Coronary Artery Risk Development in Young Adults Study

Coronary Artery Risk Development in Young Adults Study (CARDIA) is a long-term, epidemiological study funded by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH). Initiated in 1985, CARDIA was designed to investigate the development and determinants of clinical and subclinical cardiovascular disease and its risk factors. The study focuses on a large, multiracial cohort of young adults aged 18 to 30 years at the time of their enrollment, with the aim of understanding how lifestyle, behavioral, and genetic factors contribute to the risk of coronary artery disease over time.

Background

The CARDIA study was established in response to the growing need to address coronary artery disease (CAD) at its early stages. Prior to CARDIA, most research focused on middle-aged and older adults, leaving a significant gap in understanding how early life factors contribute to the development of CAD later in life. The study's design allows for the examination of changes in health and risk factors over the adult life course and their impact on the development of CAD.

Study Design

CARDIA recruited 5,115 participants from four U.S. cities: Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota; and Oakland, California. The cohort includes approximately equal numbers of African American and Caucasian participants, men and women, to ensure the study's findings are applicable across different racial and gender groups. Participants undergo extensive examinations every few years, which include medical histories, physical examinations, laboratory tests, and questionnaires about lifestyle and psychosocial factors.

Findings

Over the years, CARDIA has contributed significantly to our understanding of cardiovascular disease and its risk factors. Key findings from the study include:

• The importance of healthy lifestyle choices in young adulthood for the prevention of cardiovascular disease later in life.
• The impact of factors such as smoking, physical activity, diet, and obesity on the development of CAD.
• The role of psychosocial factors, including stress and socioeconomic status, in cardiovascular health.
• Insights into the progression of subclinical atherosclerosis and the development of hypertension and diabetes mellitus.

Impact

The CARDIA study has had a profound impact on public health policies and recommendations. Its findings have informed guidelines on physical activity, diet, and other lifestyle factors that can reduce the risk of cardiovascular disease. Additionally, CARDIA has contributed to our understanding of health disparities in cardiovascular disease, leading to more targeted interventions to reduce these disparities.

Future Directions

As the CARDIA cohort ages, the study continues to provide valuable insights into the cardiovascular health of middle-aged and older adults. Ongoing research focuses on the long-term effects of early life exposures and behaviors on cardiovascular aging, the development of heart failure, and cognitive function.