The UNC Gillings School of Global Public Health’s Collaborative Studies Coordinating Center (CSCC) has been awarded a five-year, $19 million contract by the National Institutes of Health’s National Heart, Lung and Blood Institute to conduct the next phase of the Atherosclerosis Risk in Communities (ARIC) study.
The CSCC, based in the Gillings School’s Department of Biostatistics, is led by Dr. Sonia Davis, Professor of the Practice of biostatistics at the Gillings School.
[Photo: Dr. Sonia Davis (left) and Dr. David Couper]
A prospective epidemiologic study, ARIC began in 1987, when 15,792 participants from four communities in the United States—Forsyth County, N.C.; Jackson, Miss.; Minneapolis; and Washington County, Md.—were selected randomly and enrolled in the study, which aimed to investigate the causes of atherosclerosis and its clinical outcomes, and the variation in cardiovascular risk factors, medical care and disease, by race, gender, location and date.
Over the next 30 years, investigators expanded research goals to include the characterization of stages of heart failure, identification of genetic and environmental factors leading to ventricular dysfunction and vascular stiffness, and assessment of longitudinal changes in pulmonary function, including identifying determinants of its decline.
Through a series of phone calls and in-person visits, investigators have continued to gather data on cardiovascular events experienced by members of the cohort – including coronary heart disease (CHD), heart failure, stroke and atrial fibrillation – and have studied risk factors related to the progression of cardiovascular disease from subclinical to clinical levels.
“It’s impossible to define the CSCC without acknowledging ARIC front and center,” Dr. Davis said. “It has been an honor to be the long-time Data Coordinating Center for this highly impactful study. Now, we are excited about the unprecedented opportunity ARIC provides us to assess prospectively mid-life risk factors of age-related conditions such as dementia.”
The sixth examination of the remaining living participants in the ARIC study currently is underway, and the new funding supports a seventh examination that will begin in January 2018 and last 18 months. The funding will allow investigators to collect data and new specimens, and will fund continued storage of all study specimens at three labs across the country – Baylor College of Medicine in Houston, the University of Texas Health Science Center at Houston, and the University of Minnesota.
In addition to following members of the cohort, ARIC investigators have performed ongoing surveillance of hospitalizations for heart disease in the four communities. Surveillance has included monitoring long-term trends in hospitalized myocardial infarction, CHD deaths and heart failure. This community surveillance is not part of the new funding, which instead provides resources for a pilot study comparing the current manual surveillance process to a computerized process involving extraction of data from electronic health records.
ARIC also provides a platform for ancillary studies. Given participants who began the program in their 40s, 50s or 60s, and are now in their mid-70s to mid-90s, the study offers an unprecedented opportunity to evaluate risk factors for conditions related to aging, such as neurocognitive decline.
“We collaborate with many investigators at sites across the country, some of whom are funding ancillary studies for additional data collection and for studying specimens that are being collected over many years,” said Dr. David Couper, clinical professor of biostatistics at the Gillings School, deputy director of the CSCC and principal investigator of the ARIC study coordinating center. “The cohort is such a valuable resource.”
To date, the ARIC project has resulted in publication of more than 1,800 articles in peer-reviewed journals and continues to be strong training ground for young investigators.
“We’ve been part of valuable research that has continued over a long period, and the study is still producing high-quality research, even after all this time,” said Dr. Couper.