Carotid ultrasound and echocardiography were also included in the Cardiovascular Health Study (CHS) and were quickly demonstrated to bear strong relationships with overt CVD in this older population sample, to be associated with many conventional CVD risk factors, and to be strong predictors of subsequent overt cardiovascular events. More importantly, short-term risk of clinical events was shown to be low to non-existent in the absence of subclinical disease.