• Reduce heart disease mortality to no more than 200 deaths per 100,000 population (baseline age-adjusted rate of 323.5 in 1998), West Virginia's Healthy People 2010 Flagship objective.
• Provide the opportunity for West Virginia's health science students to learn concepts of health promotion/disease prevention at the local community level. (WVRHEP)
• Partner with state government, secondary and higher education, and the private sector to reverse the obesity epidemic in West Virginia.

West Virginia (WV) is the second most rural state in the nation, with two-thirds of its 1.8 million people living in communities of less than 2500 population and 44 of its 55 counties designated non-metropolitan by the Federal Office of Management and Budget. Eighty percent of the counties in WV have full or partial designation as Health Professions Shortage Areas (HPSAs) and all but eight counties have full or partial designations as medically under served areas. Over half of the state is considered "distressed" economically by the Appalachian Regional Commission.

The economic plight of WV is reflected in the cardiovascular health of its residents. The age-adjusted rate of heart disease was 328/100,000 in 1995, 21% higher than the national average and 49th in the nation. Lifestyle clearly is an issue. Results of the Center for Disease Control (CDC) Behavioral Risk Factor Survey in 1997 showed that WV had the highest rate of obesity, the third highest rate of self-reported hypertension, and the fifth highest rate of cigarette smoking in the nation. Unfortunately the cardiovascular disease (CVD) burden of WV is typical of Appalachia in general. While death due to heart disease has declined over the past 20 years, the gap between Appalachia and the rest of the nation is widening.

The Coronary Artery Risk Detection In Appalachian Communities (CARDIAC) Project was initiated in 1998 as a means of reversing this disparity in CVD. Comprehensive in design, CARDIAC has two components, a school-based surveillance and intervention initiative, and a targeted individualized approach toward identification and referral for treatment those individuals with the most severe genetic cause of death from premature CVD: familial hypercholesterolemia (FH). CARDIAC is the first statewide CVD intervention program of its kind in the nation. Since its inception CARDIAC has grown from a small school-based CVD surveillance project piloted in three rural WV counties to an expanded multidimensional effort involving all of the state's 55 counties.

The CARDIAC Project relies on the continued support from the West Virginia Executive and Legislative Branches, and The Claude Worthington Benedum Foundation.

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