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Heinz Nixdorf Recall Study and Heinz Nixdorf
Multigenerational Study

Cardiovascular diseases continue to be the leading cause of death in Germany. Acute myocardial infarction requires special attention because it often cannot be treated appropriately due to its unpredictability and thus often leads to death. This makes it all the more important to intervene preventively and reduce the risk of infarction in advance. The condition for this is an improvement in early detection in people who are actually at high risk. The Heinz Nixdorf Recall Study was launched more than 20 years ago to prove that modern imaging methods allow better prediction of heart attack risk than conventional methods based on risk factors (Schmermund et al. Assessment of clinically silent atherosclerotic disease and established and novel risk factors for predicting myocardial infarction and cardiac death in healthy middle-aged subjects: rationale and design of the Heinz Nixdorf RECALL Study. Risk Factors, Evaluation of Coronary Calcium and Lifestyle. American heart journal. 2002;144(2):212-8). In 2000, random samples of people aged 45 to 74 were drawn from the population registration offices of the cities of Bochum, Essen and Mülheim. From 2000 to 2003 (HNR-T0), a total of 4814 participants (recruitment rate 55.8%) were examined in the specially established „Heinz Nixdorf Study Center“ (Stang et al. Baseline recruitment and analyses of nonresponse of the Heinz Nixdorf Recall Study: identifiability of phone numbers as the major determinant of response. European journal of epidemiology. 2005;20(6):489-96). In addition to interview and questionnaires as well as a series of medical examinations, a large number of biosamples were collected. Contact with the subjects is maintained on an ongoing basis, two follow-up examinations, 5 and 10 years after baseline (HNR-T1 and HNR-T2), have already taken place and questionnaires on current health are sent to the participants annually. The successful work in the Heinz Nixdorf Recall Study motivated us to devote ourselves more intensively to the question of heredity and genetics of coronary vascular calcification and thus atherosclerosis. This led to the idea of continuing the study in the form of the Heinz Nixdorf Multigenerational Study (MGS), which started in 2013 (MGS-T0). In this study, 2898 spouses and children of the first generation of the test subjects were and are being examined according to the proven study protocol of the Heinz Nixdorf Recall Study in order to be able to research the development of heart disease in families. Currently, the first follow-up examination (MGS-T1) is taking place and questionnaires on current health are sent to the participants annually.

The successful work in the Heinz Nixdorf Recall Study motivated us to devote ourselves more intensively to the question of heredity and genetics of coronary vascular calcification and thus atherosclerosis. This led to the idea of continuing the study in the form of the Heinz Nixdorf Multigenerational Study (MGS), which started in 2013 (MGS-T0). In this study, 2898 spouses and children of the first generation of the test subjects were and are being examined according to the proven study protocol of the Heinz Nixdorf Recall Study in order to be able to research the development of heart disease in families. Currently, the first follow-up examination (MGS-T1) is taking place and questionnaires on current health are sent to the participants annually.



Project management:Prof. Dr. A. Stang, PD Dr. B. Schmidt, Prof. Dr. K.-H. Jöckel
Funding:Heinz Nixdorf Foundation
Implementation:Dr. C. Emmel, Dr. T. Kühl, U. Roggenbuck, U. Slomiany, PD Dr. S. Schramm, Dr. N. Sonuc
Duration:ongoing
Contact:Recall@uk-essen.de

Data overview

Data preparation status

The data from

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Due to data security reasons (i.e., data contain potentially participant identifying information), the Heinz Nixdorf Recall Study and Heinz Nixdorf Multigenerational Study study do not allow sharing data as a public use file, but data requests can be addressed to recall@uk-essen.de.

