Minnesota Heart Survey - Risk Factor Survey
Condition: Cardiovascular Diseases; Heart Diseases; Cerebrovascular Accident; Coronary Disease; Hypertension; Myocardial Infarction
MeSH terms: Stroke; Cardiovascular Diseases; Heart Diseases; Myocardial Infarction; Coronary Disease; Infarction
Study type: Observational

Summary: 
      To continue surveillance of cardiovascular disease risk factors in the seven-county area of
      Minneapolis-St. Paul.
    

Detailed description: 
      BACKGROUND:

      Cardiovascular disease mortality rates, especially for myocardial infarction and stroke, have
      fallen markedly over the past several decades in all race, sex, and age groups in the United
      States. Between 1966 and 1986, the combined death rate for all cardiovascular diseases
      declined by 42 percent. In 1986, the death rate for coronary heart disease was 55 percent of
      what it had been in 1966, and cerebrovascular disease was 42 percent of what it had been in
      1966. The decline is assumed to be related to several factors including improved medical care
      and risk factor modification for elevated blood lipids, cigarette smoking, and hypertension.
      The Minnesota Heart Survey provide trends (1970-2002) in coronary heart disease deaths
      out-of-hospital, in hospitalization rates, case fatality and survivorship for myocardial
      infarction and stroke in the metropolitan area.

      DESIGN NARRATIVE:

      Between 1979 and 1999, R01HL23727 supported mortality surveillance and morbidity
      surveillance. Beginning in FY 2000, R01HL65755 supports the morbidity and mortality
      surveillance and R01HL23727 supports the risk factor survey.

      Mortality Surveillance: The mortality surveillance was a continuation of a surveillance study
      performed by the investigators since 1960 for the state of Minnesota. Mortality data for
      hypertension, stroke, coronary heart disease, and all cardiovascular renal disease were
      monitored for the Twin City metropolitan area with a total population of two million. Age,
      sex, area, location of death and cause-specific death rates were followed. Trends in cancer,
      diabetes, and other non-cardiovascular disease were examined. Case fatality rates, including
      one- and five-year survivorships were determined and related to coronary heart disease
      mortality trends.

      Morbidity Surveillance: All discharges from the seven-county area hospitals with acute and
      chronic myocardial heart disease and stroke listed among the discharge diagnoses were
      recorded using Professional Standards Review Organization data tapes. A ten percent random
      sample of all recorded diagnoses were validated yearly by abstracting data from hospital
      records. Each year's validation sample of definite and probable cases of myocardial
      infarction and stroke formed a cohort to be followed for mortality for one year after the
      onset of the disease event. Individual hospitals and the Professional Standards Review
      Organization in the area provided data on the total numbers of coronary care unit admissions
      and coronary artery bypass operations for each year. Beginning in August 1988, a registry was
      established for all new incident cases of coronary heart disease at the University of
      Minnesota Hospital and the Ramsey County Hospital. In 1989, twelve hospitals were part of the
      myocardial infarction registry.

      Risk Factor Surveillance: Population samples, aged 25-74 years, are recruited and measured
      for blood pressure, serum cholesterol, serum high density lipoprotein cholesterol, cigarette
      smoking, diet, physical activity, height, weight, health attitudes and beliefs, and coronary
      prone behavior. Surveys were completed in 1980-1982 and 1984-1985. The third survey conducted
      in 1990-1992 included the Willett Food Frequency Questionnaire and bioimpedance measurements.
      A nested case-control study using the 1980-1982 risk factor cohort examined the baseline
      cardiovascular disease risk factor differences between coronary heart disease in cases and
      controls.

      The study was renewed in the year 2000 under R01HL23727 to conduct a population survey of
      4,000 adults, ages 25 to 84 in 2000-2002, 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. Cohort
      and ecological analyses will be used to link secular trends in risk factors to morbidity and
      mortality from coronary heart disease, congestive heart failure, and stroke. A total of 1,000
      children and adolescents, ages 8-17, will also be surveyed using youth-specific measurement
      instruments where appropriate.