Phase V of SHS continued the examination of the genetic basis of a wide spectrum of cardiovascular phenotypes to enable quantification of CVD, assessed trends over time in cardiovascular risk factors and CVD events, with a focus on diabetes, with the goal of further evaluating the alarming prevalence of diabetes, diabetes-associated risk factors and preclinical CVD in young American Indians.The Phase V Exam was a continuation of the Family Study initiated in Phase III and greatly expanded in Phase IV.In Phase V all family members examined in Phase III and/or Phase IV were invited to participate.This re-examination incorporated the major components of Phase IV including non-invasive carotid artery ultrasound and measures of the structure and function of the heart by echocardiography.These ultrasound measures were expanded to include assessment of atherosclerosis in the legs (popliteal artery in the knee area) as an indicator of peripheral artery disease.The laboratory tests included the usual blood and urine indicators of general and cardiovascular health and new indicators of inflammation (namely, free fatty acids (FFA), C-reactive protein (CRP) and leptin), which appear to be related to obesity, insulin resistance and diabetes, all of which are important risk factors for CVD.

In addition to re-examining the members of the original families recruited in Phase III and/or Phase IV, the Strong Heart Study-V (SHS, Cardiovascular Disease in American Indians Phase V) continued the mortality and morbidity surveillance of the original SHS cohort, initiated annual mortality surveillance and limited morbidity follow-up of the non-cohort family members, and continued the study of the inheritance of CVD risk factors in American Indian families.

Phase V Manual of Operations

Phase V Data Forms