Data from NHANES I and the three cycles of NHANES I Epidemiologic Followup Study (NHEFS) were used to 1) to examine the associations between several measures of dietary quality at baseline and subsequent 14-year morbidity and mortality from CVD for a national sample of 6109 United States adults aged 45 to 74 years at baseline; 2) to assess the relative importance of the associations of dietary quality and CVD for older adults compared to middle-aged adults. Dietary variables were based on responses to the 24-hour dietary recall and the food frequency questionnaire administered at baseline and included a composite measure of dietary quality, intakes of specific nutrients, and usual consumption of foods from 19 food groups. Baseline measures used as covariates included body mass index, blood pressure, serum cholesterol, sociodemographic variables (e.g., age, race, income, occupation), behavioral variables (e.g., smoking, alcohol consumption, activity level), and chronic health conditions. CVD outcomes were determined from medical history questionnaires, hospital records and death certificates. Change in blood pressure between baseline and 10-year followup were examined as an outcome variable as well as a covariate in the association between diet and CVD.