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Evans County Studies

This study has been completed.
Information provided by:
National Heart, Lung, and Blood Institute (NHLBI) Identifier:
First received: May 25, 2000
Last updated: June 23, 2005
Last verified: June 2000

To conduct surveillance of cardiovascular morbidity and mortality and its correlation with known risk factors in all cohort study groups in Evans County, Georgia.

Cardiovascular Diseases
Heart Diseases
Myocardial Infarction
Angina Pectoris
Cerebrovascular Accident
Coronary Disease
Ischemic Attack, Transient

Study Type: Observational
Study Design: Observational Model: Natural History

Resource links provided by NLM:

Further study details as provided by National Heart, Lung, and Blood Institute (NHLBI):

Study Start Date: July 1958
Estimated Study Completion Date: August 1995
Detailed Description:


The Evans County Studies were initiated as a result of a request from the National Heart Institute in the late 1950's to develop epidemiological studies in areas where significant racial or ethnic differences in cardiovascular disease rates had been observed and where a stable population was available for long-term follow-up. Evans County was in a region of the United States known, at the time, to have the highest total death rates for all causes, of which coronary heart disease and hypertension were major contributors. At that time, Black males and females were known to have four times less coronary heart disease than white males, showed no sex differences for coronary heart disease mortality, and consumed more animal fat and had 50 percent more hypertension.

In 1960, the original Evans County Study cohort was formed when 92 percent of all residents, Black and white, aged 40-74 years and a 50 percent sample of residents aged 15-39 years were given a complete physical examination and a variety of laboratory tests. The major purpose of the original study was to determine factors associated with coronary and related cardiovascular diseases and to explain the low frequency of coronary heart disease in Blacks. Of the initial cohort of 3,102 individuals in 1960, approximately 2,500 were re-examined from 1967 to 1969. Variables studied included serum lipid levels, blood pressure, blood clotting factors, catecholamine levels, physical activity, and social, psychological, and economic factors. Necropsy data were also collected. Follow-up continued on the remaining cohort of approximately 1,900.

Over the years many additional studies were added. The Lipoprotein Phenotyping Study examined which fraction or fractions of high density lipoproteins or low density lipoproteins were related to increased risk for coronary heart disease. The Black-White Neonatal Blood Pressure Study related blood pressure levels during the first year of life to the subsequent development of hypertension and comparing similar groups in other geographical areas to the Evans County group. The Contraceptive Steroids on Blood Pressure Study, funded by the National Institute of Child Health and Human Development, related antecedent characteristics to the development of hypertension or thrombotic disease in the first time oral contraceptive user. The Evans County Health Department also participated Hypertension Detection and Followup Program clinical trial and continued surveillance of the cohort.

Other studies included: the use of defined biracial pedigree cohorts as genetic models to define the possible inheritance of hypertension, hyperlipidemias, coronary heart disease, and thrombosis; maintenance of a collection of frozen sera and food; evaluating new tests to indicate differences in intravascular coagulation between racial and social class groups as related to physical activity, social mobility, and dietary deficiency; studies of the possible relationship to hypertension of dietary sodium-potassium and calcium and selenium intake.


Follow-up of the original Evans County Study cohort was achieved by contacting each member annually by mail, telephone, or personal visit, weekly surveys of all admissions at the Evans Memorial Hospital and Statesboro Hospital; survey of daily obituaries in the local newspapers. In the event of a death, autopsy reports and hospital records were obtained. Twice a year teams of consulting neurologists and cardiologists visited Evans County to examine all suspected surviving cases of stroke, transient ischemic attack, myocardial infarction, and angina pectoris. Home visits were conducted for patients who did not visit the medical facility.


