The Dallas Heart Study: a population-based probability sample for the multidisciplinary study of ethnic differences in cardiovascular health

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Abstract

The decrease in cardiovascular death rates in the United States has been slower in blacks than whites, especially in patients <65 years of age. The Dallas Heart Study was designed as a single-site, multiethnic, population-based probability sample to (1) produce unbiased population estimates of biologic and social variables that pinpoint ethnic differences in cardiovascular health at the community level and (2) support hypothesis-driven research on the mechanisms causing these differences using genetics, advanced imaging modalities, social sciences, and clinical research center methods. A probability-based sample of Dallas County residents aged 18 to 65 years was surveyed with an extensive household health interview. The subset of participants 30 to 65 years of age provided in-home fasting blood and urine samples and underwent multiple imaging studies, including cardiac magnetic resonance imaging and electron beam computed tomography. Completed interviews were obtained for 6,101 subjects (54% black), phlebotomy visits for 3,398 (52% black), and clinic visits for 2,971 (50% black). Participation rates were 80.4% for interviews, 75.1% for phlebotomy visits, and 87.4% for clinic visits. Weighted population estimates of many measured variables agreed closely with those of the United States census and were relatively stable from the interview sample to the phlebotomy and clinic subsamples. Thus, the Dallas Heart Study provides a phenotypically well-characterized probability sample for multidisciplinary research that will be used to improve the mechanistic understanding and prevention of cardiovascular disease, especially in black Americans.

Section snippets

Human subjects protection

A community advisory board was established and aided in the wording of subject consent forms, which were approved by the institutional review boards at the University of Texas Southwestern and the Research Triangle Institute (which was responsible for developing the sampling frame, selecting the sample, screening the households, and conducting the household interview) in accordance with the Helsinki Declaration of the World Medical Association.

Sampling requirements

We recruited a probability sample with equal

Participation rates

We enrolled a much larger percentage of black patients than any other cardiovascular study that collected a probability sample, and our participation rates compare favorably with those of other health surveys in American adults (TABLE 1, TABLE 2). 14, 15, 16, 17, 18, 19, 20

Validity of population estimates from the weighted interview sample

The Dallas Heart Study estimates for the stratification variables (ethnicity, gender, and age) were identical to those from the 2000 United States census (Table 3). The estimated population distribution of educational

Discussion

The Dallas Heart Study represents a departure from previous cardiovascular health surveys6, 14, 15, 16, 17, 18, 19, 20, 21 by accessing a multiethnic, population-based probability sample to pinpoint key sources of ethnic differences in cardiovascular health at the community level and to probe the mechanistic basis of such differences using state-of-the-art imaging modalities, comprehensive genotyping, and general clinical research center methods. Detailed information regarding social and

Acknowledgements

We wish to acknowledge our gratitude to the Community Advisory Board members and for the support of the Dallas community. Dallas Heart Study investigators in the Donald W. Reynolds Cardiovascular Clinical Research Center include Ronald G. Victor, Helen H. Hobbs, Scott M. Grundy, Eric N. Olson, and R. Sanders Williams (University of Texas Southwestern Medical Center principal investigators); Richard S. Cooper (Loyola University), David S. Siscovick (University of Washington), and Joseph A. Hill

References (23)

  • National Center for Health Statistics. National Health and Nutrition Examination Survey III interviewer's manual....
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    The Dallas Heart Study is funded by a center grant from the Donald W. Reynolds Foundation, Las Vegas, Nevada. Survey instrument development was funded in part by a Patient Care and Outcomes Research Grant from the American Heart Association, Dallas, Texas, to Dr. Victor.

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