Care. 2016 May;39(5):780-7. doi: 10.2337/dc15-2338. Epub 2016 Mar 10. PubMed 26965719 ↗
  • Mente A, O'Donnell M, Rangarajan S, Dagenais G, Lear S, McQueen M, Diaz R, Avezum A, Lopez-Jaramillo P, Lanas F, Li W, Lu Y, Yi S, Rensheng L, Iqbal R, Mony P, Yusuf R, Yusoff K, Szuba A, Oguz A, Rosengren A, Bahonar A, Yusufali A, Schutte AE, Chifamba J, Mann JF, Anand SS, Teo K, Yusuf S; PURE, EPIDREAM and ONTARGET/TRANSCEND Investigators. Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension: a pooled analysis of data from four studies. Lancet. 2016 Jul 30;388(10043):465-75. doi: 10.1016/S0140-6736(16)30467-6. Epub 2016 May 20. Erratum In: Lancet. 2021 Apr 10;397(10282):1350. doi: 10.1016/S0140-6736(21)00727-3. PubMed 27216139 ↗
  • Miller V, Yusuf S, Chow CK, Dehghan M, Corsi DJ, Lock K, Popkin B, Rangarajan S, Khatib R, Lear SA, Mony P, Kaur M, Mohan V, Vijayakumar K, Gupta R, Kruger A, Tsolekile L, Mohammadifard N, Rahman O, Rosengren A, Avezum A, Orlandini A, Ismail N, Lopez-Jaramillo P, Yusufali A, Karsidag K, Iqbal R, Chifamba J, Oakley SM, Ariffin F, Zatonska K, Poirier P, Wei L, Jian B, Hui C, Xu L, Xiulin B, Teo K, Mente A. Availability, affordability, and consumption of fruits and vegetables in 18 countries across income levels: findings from the Prospective Urban Rural Epidemiology (PURE) study. Lancet Glob Health. 2016 Oct;4(10):e695-703. doi: 10.1016/S2214-109X(16)30186-3. Epub 2016 Aug 23. PubMed 27567348 ↗
  • Camacho PA, Gomez-Arbelaez D, Molina DI, Sanchez G, Arcos E, Narvaez C, Garcia H, Perez M, Hernandez EA, Duran M, Cure C, Sotomayor A, Rico A, David TM, Cohen DD, Rangarajan S, Yusuf S, Lopez-Jaramillo P. Social disparities explain differences in hypertension prevalence, detection and control in Colombia. J Hypertens. 2016 Dec;34(12):2344-2352. doi: 10.1097/HJH.0000000000001115. PubMed 27662189 ↗
  • Avezum A, Oliveira GBF, Lanas F, Lopez-Jaramillo P, Diaz R, Miranda JJ, Seron P, Camacho-Lopez PA, Orlandini A, Bernabe-Ortiz A, Cordeiro Mattos A, Islam S, Rangarajan S, Teo K, Yusuf S. Secondary CV Prevention in South America in a Community Setting: The PURE Study. Glob Heart. 2017 Dec;12(4):305-313. doi: 10.1016/j.gheart.2016.06.001. Epub 2016 Oct 20. PubMed 27773540 ↗
  • Palafox B, McKee M, Balabanova D, AlHabib KF, Avezum AJ, Bahonar A, Ismail N, Chifamba J, Chow CK, Corsi DJ, Dagenais GR, Diaz R, Gupta R, Iqbal R, Kaur M, Khatib R, Kruger A, Kruger IM, Lanas F, Lopez-Jaramillo P, Minfan F, Mohan V, Mony PK, Oguz A, Palileo-Villanueva LM, Perel P, Poirier P, Rangarajan S, Rensheng L, Rosengren A, Soman B, Stuckler D, Subramanian SV, Teo K, Tsolekile LP, Wielgosz A, Yaguang P, Yeates K, Yongzhen M, Yusoff K, Yusuf R, Yusufali A, Zatonska K, Yusuf S. Wealth and cardiovascular health: a cross-sectional study of wealth-related inequalities in the awareness, treatment and control of hypertension in high-, middle- and low-income countries. Int J Equity Health. 2016 Dec 8;15(1):199. doi: 10.1186/s12939-016-0478-6. PubMed 27931255 ↗
  • Duong M, Rangarajan S, Zhang X, Killian K, Mony P, Swaminathan S, Bharathi AV, Nair S, Vijayakumar K, Mohan I, Gupta R, Mohan D, Rani S, Mohan V, Iqbal R, Kazmi K, Rahman O, Yusuf R, Pinnaka LV, Kumar R, O'Byrne P, Yusuf S. Effects of bidi smoking on all-cause mortality and cardiorespiratory outcomes in men from south Asia: an observational community-based substudy of the Prospective Urban Rural Epidemiology Study (PURE). Lancet Glob Health. 2017 Feb;5(2):e168-e176. doi: 10.1016/S2214-109X(17)30004-9. PubMed 28104186 ↗
  • Gupta R, Kaur M, Islam S, Mohan V, Mony P, Kumar R, Kutty VR, Iqbal R, Rahman O, Deepa M, Antony J, Vijaykumar K, Kazmi K, Yusuf R, Mohan I, Panwar RB, Rangarajan S, Yusuf S. Association of Household Wealth Index, Educational Status, and Social Capital with Hypertension Awareness, Treatment, and Control in South Asia. Am J Hypertens. 2017 Apr 1;30(4):373-381. doi: 10.1093/ajh/hpw169. PubMed 28096145 ↗
  • Leong DP, McKee M, Yusuf S; PURE Investigators. Population Muscle Strength Predicts Olympic Medal Tallies: Evidence from 20 Countries in the PURE Prospective Cohort Study. PLoS One. 2017 Jan 20;12(1):e0169821. doi: 10.1371/journal.pone.0169821. eCollection 2017. PubMed 28107362 ↗
