The Coronary Artery Risk Development in Young Adults (CARDIA) study was established in 1985 by the NationalHeart, Lung, and Blood Institute (NHLBI) to study the distribution and evolution of cardiovascular disease riskbeginning in young adulthood in four U.S. communities (Birmingham, AL;Chicago, IL;Minneapolis, MN;and Oakland,CA) (www.cardia.dopm.uab.edu/). The original cohort (n=5,115) was selected to have approximately the samenumber of participants in subgroups of age (18-24 and 25-30), sex, race (black and white), and education (high schoolor less and more than high school) within each community. At Year 30 the eighth examination (July 1, 2015- June30, 2016), participants will be 48-60 years old, a time when risk factors and subclinical abnormalities are prevalentand clinical events continue to emerge. CARDIA offers the opportunity to address aspects of the development andprogression of subclinical and clinical disease that cannot be addressed in older cohorts. Specifically, CARDIA offersthe opportunity to phenotype early cardiovascular disease, including heart failure in a large cohort of white andblack adults. In addition, risk factors for cardiovascular disease can be updated. With risk factor data from previousexaminations, CARDIA has the ability to study how the entire trajectory of early adulthood to mid-to-late middle-agerisk factors and their control affects development and progression of cardiac dysfunction.