Author Contributions: Dr Wilkins had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Study concept and design: Wilkins, Dyer, Lloyd-Jones.
Acquisition of data: Lloyd-Jones.
Analysis and interpretation of data: Wilkins, Ning, Berry, Zhao, Lloyd-Jones.
Drafting of the manuscript: Wilkins, Lloyd-Jones.
Critical revision of the manuscript for important intellectual content: Wilkins, Ning, Berry, Zhao, Dyer, Lloyd-Jones.
Statistical analysis: Wilkins Ning, Zhao, Lloyd-Jones.
Obtained funding: Dyer, Lloyd-Jones.
Study supervision: Wilkins, Lloyd-Jones.
Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.
Funding/Support: Dr Lloyd-Jones and this work were supported in part by grant R21 HL085375 from the National Heart, Lung, and Blood Institute (NHLBI). Dr Berry reports receipt of funding from: the Dedman Family Scholar in Clinical Care endowment at UT Southwestern Medical Center; the NHLBI (grant K23 HL092229); and the American Heart Association (grant 10BG1A4280091). The data reported from Cardiovascular Health Study in this article were supported by contracts from the NHLBI (grants HHSN268201200036C, N01-HC-85239, N01-HC-85079 through N01-HC-85086, N01-HC-35129, N01-HC-15103, N01 HC-55222, N01-HC-75150, N01-HC-45133, and HL080295), with an additional contribution from the National Institute of Neurological Disorders and Stroke. Additional support was provided from the National Institute on Aging (grants AG-023629, AG-15928, AG-20098, and AG-027058).
Role of Sponsor: The funding agency had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.
Cardiovascular Health Study Investigators: A full list of principal Cardiovascular Health Study Investigators and institutions can be found at http://www.chs-nhlbi.org/pi.htm.
Disclaimer: This study was conducted with the use of limited-access datasets obtained by the NHLBI and does not necessarily reflect the opinions or views of the study investigators or the NHLBI. The Atherosclerosis Risk in Communities Study, Framingham Heart Study, and the Framingham Offspring Study are conducted and supported by the NHLBI in collaboration with the study investigators.
Online-Only Material: Author Audio Interview is
Additional Contributions: We thank the investigators of all the cohort studies included in this analysis for their hard work and dedication in collecting the underlying data, and especially the study participants, whose dedication and commitment have formed the basis of profound observations regarding health and disease that have contributed to improved health, longevity, and quality of life for millions of persons.