Genders Eligible for Study:   Male
Accepts Healthy Volunteers:   No

No eligibility criteria

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  More Information

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Hames CG, Greenberg BG: A Comparative Study of Serum Cholesterol Levels in School Children and their Possible Relation to Atherogenesis. Am J Public Health, 51:No. 2, March 1961
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McDonough JR, Hames CG, Stulb SC, Garrison GE: Cardiovascular Disease Field Study in Evans County, Georgia. Public Health Rep, 78:No. 12, Dec. 1963
McDonough JR, Hames CG, Griffin LH, Edwards AJ: Observations on Serum Cholesterol Levels in the Twin Population of Evans County, Ga. Circulation, XXV: June 1963
Robinson JC, Blumberg BS, Cooper AJ, Hames CG: Studies on the lnherited Variants of Blood Proteins. J Lab Clin Med, 62:No. 5, Nov. 1963
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Hames CG, McDonough JR, Elliott JL: Hypertension in Identical Twins. Lancet, 585:September 12, 1964
McDonough JR, Garrison GE, Hames CG: Blood Pressure and Hypertensive Disease Among Negroes and Whites in Evans County, Ga. Ann Intern Med, 61:(No. 2), 1964
Kueppers F, Briscoe WA, Bearn AG: Hereditery Deficiency of Serum Alpha Antitrypsin.Science, 146:1678-1679, 1964
Stulb SC, McDonough JR, Greenberg BG, Hames CG: The Relationship of Nutrient Intake and Exercise to Serum Cholesterol Levels in White Males in Evans County, Ga. Am J Clin Nutr, 16:Feb, 1965
McDonough JR, Hames CG, Stulb SC, Garrison GE: Coronary Heart Disease Among Negroes and Whites in Evans County, Ga. J Chronic Dis, 18:443-468, 1965
McDonough JR, Hames CG, Garrison GE, Stulb SC, Lichtman MA, Hefelfinger DC: Population of Evans County, Ga. J Chronic Dis, 18:243-257, 1965
Lichtman MA, Hames CG, McDonough JR: Serum Protein Electrophoretic Reactions among Negro and White Subjects in Evans County, Ga. Am J Clin Nutr, 16:492-508, 1965
McDonough JR, Hames CG, Garrison GE, Stulb SC, Lichtman MA, Hefelfinger DC: The Relationship of Hematocrit to Cardiovascular States of Health in the Negro and White Population of Evans County, Ga. J Chronic Dis. 2 - 1965
Lichtman MA, Hames CG, McDonough JR: Serum Gamma Globulin Levels Among Negroes and Whites in Evans County, Ga. Clin Res, 13:30, 1965
Hames CG, McDonough JR, Stulb SC, Garrison G: Physical Activity and Ischemic Heart Disease Among Negroes and Whites in Evans County, Ga. Prevention of Ischemic Heart Disease: Principles and Practice by Wilhelm Raab, Charles Thomas, Publisher, 1966
McDonough JR, Garrison GE, Hames CG: Blood Pressure and Hypertensive Disease Among Negroes and Whites in Evans County, Ga. In Epidemiology of Hypertension, Grune & Stratton, Inc., 1967
Lichtman MA, McDonough JR, Hames CG: Serum Gamma Globulin Concentration in Related and Non-Related Subjects. Hum Biol, 39:No 3, Sept. 1967
Hames CG: Inter-Disciplinary Findings of the Evans County Epidemiological Research Project, Workshop-Conference, Fundamental Data on Reactions of Vascular Tissue in Man, Lindau, W. Germany, April 19-25, 1970
Hames CG: The Correlation of Ischemic Heart Disease with Social Class Among Whites and Blacks in a Total Community Epidemiological Study. Lex et Scientia, 7: No 2, April-June 1970
Hames CG: Stress and Heart Disease. J Med Assn of Ga, May 1970
Simpson MT, Hames CG, Olewine DA, Ramsey FH, Meier R: Physical Activity, Catecholamines and Platelet Stickiness. Myocardiology, Vol. 1 of series entitled Recent Advances in Studies on Cardiac Structure and Metabolism. E. Bajusz and G. Rona, University Park Press, Baltimore, London, Tokyo, 1972
Heyden S: Epidemiologie Cerbraler Gefabverschulsse. Verhandlungen der Deutschen Gesellschaft fur innere Medizine, 78, Band, by J. F. Bergmann, Munchen, 1972
Heyden S, Bartel A, Cassel JC, Hames CG, Tyroler HA, Meier R: Physiologische, Pharmakologische Und Klinische Wirkungen Des Kaffees. Supplementum 14, Darmstadt, 1972
Tyroler HA, Heyden S, Hames CG: Weight and Hypertension: Evans County Studies in Blacks and Whites. In Paul O (Ed) Epidemiology and Control of Hypertension, Second International Symposium on the Epidemiology of Hypertension, Chicago Heart Association, 1974
Hames CG: Most likely to Succeed as a Candidate for a Coronary Attack. New Horizons in Cardiovascular Practice, University Park Press, 1975
Hames CG: Critique: Diet and Hyperlipidemia as Primary Etiological Factors in Ischemic Heart Disease. Henry I. Russek (Ed) in: Cardiovascular Problems, University Park Press, Baltimore, 1976
Hames CG: A Study of Behavioral Modification and Physiological Response Their Possible Relationship to lschemic Heart Disease. Henry I. Russek (Ed) in: Cardiovascular Problems, University Park Press, Baltimore, 1976
