The general aim of this revised competing continuation application is to address, in a timely and effective way, important unanswered questions in cardiovascular epidemiology employing data and analyses from four large Chicago population cohorts. The application focuses on six Specific Aims, and these foci are as follow: a) factors influencing CHD-CVD risk long-term in young adult women and men (ages 18-39 at baseline); b) factors influencing CHD-CVD risk long-term in African-American women and men; c) factors influencing CHD-CVD risk during both earlier and later follow-up (first 15 years and beyond 15 years of follow-up); d) impact of baseline low risk status on long-term risk of mortality from CHD, CVD, non-CVD, and all causes; e) relationship of habitual intake of multiple food groups to 10-year change in serum cholesterol, blood pressure, weight, and to 30-year risks of death from CHD, CVD, cancers, and all causes; f) differences in risk factors impact between groups based on sex, race, age or risk factor status. Questions that are addressed in this application remain unanswered primarily because of the following issues with most other cohort studies. 1) Other cohort studies have not included large numbers of young adult women and men (ages 18-39 with long enough follow-up to accrue substantial numbers of deaths from CHD, CVD or all causes. 2) Other cohort studies have not included substantial numbers of young (ages 18-39) and middle-aged (ages 40-59) African-American women and men to enable detailed study of risk factors and their relations to CHD, CVD and total mortality in this important subgroup of Americans. 3) Other cohort studies have not included participants with markedly differing baseline ages to permit comparisons of risk factor relations in persons of different ages. 4) Other cohort studies have not had samples of women and men large enough, or durations long enough, to assess long-term impact for both genders of low risk status, determined at baseline ages 18-39 and 40-59. 5) Other cohort studies have not included detailed baseline assessment of food and nutrient intakes, combined with repeat risk factor measurements and determination of cause-specific mortality in long-term follow-up. In addition to the unique and important questions- related to current public policy concerns- that this research will address, and the critical characteristics of the four large Chicago cohorts under study for over 25 years, the investigators note that the research team is knowledgeable and experienced and has been engaged together for years in the productive conduct of similar and related research.
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