Cardiovascular Diseases Clinical Trial
To measure by gas-liquid chromatography the relative concentrations of all saturated and unsaturated fatty acids found in the cholesterol ester and phospholipid fractions of plasma from 4,000 subjects participating in the Atherosclerosis Risk in Communities (ARIC) study. The data were used to clarify the role of various fatty acids in atherosclerosis.
BACKGROUND:
The ARIC study is a large population-based, prospective, multicenter study supported by
NHLBI which began in 1986, and is designed to investigate the etiology and natural history
of atherosclerosis and cardiovascular risk factors. It involves investigation of four
cohorts, each with 4,000 adults ages 45 to 65 from four different communities. The study
conducts surveillance for hospitalized myocardial infarction, fatal cardiovascular disease,
and stroke in its cohorts and of the community from which they are drawn. Events are
classified by a Morbidity and Mortality Classification Committee using standardized
criteria.
Data collected on the ARIC cohort at baseline included: a clinical history, a physical
examination including blood pressure, height, weight, and anthropometry. A second history
and physical examination were performed after three years, and annual telephone interviews
were conducted in the intervening years. Laboratory studies at baseline and at three years
included: electrocardiogram, pulmonary function tests, ultrasonographic examination of both
carotids and one popliteal artery for direct visualization of the atherosclerotic process in
peripheral large vessels, and numerous blood studies. Certain hemostatic and lipid tests
were performed only in 'cases' with ultrasonographically determined carotid atherosclerosis
and matched normal 'controls.'
The ARIC clinical history did collect some dietary history using the Willett Questionnaire,
and asked a few questions regarding fish consumption. However, specific questions were brief
and only semi-quantitative. Direct measurement of plasma fatty acid content as an ancillary
study in the Minnesota cohort of the ARIC study gave far more objective information on
specific fatty acid consumption and was invaluable in sorting out the true role that various
fatty acids play in the prevention of coronary heart disease. Furthermore, measurement of
plasma fatty acids in Minnesota ARIC subjects allowed investigation of the relationships
between plasma fatty acids composition and the vast amount of laboratory and clinical
outcome data which the ARIC study collected. Because the clinical and other laboratory data
for each ARIC participant were already available in the computerized data base, a tremendous
amount of valuable information was derived on plasma fatty acid relationships with
laboratory findings and clinical outcome in a large, randomly selected United States
population.
DESIGN NARRATIVE:
The studies were ancillary to the ARIC study. A cross-sectional study examined the
association of plasma fatty acids with plasma lipids, hemostatic parameters, and blood
pressure. A nested case-control study examined the association of plasma fatty acids in 75
Minnesota cases with carotid atherosclerosis versus 75 normal matched controls. A third
study examined the association of plasma fatty acids with incident clinical cardiovascular
events, namely myocardial infarction and stroke.
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