The atherosclerotic process begins in childhood and advances through adult life when occlusive vascular disease results in coronary heart disease, stroke and peripheral vascular disease. Although risk factors have been established in adult populations, risk factors when measured in childhood have not been directly related to morbidity and mortality from occlusive atherosclerotic disease. The ultrasonographic measurement of carotid artery intimal-medial thickness (IMT) in adults is related not only to the risk for stroke but also to the severity of atherosclerotic disease in the coronary arteries. In 1970, a population of school age children and adolescents was first examined in Muscatine, Iowa, and since then has been followed to examine the predictive value of childhood risk factor levels for cardiovascular disease. A sample of this longitudinal cohort, with risk factors measured at least twice during childhood and once during adult life, is available for study. It is representative of the initial population, which presently ranges in age from 31 to 40 years, and lives in the Muscatine area. The investigators note that this cohort provides an opportunity to examine the relationship of risk factors measured in childhood to IMT in early adulthood and to examine familial factors which may be related to increased IMT. In this application, the investigators describe a study to examine the following: 1) the relationship of body mass index (BMI), blood pressure, total cholesterol, and smoking behaviors measured in childhood to IMT measured in early adulthood; 2) the relationship of risk factors (BMI, blood pressure, total cholesterol, LDL-C, HDL-C, Apo A1, Apo B, Lp(a), Apo E genotypes, glucose insulin and smoking) to IMT in young adults; 3) the relationship of risk factor 'load' from childhood to adult life to IMT; 4) the relationship of IMT in young adults to familial mortality in first- and second-degree relatives due to vascular disease; and 5) the degree of familial aggregation of IMT in young adults and their parents. The investigators believe this study will provide a view of the significance of IMT in young adults not only in its relationship to risk factors in childhood and young adulthood but also to familial factors that may be responsible for accelerated atherosclerosis.
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