To conduct a prospective study of the environmental and genetic factors influencing the development of cardiovascular disease in African American men and women. The cohort is an expansion of the Jackson, Mississippi site of the Atherosclerosis Risk in Communities (ARIC) study and is a partnership among two minority institutions (Jackson State University, Tougaloo College), and one majority institution in Jackson, Mississippi (the University of Mississippi Medical Center), and the NIH National Center on Minority Health and Health Disparities (NCMHD) and the National Heart, Lung, and Blood Institute (NHLBI).

BACKGROUND: Heart disease and stroke remain the first and third leading killers of all Americans, with a disproportionate share of the burden borne by African Americans. Cardiovascular and total mortality are known to be higher in Black than white Americans, but reasons for these differences remain to be defined. In addition, well-documented declines in cardiovascular and coronary disease mortality in the past three decades have not been shared equally between Blacks and whites; age-adjusted death rates were identical in both groups in 1980, but by 1994 the rate among African Americans was 14 percent higher than in whites. The race difference in magnitude of coronary heart disease (CHD) mortality is greater in women than men and higher in middle age, so that CHD deaths tend to occur in Blacks about five years earlier than in whites. Excess cerebrovascular disease incidence and mortality in Blacks are even greater than the differences noted in CHD.

Cardiovascular mortality rates in Mississippi are the highest in the United States for all race-sex groups and are approximately 25 percent higher than the United States average. Age-adjusted CVD mortality for African American women in Mississippi was 75 percent higher than in white women in 1994, and for African American men was 47 percent higher than in white men.

Prevalence of hypertension is nearly 40 percent greater in African Americans than whites and its sequelae are more frequent and severe. Evidence of target organ damage such as renal failure and left ventricular hypertrophy is more common in Black than white hypertensives at comparable levels of blood pressure. Many other risk factors are also more common in Blacks, including diabetes, Lp(a) and obesity (in women) while others such as elevated total cholesterol, reduced HDL-cholesterol and heavy cigarette smoking are more common in whites.

DESIGN NARRATIVE: The Jackson Heart Study (JHS), an Institute-initiated prospective study of the environmental and genetic factors influencing the development of cardiovascular disease (CVD) in African-Americans, is sponsored by the National Heart, Lung, and Blood Institute (NHLBI) and the National Center on Minority Health and Health Disparities (NCMHD) of the National Institutes of Health. The Jackson Heart Study initial examination began in the fall of 2000, included men and women aged 35-84 and took three years to complete. The study is a partnership among NHLBI, NCMHD, and three local institutions: Jackson State University, Tougaloo College and the University of Mississippi Medical Center. The Coordinating Center, located at Jackson State University, collects and analyzes data. The Undergraduate Training Center at Tougaloo College offers coursework to students in public health and epidemiology and provides practical experience in health research to prepare them for potential careers in these fields. The Exam Center at the University of Mississippi is responsible for recruiting participants and conducting the examinations. By incorporating state-of-the-art physiologic and epidemiologic methods in a stable population-based minority cohort, providing research experience, and building research capabilities at minority institutions, the Jackson Heart Study is uniquely positioned to answer key questions regarding the excess burden of CVD among African-Americans and to address the critical shortage of minority investigators trained in epidemiology and prevention. The Second Exam begins in September 2005.

Ages Eligible for Study:  35 Years   -   84 Years,  Genders Eligible for Study:  Both

Criteria