Flowchart illustrating the study design of SHFS and the selection of study participants.
The Strong Heart Family Study (SHFS) was initiated in 1997 by enrolling 967 family members of the original cohort, and then expanded in 2001–2003 by enrolling a total of 3,665 participants from 94 families including the re-examination of most of the 967 family members. The current analysis excluded 874 participants because one community withdrew consent for continuing participating in the study. After further excluding participants with overt CVD and missing data on either PAI-1 or LTL, a total of 2,560 participants were included in the cross-sectional analysis and 475 participants were included in the longitudinal analysis.