Over the past 20 years, the Atherosclerosis Risk In Communities (ARIC) Study has provided important new information on risk factors for atherosclerosis and its progression, on risk factors for coronary heart disease and stroke, and on trends in community rates of cardiovascular disease. We herein propose continuation of ARIC from 2005 to 2012. There are separate proposals for each ARIC Field Center, the Coordinating Center, and the Laboratories. Our aims for renewal in response to the ARIC RFPs are: 1. Completion of 23 years of coronary heart disease (CHD) surveillance in the four ARIC communities, permitting detection of trends in CHD Incidence, case fatality, and mortality in racesex-specific subgroups. For 2005-2009, CHD Surveillance will expand to 75-84 year olds, and inpatient heart failure (55 years and older) and outpatient heart failure surveillance (65 years and older) will be undertaken. 2. Follow-up of ARIC's previously examined cohort for cardiovascular disease (CVD) morbidity and mortality over 23 years, to identify factors related to Incident CHD, stroke, and for 2005-2009, heart failure. 3. Identification and characterization of novel genetic and biochemical risk factors for CVD using stored blood, urine, and DNA samples from available subclinical disease cases, available and newly-occurring CVD cases and control subjects, and subgroups with rapid progression of subclinical disease. The genes and analytes to be measured will be identified via a pathway approach to atherosclerosis and CVD. An extension will enable ARIC to continue to (1) address community trends in CVD and (2) make use of its valuable database and biosample resource to address new questions on the etiology of cardiovascular disease. The Collaborative Studies Coordinating Center has served as the ARIC coordinating center (CC) and will continue providing the overall operation and scientific coordination for the ARIC study with special emphasis on statistical methodology. CC staff will participate in all the ARIC committees and subcommittees, will coordinate conference calls and take minutes. The CC staff will actively participate in writing manuscripts as lead and co-authors and provide statistical advice, analyses and review when needed. The CC will maintain and participate in development of manuals, forms, and instructions. Training sessions will be coordinated by CC staff. Data management, including systems for data entry and systems to prepare data files for analyses, will be maintained and created for HF and mortality and morbidity classification (MMCC) for CHD and HF. All MMCC activities will be coordinated by CC. Quality control reports will be prepared and monitoring visits to field centers and central agencies will be on going. The CC will respond to needs of community surveillance (CHD and HF), AFU, and laboratory studies (including case-cohort studies) as issues arise. The CC will maintain and update two websites for ARIC. The CC will coordinate ARIC's efforts to disseminate data to investigators within and outside the ARIC scientists.