Cardiovascular Health Study (CHS)
What is the goal of the CHS?
The NHLBI has pioneered research that helped shape the understanding of risk factors for cardiovascular disease in middle-aged Americans. The goal of the Cardiovascular Health Study (CHS) is to identify risk factors for cardiovascular disease related to the onset of coronary heart disease and stroke in adults aged 65 or older. The CHS also serves as a platform to investigate a variety of other research topics that impact older adults, such as pulmonary disorders, diabetes, kidney disease, vascular dementia, and frailty.
- Since 1988, the CHS has aimed to identify risk factors related to the onset of coronary heart disease and stroke in adults aged 65 or older.
- Nearly 6,000 men and women were recruited from four communities for the study.
- The CHS characterized a previously unrecognized form of heart failure that is especially common in older adults.
- CHS investigators were among the first to report on the importance of markers of inflammation in the development of cardiovascular disease.
- Data from the CHS has led to more than 1,500 published research papers. As the cohort has aged, CHS has become an important study of the aging process.
What are the key findings of the CHS?
One of the most frequently cited papers to emerge from the CHS included the results of a study that explored the contribution of cardiovascular disease that is present without specific symptoms. Researchers found that as we age, a large amount of plaque buildup and thickening occurs in the carotid arteries, and these changes may not cause symptoms. The presence of this plaque, known as atherosclerosis, predicts a higher risk of a stroke or heart attack. This was a landmark finding, demonstrating the importance of identifying the earliest stages of a cardiovascular disease process.
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How is the CHS conducted?
The study recruited 5,888 men and women aged 65 or older in four U.S. communities—Sacramento, CA; Hagerstown, MD; Winston-Salem, NC; and Pittsburgh, PA—conducting annual clinical exams between 1989 and 1999. CHS research was conducted with an emphasis on subclinical measures, or measures of disease without signs and symptoms that are detectable by physical examination or laboratory test. Extensive initial physical and laboratory evaluations were performed to identify the presence and severity of cardiovascular risk factors, such as high blood pressure, high cholesterol, and pre-diabetes; subclinical disease, such as carotid artery atherosclerosis, left ventricular enlargement, and transient ischemia; and cardiovascular disease that has obvious signs and symptoms. These exams permitted evaluation of cardiovascular risk factors in older adults, particularly in groups previously under-represented in studies, such as women, African-Americans, and adults aged 65 or older.
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In 1948, President Truman signed legislation that created what is now the NHLBI to address America's emerging cardiovascular disease epidemic. In the decades since its founding, the NHLBI has funded research that has led to a dramatic 40 percent reduction in annual deaths from both heart disease and stroke and is now averting over 1 million deaths annually from coronary heart disease – a phenomenal return on the nation’s public investment in medical research.