THE ATHEROSCLEROSIS RISK IN COMMUNITIES (ARIC) STUDY - FIELD CENTER - TASK ORDER 01, TASK AREA A

社区动脉粥样硬化风险(ARIC)研究始于1985年，由两部分组成：基于社区的监测和前瞻性队列研究。社区监测旨在监测美国四个社区住院心肌梗死(MI)和致命冠心病(CHD)的趋势：北卡罗来纳州福赛斯县、密苏里州杰克逊、明尼阿波利斯郊区和马里兰州华盛顿县。2005年增加了对住院心力衰竭(HF)事件的监测。这些社区被选择来提供四(4)个地理位置的数据，这些地理位置的死亡率范围在城市、郊区和农村环境中。这项队列研究旨在调查同一社区的中年白人或非洲裔美国成年人中动脉粥样硬化的危险因素和自然病史以及临床动脉粥样硬化的发展。这项研究招募了15,792名最初年龄在45岁-之间的白人或非洲裔美国人参与者，并选定的参与者在研究的前十年(1987-1989、1990-1992、1993-1995和1996-1998)接受了三年一次的临床检查。2011-13年的临床检查对69-89岁的6,500多名参与者进行，重点是确定社区居住参与者的心力衰竭阶段，并能够识别导致心功能障碍和血管僵硬的遗传和环境因素。这些数据为涵盖广泛主题的几项辅助研究提供了基础。2018-19年对近3600名75岁及以上的参与者进行的临床检查支持了NIH拨款资助的12项辅助研究的检查内容，这些研究涉及的主题包括射血分数(HFpEF)保留的心力衰竭的进展、冠状动脉钙化、新型持续心电监测技术检测到的心房颤动负荷、糖尿病、痴呆、脑淀粉样蛋白沉积以及动脉僵硬和认知的变化。在各自的后续检查中，存活队列的参与率分别为91%、82%、74%、65%和50%。已经对血液样本进行了可能的生化危险因素检测，并储存起来用于病例对照研究。DNA被提取出来，淋巴细胞被冷冻保存(为了可能永生)，用于候选基因的研究、全基因组扫描、表达和其他组学研究。自基线以来，还每12个月联系一次队列成员(自2012年以来每6个月联系一次)，以获取有关生命状况、当前居住地、重大疾病或伤害以及接触者之间住院情况的信息，以确定临床心血管疾病(CVD)事件。在最后一次完成的随访期，队列接触率为78%。截至2021年，研究结果已在2600多份出版物中发表。

The Atherosclerosis Risk in Communities (ARIC) Study was initiated in 1985 with two components: community-based surveillance and a prospective cohort study. The community surveillance aimed to monitor trends in hospitalized myocardial infarction (MI), fatal coronary heart disease (CHD) in four U.S. communities: Forsyth County, NC; Jackson, MS; suburbs of Minneapolis, MN; and Washington County, MD. Surveillance for hospitalized heart failure (HF) events was added in 2005. The communities were selected to provide data across four (4) geographic locations with a range of mortality rates, in urban, suburban, and rural settings. The cohort study aimed to investigate the risk factors for and natural history of atherosclerosis and development of clinical atherosclerosis in middle-aged white or African American adults from the same communities. The study recruited in 15,792 white or African American participants initially aged 45-64 years and selected participants received triennial clinical exams over the first ten years of the study (1987-1989, 1990-1992, 1993-1995, and 1996-1998). The clinical exam in 2011-13 was conducted on over 6,500 participants 69-89 years with a focus on characterizing heart failure stages in community-dwelling participants and enabling identification of genetic and environmental factors leading to ventricular dysfunction and vascular stiffness. These data provided the basis for several ancillary studies covering a breadth of topics. The clinical exam in 2018-19 on almost 3,600 participants 75 years and older supported exam components from 12 NIH grant-funded ancillary studies on topics including progression of Heart Failure with preserved Ejection Fraction (HFpEF), coronary artery calcification, atrial fibrillation burden detected by novel continuous ECG monitoring technology, diabetes, dementia, brain amyloid deposition, and changes in arterial stiffness and cognition. Participation of the surviving cohort was 91, 82, 74, 65, and 50% at each of the respective follow-up examinations. Blood samples have been assayed for putative biochemical risk factors and stored for case-control studies. DNA has been extracted and lymphocytes cryopreserved (for possible immortalization) for study of candidate genes, genome-wide scanning, expression, and other –omics investigations. Since baseline, cohort members have also been contacted every 12 months (and every 6 months since 2012) to obtain information on vital status, current residence, major illness or injury, and hospitalizations occurring between contacts to identify clinical cardiovascular disease (CVD) events. Cohort contact was 78% at the last completed follow-up period. Findings have been presented in over 2,600 publications as of 2021.