Objectives
The Heart and Vascular Health Study (HVH) is a case-control study of risk factors for the development of myocardial infarction (MI), stroke, venous thrombosis (VT), and atrial fibrillation (AF). The study setting is Group Health, an integrated health care delivery system in Washington State.

Background
The study originated in 1988 with the examination of risk factors for MI. Over the ensuing years, the study has been funded by a series of grants, which have added case subjects with stroke, VT, and AF, and used a common control group. Study aims have focused on the associations of medication use with cardiovascular events. Starting in 1997, the study aims expanded to include genetic associations with cardiovascular disease. Participants recruited in 2009 or later and who provided blood samples for genetic analysis were asked for consent to deposit genetic and phenotype data in dbGaP.

Subjects
Case subjects were identified by searching for ICD-9 codes consistent with MI, stroke, VT, or AF. For VT and AF, cases diagnosed ... (Show More)

Objectives
The Heart and Vascular Health Study (HVH) is a case-control study of risk factors for the development of myocardial infarction (MI), stroke, venous thrombosis (VT), and atrial fibrillation (AF). The study setting is Group Health, an integrated health care delivery system in Washington State.

Background
The study originated in 1988 with the examination of risk factors for MI. Over the ensuing years, the study has been funded by a series of grants, which have added case subjects with stroke, VT, and AF, and used a common control group. Study aims have focused on the associations of medication use with cardiovascular events. Starting in 1997, the study aims expanded to include genetic associations with cardiovascular disease. Participants recruited in 2009 or later and who provided blood samples for genetic analysis were asked for consent to deposit genetic and phenotype data in dbGaP.

Subjects
Case subjects were identified by searching for ICD-9 codes consistent with MI, stroke, VT, or AF. For VT and AF, cases diagnosed in both inpatient and outpatient settings were included. For MI, stroke, and AF, only incident cases were eligible for inclusion in the study. Medical records were reviewed to confirm the diagnosis. Control subjects were identified at random from the Group Health enrollment, and were matched to MI cases, the largest case group, on age, sex, treated hypertension status, and year of identification.

Design
All subjects have an index date. For cases, the index date is the date that the cardiovascular event (MI, stroke, VT, or AF) came to clinical attention. For controls, the index date is a random date within the range of the case index dates. For both cases and controls, information was collected from the inpatient and outpatient medical record, by telephone interview with consenting survivors, and from the Group Health pharmacy and laboratory databases. Consenting participants provided a blood specimen.

Genetic Research
Genetic factors underlying cardiovascular disease are studied using DNA isolated from the blood samples. HVH participants have had genome-wide genotyping using the Illumina OmniExpress chip.