  • Khatib R, Giacaman R, Khammash U, Yusuf S. Challenges to conducting epidemiology research in chronic conflict areas: examples from PURE- Palestine. Confl Health. 2017 Feb 22;10:33. doi: 10.1186/s13031-016-0101-x. eCollection 2016. PubMed 28239410 ↗
  • Chow CK, Corsi DJ, Gilmore AB, Kruger A, Igumbor E, Chifamba J, Yang W, Wei L, Iqbal R, Mony P, Gupta R, Vijayakumar K, Mohan V, Kumar R, Rahman O, Yusoff K, Ismail N, Zatonska K, Altuntas Y, Rosengren A, Bahonar A, Yusufali A, Dagenais G, Lear S, Diaz R, Avezum A, Lopez-Jaramillo P, Lanas F, Rangarajan S, Teo K, McKee M, Yusuf S. Tobacco control environment: cross-sectional survey of policy implementation, social unacceptability, knowledge of tobacco health harms and relationship to quit ratio in 17 low-income, middle-income and high-income countries. BMJ Open. 2017 Mar 31;7(3):e013817. doi: 10.1136/bmjopen-2016-013817. PubMed 28363924 ↗
  • Yusufali AM, Khatib R, Islam S, Alhabib KF, Bahonar A, Swidan HM, Khammash U, Alshamiri MQ, Rangarajan S, Yusuf S. Prevalence, awareness, treatment and control of hypertension in four Middle East countries. J Hypertens. 2017 Jul;35(7):1457-1464. doi: 10.1097/HJH.0000000000001326. PubMed 28486270 ↗
  • Walli-Attaei M, Rosengren A, Rangarajan S, Breet Y, Abdul-Razak S, Sharief WA, Alhabib KF, Avezum A, Chifamba J, Diaz R, Gupta R, Hu B, Iqbal R, Ismail R, Kelishadi R, Khatib R, Lang X, Li S, Lopez-Jaramillo P, Mohan V, Oguz A, Palileo-Villanueva LM, Poltyn-Zaradna K, R SP, Pinnaka LVM, Seron P, Teo K, Verghese ST, Wielgosz A, Yeates K, Yusuf R, Anand SS, Yusuf S; PURE investigators. Metabolic, behavioural, and psychosocial risk factors and cardiovascular disease in women compared with men in 21 high-income, middle-income, and low-income countries: an analysis of the PURE study. Lancet. 2022 Sep 10;400(10355):811-821. doi: 10.1016/S0140-6736(22)01441-6. PubMed 36088949 ↗
  • Narula N, Wong ECL, Dehghan M, Mente A, Rangarajan S, Lanas F, Lopez-Jaramillo P, Rohatgi P, Lakshmi PVM, Varma RP, Orlandini A, Avezum A, Wielgosz A, Poirier P, Almadi MA, Altuntas Y, Ng KK, Chifamba J, Yeates K, Puoane T, Khatib R, Yusuf R, Bostrom KB, Zatonska K, Iqbal R, Weida L, Yibing Z, Sidong L, Dans A, Yusufali A, Mohammadifard N, Marshall JK, Moayyedi P, Reinisch W, Yusuf S. Association of ultra-processed food intake with risk of inflammatory bowel disease: prospective cohort study. BMJ. 2021 Jul 14;374:n1554. doi: 10.1136/bmj.n1554. PubMed 34261638 ↗
  • Pertiwi K, Kupers LK, Geleijnse JM, Zock PL, Wanders AJ, Kruger HS, van Zyl T, Kruger IM, Smuts CM. Associations of linoleic acid with markers of glucose metabolism and liver function in South African adults. Lipids Health Dis. 2020 Jun 16;19(1):138. doi: 10.1186/s12944-020-01318-3. PubMed 32546275 ↗
  • Dehghan M, Mente A, Rangarajan S, Mohan V, Lear S, Swaminathan S, Wielgosz A, Seron P, Avezum A, Lopez-Jaramillo P, Turbide G, Chifamba J, AlHabib KF, Mohammadifard N, Szuba A, Khatib R, Altuntas Y, Liu X, Iqbal R, Rosengren A, Yusuf R, Smuts M, Yusufali A, Li N, Diaz R, Yusoff K, Kaur M, Soman B, Ismail N, Gupta R, Dans A, Sheridan P, Teo K, Anand SS, Yusuf S. Association of egg intake with blood lipids, cardiovascular disease, and mortality in 177,000 people in 50 countries. Am J Clin Nutr. 2020 Apr 1;111(4):795-803. doi: 10.1093/ajcn/nqz348. PubMed 31965140 ↗
  • Wentzel-Viljoen E, Laubscher R, Vorster HH. Changes in food intake from 2005 to 2010 by a cohort of black rural and urban African men and women in the North West Province of South Africa: the PURE-NWP-SA study. Public Health Nutr. 2018 Nov;21(16):2941-2958. doi: 10.1017/S1368980018001878. Epub 2018 Aug 28. PubMed 30149823 ↗
  • Wentzel-Viljoen E, Lee S, Laubscher R, Vorster HH. Accelerated nutrition transition in the North West Province of South Africa: results from the Prospective Urban and Rural Epidemiology (PURE-NWP-SA) cohort study, 2005 to 2010. Public Health Nutr. 2018 Oct;21(14):2630-2641. doi: 10.1017/S1368980018001118. Epub 2018 May 8. PubMed 29734966 ↗