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Selected publications

  • Baak L, Frank M, Dürig J, Dührsen U, Hoffmann P, Nöthen MM, Dragano N, Erbel R, Jöckel KH, Schmidt B (2022). A Genetic Risk Score of Alleles Related to MGUS Interacts with Socioeconomic Position in a Population-based Cohort. Scientific Reports 12:4409. https://doi.org/10.1038/s41598-022-08294-x
  • Bittner N, Korf HW, Stumme J, Jockwitz C, Moebus S, Schmidt B, Dragano N, Caspers S (2022). Multimodal investigation of the association between shift work and the brain in a population-based sample of older adults. Sci Rep. 2022 Feb 22;12(1):2969.
  • Cainzos-Achirica M, Quispe R, Mszar R, Dudum R, Al Rifai M, Erbel R, Stang A, Jöckel KH, Lehmann N, Schramm S, Schmidt B, Toth PP, Rana JS, Lima JAC, Doria de Vasconcellos H, Lloyd-Jones D, Joshi PH, Ayers C, Khera A, Blaha MJ, Greenland P, Nasir K. Coronary Artery Calcium Score to Refine the Use of PCSK9i in Asymptomatic Individuals: A Multicohort Study. J Am Heart Assoc. 2022 Aug 16;11(16):e025737. PMID: 35943062.
  • Gronewold J, Duman EE, Engel M, Engels M, Siegrist J, Erbel R, et al. Association between life events and later depression in the population-based Heinz Nixdorf Recall study-The role of sex and optimism. PLoS One. 2022;17(7): e0271716. PMID: 35857802.
  • Gronewold J, Jokisch M, Schramm S, Himpfen H, Ginster T, Tenhagen I, et al. Periventricular rather than deep white matter hyperintensities mediate effects of hypertension on cognitive performance in the population-based 1000BRAINS study. J Hypertens. 2022. PMID: 35983864.
  • Hovanec J, Weiss T, Koch HM, Pesch B, Behrens T, Kendzia B, et al. Smoking intensity and urinary nicotine metabolites by socioeconomic status in the Heinz Nixdorf Recall study. BMC Public Health. 2022;22(1): 302. PMID: 35164711.
  • Matusch E, Frank M, Kara K, Mahabadi AA, Dragano N, Erbel R, Jöckel KH, Schmidt B. Impact of socioeconomic and cardiovascular risk factors on the effect of genetic variants associated with NT-proBNP. Sci Rep. 2022 Sep 16;12(1):15560. PMID: 36114409.
  • Alkhalawi E, Orban E, Schramm S, Katsarava Z, Hoffmann B, Moebus S (2021) Residential traffic noise exposure and headaches: Results from the population-based heinz nixdorf recall study. Noise & Health 23, 1-10. DOI: 10.4103/nah.NAH_1_20.
  • Cainzos-Achirica M, Quispe R, Dudum R, Greenland P, Lloyd-Jones D, Rana JS, Lima JAC, Doria de Vasconcellos H, Joshi PH, Khera A, Ayers C, Erbel R, Stang A, Jöckel KH, Lehmann N, Schramm S, Schmidt B, Toth PP, Patel KV, Blaha MJ, Bittencourt M, Nasir K (2021). CAC for Risk Stratification Among Individuals With Hypertriglyceridemia Free of Clinical Atherosclerotic Cardiovascular Disease. JACC Cardiovasc Imaging. 2021 Dec 8:S1936-878X(21)00835-4. doi: 10.1016/j.jcmg.2021.10.017.
  • Chen J, Rodopoulou S, de Hoogh K, Strak M, Andersen ZJ, Atkinson R, Bauwelinck M, Bellander T, Brandt J, Cesaroni G, Concin H, Fecht D, Forastiere F, Gulliver J, Hertel O, Hoffmann B, Hvidtfeldt UA, Janssen NAH, Jockel KH, Jorgensen J, Katsouyanni K, Ketzel M, Klompmaker JO, Lager A, Leander K, Liu S, Ljungman P, MacDonald CJ, Magnusson PKE, Mehta A, Nagel G, Oftedal B, Pershagen G, Peters A, Raaschou-Nielsen O, Renzi M, Rizzuto D, Samoli E, van der Schouw YT, Schramm S, Schwarze P, Sigsgaard T, Sorensen M, Stafoggia M, Tjonneland A, Vienneau D, Weinmayr G, Wolf K, Brunekreef B, Hoek G (2021) Long-Term Exposure to Fine Particle Elemental Components and Natural and Cause-Specific Mortality-a Pooled Analysis of Eight European Cohorts within the ELAPSE Project. Environ Health Perspect 129, 47009. https://doi.org/10.1289/EHP8368.