Olewine DA, Simpson MT, Ramsey FR, Thomas G, Hames CG: Submaximal Exercise Response to Plasma and Urinary Catecholamines in Young Adult Males of Different Aerobic Capacities. Physiologist, 19:(No. 3), August, 1976
Farmer PK, Olewine DA, Comer DW, Edwards ME, Coleman TM, Thomas G, Hames CG: Frontalis Muscle Tension and Occipital Alpha Production in Young Males with Coronary Prone (Type A) and Coronary Resistant (Type B) Behavior Patterns: Effects of Exercise. Med and Sci in Sports, 10:51, 1978
Hames CG, Heyden S, Prineas R, Heiss G, Comberg HU, Sneiderman CH: The Natural History of Hypertension in Evans County, Ga. ln: Athero- sclerosis: Its Pediatric Aspects, Grune & Stratton, 1978
Heyden S, Manegold CH, Hames CG, and Patzschke U: Natriumbeschrankung als therapeutische und praventive maBnahme bei Hypertonie. Aktuelle Ernahrungsmedizin, June, 1978
Olewine DA, Thomas G, Simpson MT, Hames CG: 24 Hour Urinary Steroid Excretion Pattern in Young Males with Type A and Type B Behavior Patterns. Physiologist, 21:4, Aug, 1978
Comberg HU, Stern B: Blutdrucksenkung Bei Linolsaurereicher Diat-Zwei Pilotstudien. Aktuelle Ernahrungsmedizin in Klinik Und Praxis. Ban 3, Heft 5, Oct, 1978
Farmer PK, Olewine DA, Comer DW, Edwards M, Coleman TM, Thomas G, Hames CG: Effect of Submaximal Exercise on Recovery Frontalis Muscle Tension and Occipital Alpha Wave Production in College-Aged Males. ASB Bulletin, 25:(No. 2), 87, Apr 1978
Heyden S, Tyroler HA, Heiss G, Hames CG, Bartel A: Coffee Ingestion and Total Mortality Rates. Obesity Ger Med, 8:4, July-Aug, 1979
Patzschke U, Manegold Ch: Hypokaliamiezeichen. Im: Elektrokardiogram Unter Antihypertensiver Behandling. Schweizerische Rundschau fur Medizin (Praxis) 68N: 28, 908-915, 1979
Patzschke U, Manegold Ch: Essentiele Hypertonie: Gestaltwandel Unter Antihypertensiver Behandlung. Diagnostik 12:167-169, 1979
Manegold Ch, Patzschke U: Ruckbildung Der Linesventrikularen Hypertrophie Im: Elektrokardiogram Wahrend Antihypertensiver Behandlung. George Thiese, Publishers, Stuttgard, 8, June, 1979
Patzschke U, Manegold Ch, Wolff G: Ruckbildung Hypertoniebedingter Veranderungen Im: Elektrokardiogram Unter Antihypertensiver Behandlung. Therapeutische Mitteilung, Muncik, med. Wachr 1221, Nr, 23, 1979
Tyroler HA: Editorial - John C. Cassel Memorial Symposium. J. Chronic Dis. 33:261, 1980
Heyden S, Nelius SJ, Hames CG: Obesity, Salt Intake and Hypertension. J Cardiovasc Med. Nov, 1980
Andrews J, Hames CG, Metts J, Davis J: Status of Selenium, Cadmium and Glutathione Peroxidase in Blood of Cardiovascular Diseased and Normal Subjects from Rural and Urban Area of the Cardiovascular Part of Southeastern United States. Trace Substances Environ Health, Vol 14, D.D. Hemphill, University of Missouri Press, 1980
Hames CG, Heyden S: Risk Factors and Hypertension. J Med Assn of Ga. 70:337-338, 1981
Patzschke U, Wolff Ch, Muhlbaier LH, Manegold Ch: Serumpipide Bei Essentiellen Hypertonikern Unter Chlortalidontherapie. Therapiewoche, 31:3405-3414, 1981
Kark JD, Smith AH, Switzer BR, Hames CG: Retinol, Carotene, and the Cancer Cholesterol Association. Lancet, June 20, 1981
Hames CG: Opportunities for Research in Family Practice. Proceedings of the Georgia Rural Health Conference, Mercer University, Macon, Georgia, Oct. 21 and 22, 1982
Davis CE, Knowles M, Kark J, Heyden S, Hames CG, Tyroler HA: Serum Cholesterol Levels and Cancer Mortality: Evans County Twenty-Year Followup Study. Am Oil Chemist Soc, Chapt. 55, pp. 892-900, 1983
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McAdam PA, Smith DK, Kuske TT, Teague RJ, Feldsman DS, Hames CG, Feldman EB: Selenium Status in Residents of Georgia, U.S.A. Nutr Res, Suppl 1, 144-146, 1985
Hudy SP, Caster WO, Hames CG: Changes in Food and Nutrient Intake Patterns Observed in Older Men and Women in Evans County, Ga. J Clin Exp Gerontology, 7 (2) 99-113, 1985
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Hypertension Control in Black Women Would Have Major Health Impact: lntern Med News, July 15-31, 1986. (published interview).
Olewine DA, Simpson MT, Jenkins CD, Ramsay FH, Zyzanski SJ, Thomas G, Hames CG: Catecholamines, Platelet Adhesiveness and the Coronary Prone. Psychiatric Spectator. VIII:No 5, April 1972 Identifier: NCT00005122     History of Changes
Other Study ID Numbers: 901
Study First Received: May 25, 2000
Last Updated: June 23, 2005
Health Authority: United States: Federal Government

Additional relevant MeSH terms:
Angina Pectoris
Cardiovascular Diseases
Cerebral Infarction
Coronary Artery Disease
Coronary Disease
Heart Diseases
Ischemic Attack, Transient
Myocardial Infarction
Arterial Occlusive Diseases
Brain Diseases
Brain Infarction
Brain Ischemia
Central Nervous System Diseases
Cerebrovascular Disorders
Chest Pain
Myocardial Ischemia
Nervous System Diseases
Pathologic Processes
Signs and Symptoms
Vascular Diseases processed this record on November 23, 2014