Atherosclerosis Risk in Communities Study
(ARIC)
“the Framingham of the 1990’s”
Two components:
1. Community surveillance – estimate CVD
incidence
2. Cohort – validate and facilitate
interpretation of surveillance data
(See http://www.cscc.unc.edu/aric/)
Communities in ARIC Study
⦁ Forsyth County, North Carolina (biracial)
⦁ Jackson, Mississippi (blacks)
⦁ Suburban Minneapolis, Minnesota
⦁ Washington County, Maryland
Defined geographical entities, well-delineated medical care referral patterns, black and white, urban and
rural
Demographics of ARIC study communities, 1980
Age-adjusted mortality rates* in ARIC study communities, 1980
Cohort study added to enhance ARIC community surveillance
Cohort study – more and better data:
1. More data: provides information on risk factors and out-of-hospital medical care
2. Better data: uses standard methods for ascertaining events (surveillance relies on health care system)
Measure preclinical CVD (atherosclerosis) and CVD precursors
1. assess association of risk factors with both underlying and clinical diseases
2. assess value of B-mode ultrasound diagnosis in predicting clinical diseases
3. store blood in hope of discovering unsuspected precursors of CVD
Community surveillance enhances generalizability of cohort findings
1. Cohort study – compare incidence rates and characteristics of events in residents who do and who do not
participate in cohort
2. Community surveillance – compare the study communities’ CHD experience with areas in the U.S.
ARIC community surveillance for
hospitalized MI and CHD death in age 35-74
⦁ Hospital records with discharge diagnosis of MI or related “screening” diagnoses
⦁ Death certificates with various CHD manifestations coded as the cause of death
⦁ Interviews with physician and next-of-kin for deaths outside the hospital