  • Collaboration NCDRF. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet (London, England). 2021;398(10304):957-80. https://doi.org/10.1016/S0140-6736(21)01330-1.
  • Collaboration NCDRF. Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight. Elife. 2021;10. https://doi.org/10.7554/eLife.60060.
  • Demirer I, Schmidt B, Schramm S, Erbel R, Jöckel KH, Pförtner TK (2021): Does allostatic load predict incidental coronary events differently among sexes? Comprehensive Psychoneuroendocrinology Volume 8, November 2021, https://doi.org/10.1016/j.cpnec.2021.100089.
  • Emmel C, Frank M, Nico Dragano, Nöthen MM, Erbel R, Jöckel KH, Schmidt B (2021). A genetic sum score of effect alleles associated with serum lipid concentrations interacts with educational attainment. Scientific Reports 2021 11:16541. https://doi.org/10.1038/s41598-021-95970-z
  • Frank M, Hensel J, Baak L, Schramm S, Dragano N, Weimar C, et al. Interaction of Alzheimer’s Disease-Associated Genetic Risk with Indicators of Socioeconomic Position on Mild Cognitive Impairment in the Heinz Nixdorf Recall Study. J Alzheimers Dis. 2021;82(4):1715-25. PMID: 34219719.
  • Gronewold J, Kropp R, Lehmann N, Stang A, Mahabadi AA, Weimar C, et al. Population impact of different hypertension management guidelines based on the prospective population-based Heinz Nixdorf Recall study. BMJ Open. 2021;11(2):e039597. PMID: 33597131.
  • Hornung N, Frank M, Dragano N, Dürig J, Dührsen U, Moebus S, Erbel R, Stang A, Jöckel KH, Schmidt B (2021). Monoclonal gammopathy of undetermined significance is associated with prostate cancer in a population‑based cohort study. Scientific Reports 2021 11:19266. https://doi.org/10.1038/s41598-021-98803-1
  • Icks A, Wittgens C, Haastert B, Jockel KH, Engel M, Erbel R, et al. High Depressive Symptoms in Previously Undetected Diabetes – 10-Year Follow-Up Results of the Heinz Nixdorf Recall Study. Clin Epidemiol. 2021;13:429-38. PMID: 34140811.
  • Kowall B, Lehnich AT, Schramm S, Schmidt B, Erbel R, Jockel KH, et al. Family aggregation of sleep characteristics: Results of the Heinz Nixdorf Recall and the Multi-Generation Study. PLoS One. 2021;16(6):e0252828. PMID: 34086822.
  • Kowall B, Rathmann W, Kuss O, Herder C, Roden M, Stang A, et al. Associations between haemoglobin A1c and mortality rate in the KORA S4 and the Heinz Nixdorf Recall population-based cohort studies. Diabetes Metab Res Rev. 2021;37(2):e3369. PMID: 32558166.
  • Lucht S, Glaubitz L, Moebus S, Schramm S, Jockwitz C, Caspers S, Hoffmann B (2021) Long-term air pollution, noise, and structural measures of the Default Mode Network in the brain: Results from the 1000BRAINS cohort. Int J Hyg Environ Health 239, 113867. DOI: 10.1016/j.ijheh.2021.113867.
  • Ohlwein S, Hennig F, Lucht S, Schmidt B, Eisele L, Arendt M, et al. Air Pollution and Polyclonal Elevation of Serum Free Light Chains: An Assessment of Adaptive Immune Responses in the Prospective Heinz Nixdorf Recall Study. Environ Health Perspect. 2021;129(2):27004. PMID: 33596105.
  • Pechlivanis S, Jung D, Moebus S, Lehmann N, Mahabadi AA, Hoffmann P, et al. Pharmacogenetic association of diabetes-associated genetic risk score with rapid progression of coronary artery calcification following treatment with HMG-CoA-reductase inhibitors -results of the Heinz Nixdorf Recall Study. Naunyn Schmiedebergs Arch Pharmacol. 2021;394(8):1713-25. PMID: 34021798.
