Beginning in 1987, each participant in the prospective San Antonio Heart Study 1 was recalled as close as possible to the eighth anniversary of his or her baseline examination and re-examined. Subjects had fasting lipid and lipoprotein determinations, a glucose tolerance test to diagnose incident cases of non-insulin dependent diabetes mellitus according to the National Diabetes Data Group criteria, blood pressure measurements, a resting electrocardiogram, and completed a questionnaire to elicit information on possible cardiovascular endpoints. Medical records were obtained to document the endpoints. Subjects with a history of peripheral vascular disease or diabetes had ankle/arm blood pressure ratios determined before and after exercise. Deaths were ascertained in the course of routine follow-up supplemented by search of state health department and National Death Index records. Death certificates were requested and for those certificates indicating diabetes or cardiovascular disease as the cause of death, hospital or physician records were requested and reviewed. Standardized criteria were used to validate cause of death. Endpoints included diabetes, sudden cardiac death, non-fatal (including silent) myocardial infarction, angina pectoris, cerebrovascular and peripheral vascular disease. The study was renewed in 1992 to continue follow-up.