Related links

Individual participant data

Plan to share: Yes — During study conduct only with the investigators who have participated /contributed to the study. Select summary data may be shared with policy makers for specific purposes.The study exec will consider specific requests for data analyses by non-contributing individuals 3 years after the study has been completed (i.e. complete recruitment and a minimum of 10 years follow up in all) and the participating investigators have had an opportunity to explore questions that they are interested in. Costs related to data curating ,and related efforts will need to be met by anybody not contributing to the study and requesting analyses

Supporting information: Study protocol, Csr

08

Registry details

Key details

Study ID
NCT03225586
Lead sponsor
Population Health Research Institute
Collaborators
Canadian Institutes of Health Research (CIHR), Heart and Stroke Foundation of Ontario
Responsible party
Salim Yusuf's office (Executive Director, Population Health Research Institute, Population Health Research Institute) — Principal investigator
First posted
Jul 21, 2017
Start date
Jan 1, 2002
Primary completion
Dec 31, 2030 (estimated)
Completion
Dec 31, 2030 (estimated)
Last update
Jan 31, 2024

Study contacts

Sumathy Rangarajan, MSc
Contact
sumathy.rangarajan@phri.ca
905-521-2100 ext. 40464
Janette Panhuis, BScN, MBA
Contact
janette.panhuis@phri.ca
905-521-2100 ext. 40386
Salim Yusuf, DPhil
principal investigator · Executive Director

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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