The objectives of this research, based on the Charleston Hearth Study (original cohort n=2283), are to provide one of the first community based estimates of the prevalence of ischemic heart disease, co-morbidity, and their correlates in elderly blacks and to compare the findings in whites. This research will measure the physical and cognitive functional status in blacks, identify their current correlates and compare them with whites; in the process, the Framingham Disability study will be replicated for whites and new information will be provided for blacks. Other objectives to be met by this investigation will be to identify and quantify the biomedical and sociodemographic determinants of long term survival (25 years) in black men and women and to compare them in whites; to determine the risk factor significance of Minnesota coded ECG abnormalities in blacks and whites. Comparison of risk function in Charleston and Evans Counties will be carried out with he goal of developing pooled predictors. Coronary heart disease (CHD) is the leading cause of death among U.S. Blacks and although there has been a decline in CHD mortality among blacks, evidence is emerging that fatal and non-fatal CHD rates may now be exceeding those of whites. CHD is a major threat to blacks, who despite improvements in health, remain relatively disadvantaged by low income and other impediments to a healthier life style. Over one half of the blacks in the US live in the South and the Charleston Heart Study offers the opportunity to study disease and disability status in a relevant environment that includes urban and rural residents. Knowing the magnitude of coronary disease, associated diseases, disability, and their correlates or determinants will provide the first step to insure adequate care facilities for elderly blacks and to determine if the health problems are different from elderly whites. Preliminary examination of data from the 1984/85 recall indicate sex and racial differences in disability status and perception of health. The goals of this investigation will be met by recalling surviving black and white men and women (n approximately 1300); to ascertain physical and cognitive functioning risk factor status and medical histories; to measure blood pressure, weight, height and heart function by auscultation, ECG, and Echocardiography; to assess lipoproteins, glucose, and other biochemical parameters. The response rate in the 1987/88 recall is anticipated to be high since in 1984/85 we were able to ascertain the vital status of 98% of original (1960) respondents and to interview 93% of those still living. This investigation will make important contributions to the understanding of coronary disease in elderly blacks and whites and to the identification of aging problems and their determinants.
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