The ASKLEPIOS study started in 2002 with a medium-term goal of providing better understanding into the interplay between ageing, haemodynamics (and non-haemodynamic stresses) on the development of cardiovascular disease. The long-term goal is to focus on better risk prevention strategies.

The study cohort consists of a representative, random population sample of >2500 apparently healthy Belgian subjects, examined initially in 2002–2004 and currently undergoing re-examination after a 10-year interval (completion due Q4 2014). An overarching theme has been the study of time-integrative biomarkers, which reflect a cumulative – preferably lifecourse – risk factor burden. These include biomechanics-derived biomarkers (arterial stiffness, altered haemodynamics, cardiac remodeling), but also blood-borne ageing biomarkers (telomere length, DNA methylation) and imaging-based biomarkers (intima-media thickness and plaque accumulation).

Asklepios, from the beginning, was (and is) a very close collaboration between clinicians and engineers. An important research focus has been the study of haemodynamics as complex time-varying phenomena, by combining pressure, flow and diameter or volume curves, an approach that is currently feasible in clinical practice datasets, using non-invasive tools.

In recent years, we better understand how subtle cardio-vascular dysfunctions, while asymptomatic at rest, become clinically relevant when heart and vessels need to effectively interact in order to perform an exercise. Therefore, in the current re-examination of our 2500 subjects, we are extending our characterization by not only studying the subjects at rest, but also whilst a haemodynamic load is imposed (by isometric handgrip), an approach – we believe – that will allow for an even more profound insight in this complex field.