The general aim of this competing continuation application is to address, in a timely and cost-effective way, important unanswered questions in cardiovascular epidemiology employing data and analyses from the Chicago Heart Association Detection Project in Industry cohort. This application focuses on the three Specific Aims from the current budget period that require additional follow-up, and hence additional end point events, to be fully and completely addressed: a) factors influencing CHD-CVD risk long-term in young adult women (ages 18-39 at baseline); b) factors influencing CVD-CHD risk long-term in young adult and middle-aged African-American women and men; and c) impact of baseline """"""""low risk"""""""" status on long-term mortality from CHD, CVD, non-CVD, and all causes in young adult women (ages 18-39), including African-American and white women. Questions that are addressed in this application remain unanswered primarily because most other cohort studies: 1) Have not included large numbers of young adult women (ages 18-39) with long enough follow-up to accrue substantial numbers of deaths from CHD, CVD, or all causes. 2) 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) Have not included participants with markedly differing baseline ages to permit comparisons of risk factor relations in younger versus middle-aged or older persons. 4) 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. 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 Chicago cohorts under study for over 25 years, 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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