In the community surveillance component, the four communities are investigated to determine the long term trends in hospitalized MI and CHD deaths in approximately 470,000 men and women aged 35-84 years.  Events are investigated by review of hospital records and by query of physicians and family members and are given standardized diagnoses.  Starting in 2006, surveillance of inpatient (ages 55 years and older) and outpatient heart failure (ages 65 years and older) is included for the events occurring in 2005 and later.