The Phase IV Exam is a continuation and marked expansion of the Family Study initiated in Phase III. Phase IV recruited and examined 90 more families and performed linkage analysis on a total sample of 3,776 individuals from 94 families including re-examination of the 900 Phase III Family Study participants. The major components of Phase IV include non-invasive carotid ultrasound and pressure waveform analysis, measures of LV structures and function by echocardiography, and laboratory tests (include measures of Thyroid Stimulating Hormone (TSH) and Endothelin and VCAM-1) and DNA marker typing.

The Strong Heart Study-IV (SHS, Cardiovascular Disease in American Indians Phase IV) continued the mortality and morbidity surveillance of the original cohort, the study of the inheritance of risk factors in American Indian families, and the re-examination of the members of the original families recruited in Phase III.

Phase IV Manual of Operations (PDF)

Phase IV Data Forms (PDF)

Phase IV Data Dictionary (PDF)