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Multi-Ethnic Study of Atherosclerosis (MESA)

Objectives:

This project investigated the prevalence, correlates, and progression of subclinical CVD and risk factors that predict progression to clinically overt CVD, and that predict progression of subclinical disease itself, in a population-based sample of 6,800 ethnically diverse men and women.

Background:

Prospective epidemiologic studies of cardiovascular disease (CVD) have traditionally relied on the occurrence of clinically overt events, such as myocardial infarction, stroke, and coronary heart disease death, to identify factors predicting development of disease. This design has served well to identify many CVD risk factors, but more recent study designs utilizing earlier, subclinical endpoints hold promise for furthering our capacity to predict and prevent CVD.

Subjects:

The cohort is a population-based sample of 6,800 men and women aged 45–84 years. The participants were selected from six US field centers. Approximately 38% of the cohort is White, 28% African-American, 23% Hispanic, and 11% Asian (of Chinese descent).

Design:

Baseline measurements include measurement of coronary calcium using computed tomography; measurement of ventricular mass and function using cardiac magnetic resonance imaging; measurement of flow-mediated brachial artery endothelial vasodilation, carotid intimal-medial wall thickness, and distensibility of the carotid arteries using ultrasonography; measurement of peripheral vascular disease using ankle and brachial blood pressures; electrocardiography; and assessments of microalbuminuria, standard CVD risk factors, sociodemographic factors, life habits, and psychosocial factors. Blood samples are assayed for putative biochemical risk factors and stored for use in nested case-control studies. DNA will be extracted and lymphocytes will be immortalized for genetic studies. Participants will be followed through 2008 for identification and characterization of CVD events, including acute myocardial infarction and other coronary heart disease, stroke, peripheral vascular disease, and congestive heart failure; therapeutic interventions for CVD; and mortality. (Am J Epi 2002;156:871-881)

 
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