Data from the most recent population survey (2000-02) of the Minnesota Heart Survey (MHS) indicate that previous favorable trends in cardiovascular risk levels are attenuating. While cigarette smoking continues to decline, mean body weight rose substantially and rapidly. Other factors present more mixed patterns. Serum cholesterol declined in older adults associated with widespread drug treatment. In younger adults serum cholesterol is rising, as is fat intake. Blood pressure detection and treatment is again improving. However, unfavorable trends in "normotensives" are observed as more become "prehypertensive". We anticipate that future trends in cardiovascular disease will reflect these changes in the classical risk factors. Progress may or may not continue. We propose to conduct another population survey of 4,800 adults ages 25-84 in 2005-07, to detect current levels and trends in cardiovascular disease risk factors including blood lipids, blood pressure, cigarette smoking, dietary fat intake, obesity, diabetes, physical inactivity, medication use and new markers for atherosclerotic disease. The proposed survey will build upon five previous, independent cross-sectional surveys conducted in 1980-82, 1985-87, 1990-92, 1995-97 and 2000-02, which collectively examined more than 27,000 adults in the Minneapolis/St. Paul metropolitan area (2.6 million residents, 2000 census). Using the sampling strategy of prior surveys, households will be randomly selected by a two-stage cluster design. A wide range of risk factors for cardiovascular disease will be measured using identical methods to previous surveys. Secular trends in risk factors to morbidity and mortality from coronary heart disease, congestive heart failure and stroke trends within the same population will be analyzed using new analytic methods. To estimate risk factor levels in children and adolescence, 1,200 youth ages 8-17 (offspring of the selected adults) will be recruited and examined using youth specific measurement instruments where appropriate. These findings will be compared to a similar group measured in 2000-02. At the suggestion of NHLBI, the study will oversample ethnic minorities to obtain 25% of the total group of 6,000 adults and children. Serial ascertainment of risk factor levels in populations is crucial to understanding, predicting and controlling population levels of cardiovascular disease. The Minnesota Heart Survey has been, and continues to offer, a powerful resource to examine long-term trends in cardiovascular disease risk factors and outcomes.