Cardiovascular Health Study

The Cardiovascular Health Study (CHS) is a population-based cohort study initiated by the National Heart, Lung and Blood Institute (NHLBI) in 1987 to determine the risk factors for development and progression of cardiovascular disease (CVD) in older adults, with an emphasis on subclinical measures. The study recruited 5,888 adults aged 65 or older at entry in four U.S. communities and conducted extensive annual clinical exams between 1989-1999 along with semi-annual phone calls, events adjudication, and subsequent data analyses and publications. Additional data are collected by studies ancillary to CHS. In June 1990, four Field Centers (Sacramento, CA; Hagerstown, MD; Winston-Salem, NC; Pittsburgh, PA) completed the recruitment of 5201 participants. Between November 1992 and June 1993, an additional 687 African Americans were recruited using similar methods. Blood samples were drawn from all participants at their baseline examination and during follow-up clinic visits and DNA was subsequently extracted from available samples. CHS analyses were limited to participants with available DNA who consented to genetic studies. The baseline examinations consisted of a home interview and a clinic examination that assessed not only traditional risk factors but also measures of subclinical disease, including carotid ultrasound, echocardiography, electrocardiography, and pulmonary function. Between enrollment and 1998-99, participants were seen in the clinic annually, and contacted by phone at 6-month intervals to collect information about hospitalizations and potential cardiovascular events. Major exam components were repeated during annual follow-up examinations through 1999. Cranial MRI scans, retinal photography, and tests of endothelial function were added as new components. Standard protocols for the identification and adjudication of events were implemented during follow-up. The adjudicated events are CHD, angina, heart failure (HF), stroke, transient ischemic attack (TIA), claudication and mortality. Adjudication of cause of death continues using a streamlined protocol; adjudication of other events ended in June 2015. Deep venous thrombosis and pulmonary embolism events from baseline through 2001 were adjudicated in an ancillary study: the Longitudinal Investigation of Thromboembolism Etiology (LITE). Since 1999, participants have been contacted every 6 months by phone, primarily to ascertain health status and for events follow-up. The study was initially approved by institutional review boards at the Field Centers (Wake Forest, University of California – Davis, Johns Hopkins University, University of Pittsburgh), the Core Laboratory (University of Vermont) and at the Coordinating Center (University of Washington). The University of Washington now handles CHS Data Repository approvals.