Most of the information about factors that increase the risk of heart disease comes from non-Indian populations. We assume that the same factors contribute to heart disease in Indians. To be sure of which factors contribute to heart disease in Indians, it was necessary to do more than one examination. The second examination was conducted to show whether these risk factors change with time. In addition, new measurements were added to increase our understanding of heart disease and lung disease among American Indians. These were the objectives of the second examination – the Phase II examination.
The Phase II examination was conducted between 1993 and 1995. It re-examined 89% of all surviving members of the original cohort. During the examination, medical history was updated and a 24-hour dietary recall was performed on all individuals. Alcohol consumption and tobacco use were reassessed. The physical examination included measures of body fat, body circumferences and blood pressure, an evaluation of peripheral vascular disease, and a 12-lead resting electrocardiogram (ECG). Measures of pulmonary function, an echocardiogram, and a gallbladder sonogram were added. Laboratory measurements included fasting and post-load glucose, and fasting insulin, fasting lipids, fibrinogen, PAI1, glycated hemoglobin, and urinary albumin and creatinine; red blood cell allotypes were also assessed. Blood samples for future analysis were again stored at -70°.