In 1997, the study was renewed and extended through 2002, and from 2002-2010, and again in 2012 in order to study the impact of genetic factors on the evolution from childhood cardiovascular risk factors to subclinical and clinical morbidity in an adult population, ages 20 to 43, who had been followed over a long period of time. The study also seeks to study the association of risk factor phenotypes to anatomic changes in the cardiovascular system as seen by necropsy. The population for genotype-phenotype studies includes approximately 1,400 siblings derived from 178 longitudinal birth cohorts. The cardiovascular phenotypes include obesity, blood pressure, lipids, lipoproteins, apoproteins, homocysteine, glucose-insulin, fibrinogen, plasminogen activator inhibitor-1 and von Willebrand Factor. Environmental risk factors consist of sociodemographic characteristics, tobacco and alcohol use, oral contraception, physical activity, cognitive and physical function, and quality of sleep and diet. Subclinical morbidity includes echo-Doppler measurements of cardiac-carotid structure and function. Using robust sibling pair linkage methods, a genome-wide search involving 391 markers with spacing of 10 centimorgans is conducted for genes which influence quantitative traits. This is supplemented with 41 highly polymorphic markers located in or near candidate genes likely to be related to obesity, lipoprotein metabolism, blood pressure, insulin resistance, diabetes, atherogenesis and thrombosis.