  • Rudman M, Frank M, Emmel C, Matusch E, Kara K, Mahabadi AA, et al. Socioeconomic position is associated with N-terminal pro-brain natriuretic peptide (NT-proBNP)-Results of the population-based Heinz Nixdorf Recall study. PLoS One. 2021;16(8):e0255786. PMID: 34415953.
  • Schramm S, Jokisch M, Jockel KH, Herring A, Keyvani K. Is kallikrein-8 a blood biomarker for detecting amnestic mild cognitive impairment? Results of the population-based Heinz Nixdorf Recall study. Alzheimers Res Ther. 2021;13(1):202. PMID: 34930454.
  • Schramm S, Schliephake L, Himpfen H, Caspers S, Erbel R, Jockel KH, et al. Vitamin D and white matter hyperintensities: results of the population-based Heinz Nixdorf Recall Study and 1000BRAINS. Eur J Neurol. 2021;28(6):1849-58. PMID: 33686727.
  • Schramm S, Tenhagen I, Schmidt B, Holle-Lee D, Naegel S, Katsarava Z, et al. Prevalence and risk factors of migraine and non-migraine headache in older people – results of the Heinz Nixdorf Recall study. Cephalalgia. 2021;41(6):649-64. PMID: 33269953.
  • Schulz CA, Mavarani L, Reinsch N, Albayrak-Rena S, Potthoff A, Brockmeyer N, Hower M, Erbel R, Jöckel KH, Schmidt B, Esser S; HIV HEART Aging Study Group and Heinz Nixdorf Recall Investigative Group (2021). Prediction of future cardiovascular events by Framingham, SCORE and asCVD risk scores is less accurate in HIV-positive individuals from the HIV-HEART Study compared with the general population. HIV Med. 2021 Sep;22(8):732-741. doi: 10.1111/hiv.13124. Epub 2021 May 24.
  • Stolpe S, Kowall B; Zwanziger D, Frank M, Jöckel KH, Erbel R, Stang A (2021). External validation of six clinical models for prediction of unknown chronic kidney disease in a German population. doi: https://doi.org/10.1101/2021.12.23.21268085
  • Strak M, Weinmayr G, Rodopoulou S, Chen J, de Hoogh K, Andersen ZJ, Atkinson R, Bauwelinck M, Bekkevold T, Bellander T, Boutron-Ruault MC, Brandt J, Cesaroni G, Concin H, Fecht D, Forastiere F, Gulliver J, Hertel O, Hoffmann B, Hvidtfeldt UA, Janssen NAH, Jockel KH, Jorgensen JT, Ketzel M, Klompmaker JO, Lager A, Leander K, Liu S, Ljungman P, Magnusson PKE, Mehta AJ, Nagel G, Oftedal B, Pershagen G, Peters A, Raaschou-Nielsen O, Renzi M, Rizzuto D, van der Schouw YT, Schramm S, Severi G, Sigsgaard T, Sorensen M, Stafoggia M, Tjonneland A, Verschuren WMM, Vienneau D, Wolf K, Katsouyanni K, Brunekreef B, Hoek G, Samoli E (2021) Long term exposure to low level air pollution and mortality in eight European cohorts within the ELAPSE project: pooled analysis. BMJ 374, n1904. doi: https://doi.org/10.1136/bmj.n1904.
  • Wolf K, Hoffmann B, Andersen ZJ, Atkinson RW, Bauwelinck M, Bellander T, Brandt J, Brunekreef B, Cesaroni G, Chen J, de Faire U, de Hoogh K, Fecht D, Forastiere F, Gulliver J, Hertel O, Hvidtfeldt UA, Janssen NAH, Jorgensen JT, Katsouyanni K, Ketzel M, Klompmaker JO, Lager A, Liu S, MacDonald CJ, Magnusson PKE, Mehta AJ, Nagel G, Oftedal B, Pedersen NL, Pershagen G, Raaschou-Nielsen O, Renzi M, Rizzuto D, Rodopoulou S, Samoli E, van der Schouw YT, Schramm S, Schwarze P, Sigsgaard T, Sorensen M, Stafoggia M, Strak M, Tjonneland A, Verschuren WMM, Vienneau D, Weinmayr G, Hoek G, Peters A, Ljungman PLS (2021) Long-term exposure to low-level ambient air pollution and incidence of stroke and coronary heart disease: a pooled analysis of six European cohorts within the ELAPSE project. Lancet Planet Health 5, e620-e632. https://doi.org/10.1016/S2542-5196(21)00195-9. Zamrik T, Frank M, Emmel C, Rump LC, Erbel R, Jockel KH, et al. Association between socioeconomic position and cystatin C in the Heinz Nixdorf Recall Study. Sci Rep. 2021;11(1):19387. PMID: 34588554.