Starting in 2005, subjects enrolled in the MRI substudy began to have echocardiograms and 24hour ambulatory blood pressure monitoring. Subjects will be followed by annual telephone interviews to ascertain stroke, MI, death, and changes in cognitive state. In-person assessment will be done for all subjects who screen positive. Community stroke surveillance will be maintained to insure stroke detection among the cohort. Specific diagnostic committees classify stroke, MI and vascular death. The strengths of this cohort study are the wealth of baseline data already assembled, the triethnic composition residing in the same community, the outstanding followup record, the evaluation of putative risk factors, and the innovative assessment of MRI subclinical disease and carotid subclinical disease. The study primary hypotheses are:1. To determine the independent association of insulin resistance among nondiabetics and the incidence of stroke, as well as stroke, MI or vascular death, after adjusting for known modifiable risk factors such as hypertension, lipids, cigarettes, and alcohol. 2.