COMMUNITY SURVEILLANCE OF CARDIOVASCULAR DISEASE--RISK F

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Data from the most recent survey (1995-97) of the Minnesota Heart Survey (MHS) indicate that previously favorable trends in cardiovascular risk factor levels are attenuating. While cigarette smoking and self-reported dietary fat intake continued to decline, mean body weight rose substantially and rapidly, physical activity decreased, and the previous decline in serum total cholesterol was no longer apparent. These trends may or may not continue in the future. As part of the Minnesota Heart Survey, we propose to conduct another population survey of 4,000 adults, ages 25-84 years in 2000-02, to detect current trends in cardiovascular disease risk factors, including serum lipids, blood pressure, cigarette smoking prevalence, dietary fat intake, obesity, diabetes, physical inactivity, fibrinogen, and serum vitamin E. The proposed survey will build upon four previous, independent cross-sectional surveys conducted in 1980-82, 1985-87, 1990-92, and 1995-97, which collectively examined 23,000 adults in the metropolitan Minneapolis-St. Paul (2.3 million residents in 1990). Using a sampling strategy identical to that of prior surveys, households will be randomly selected by a two-stage cluster design. A wide range of risk factors for cardiovascular disease will be measured using previously employed methods. Cohort and ecological analyses will link secular trends in risk factors to morbidity and mortality from coronary heart disease, congestive heart failure, and stroke within the same population. To estimate risk factor levels in children and adolescents, 1,000 youth ages 8-17, offspring of selected adults, will also be recruited and examined using youth-specific measurement instruments where appropriate (e.g., physical activity and smoking). New methodological studies are proposed to understand trends in reported dietary intake which are irreconcilable with trends in body weight and serum cholesterol. New information will be collected on measures of leisure time physical inactivity and diet validation. Serial ascertainment of risk factor levels in populations is crucial to understanding, predicting, and controlling population trends in cardiovascular disease. The Minnesota Heart Survey has been, and continues to offer, a powerful resource to examine long-term trends in cardiovascular disease risk factors.