By 20 years’ follow up in the CARDIA cohort (ages 18-30 at baseline), there were 27 cases of incident heart failure. Strikingly, of the 27 participants affected, 26 self-identified as being Black. Among Black participants, baseline variables significantly associated with incident heart failure included higher diastolic blood pressure and body mass index, lower high-density lipoprotein cholesterol, and presence of kidney disease. Three-fourths of those in whom heart failure developed had hypertension by the time they were 40 years of age. From reference 35 with permission.