Atherosclerosis Risk in Communities (ARIC) Study

Project timeline
1985-ongoing (project currently funded through 2028)
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What is the goal of the ARIC study?

The Atherosclerosis Risk in Communities (ARIC) study initially served to identify risk factors for subclinical atherosclerosis, . The study included Black and white adults between the ages of 45 and 65 who lived in four U.S. communities across the country. 

As participants have aged, study goals have shifted to focus on risk factors for heart diseases including heart attack (myocardial infarction), coronary heart disease, stroke, and heart failure.

The study also aims to measure how heart disease risk factors, medical care, and health outcomes vary by race, ethnicity, sex, location, and time. 


  • ARIC enrolled approximately 16,000 adults from four U.S. communities and has monitored them for over 35 years.
  • The study helped understand the risks of heart attack, hospitalizations from heart failure, and deaths from heart disease in over 400,000 adults.
  • Findings helped shape clinical guidelines used by healthcare providers to treat coronary heart disease, diabetes, stroke, and chronic kidney disease.
  • ARIC has published more than 2,800 scientific articles.

What are the key findings of the ARIC study?

The ARIC study has led to many discoveries that have increased our understanding of the causes of atherosclerosis and heart disease. These discoveries have shaped evidence-based clinical practice guidelines for coronary heart disease, diabetes, stroke, and chronic kidney disease. 

For 25 years, ARIC’s community surveillance data have provided important, validated information about the occurrence of coronary heart disease and how often it leads to death in the United States. 

More information
- Atherosclerosis Risk in Communities (ARIC) Study

Highlighting further key findings and accomplishments, the ARIC study:

  • Became the first U.S. population-based study to establish a specific clinical characteristic — thickness of the carotid intima-media (IMT) — as a marker or indicator for atherosclerosis before other detectable signs or symptoms. Accounting for this marker in clinical care can improve heart disease outcomes.
  • Provided long-term, prospective data about how previously unknown risk factors such as lipoprotein A or vitamin D levels and fat distribution impact heart disease in Black and African American people. 
  • Increased understanding of risk factors for heart failure so researchers could create useful models to predict heart failure and stroke. These models include information specifically about risks for Black and African American people, some of the first models to do so. 
  • Became the first study to document a set of health metrics that indicate likelihood for heart disease and provide evidence that the number of health metrics a person meets relates to their risk for heart disease. The American Heart Association calls this set of health metrics Life’s Essential 8. 
  • Played a major role in identifying specific gene mutations (PCSK9 mutations) that can lead to low cholesterol levels and decreased coronary heart disease risk.
  • Identified that high levels of inflammatory markers are associated with a higher risk for diabetes, a discovery that helped drive the current understanding of the ways inflammation can cause diabetes.
  • Produced some of the first evidence that lifestyle factors contribute to the risk of venous thromboembolism, a blood clot that starts in a vein. The findings offered some key areas to target prevention efforts. 

How is the ARIC study conducted?

The ARIC study was divided into two parts: community surveillance, where researchers collected general information about the health of the communities based on available data, and a cohort study, where individual participants volunteered to provide specific samples and data to researchers as part of the research study.

The community surveillance arm (1987-2014) tracked deaths from heart attack, or myocardial infarction, and coronary heart disease for over 400,000 adults ages 35 to 84 living in four communities. 

  • Forsyth County, North Carolina
  • Jackson, Mississippi
  • Eight northern suburbs of Minneapolis, Minnesota
  • Washington County, Maryland. 

From 2005 to 2014, the study also looked at the rate of hospitalization for heart failure among adults in these communities who were age 55 and older. 

Participants in the cohort study were also recruited from the four ARIC study communities. 

More information
- Atherosclerosis Risk in Communities (ARIC) Study

The cohort was started in 1985 to improve researchers’ understanding of what they observed from community surveillance. Data were validated using standard methods for cohort studies that follow a group of people over a long period of time. They were also validated through additional information, such as risk factors and out-of-hospital medical care.

Researchers recruited 15,792 Black and white adults ages 45 to 64, who completed four clinic exams in the first decade of the study (1987-1989, 1990 -1992, 1993 -1995, and 1996 -1998). 

Starting in 2011, additional exams were conducted (2011-13, 2016-17, and 2018-19). Participants are also contacted by telephone twice a year to report on their health and any hospitalizations.