The Coronary Artery Risk Development in Young Adults (CARDIA) study examines the development and determinants of clinical and subclinical cardiovascular disease and their risk factors.   It began in 1985-6 with a group of 5115 Black and White men and women aged 18-30 years.  The participants were selected so that there would be approximately the same number of people in subgroups of race, gender, education (high school or less and more than high school) and age (18-24 and 25-30 years) in each of four field centers: Birmingham, AL; Chicago, IL; Minneapolis, MN; and Oakland, CA.  These same participants were asked to participate in follow-up examinations during 1987-1988 (Year 2), 1990-1991 (Year 5), 1992-1993 (Year 7), 1995-1996 (Year 10), 2000-2001 (Year 15), 2005-2006 (Year 20), 2010-2011 (Year 25), 2015-2016 (Year 30), and 2020-2022 (Year 35).  A majority of the group has been examined at each of the follow-up examinations (90%, 86%, 81%, 79%, 74%, 72%, 72%, 71%, and 67% [despite the impact of the COVID-19 pandemic at Year 35], respectively).  While the specific aims of each examination have varied, data have been collected on a variety of factors believed to be related to heart disease.  These include factors with clear links to heart disease such as blood pressure, cholesterol and other lipids, and glucose.  Data have also been collected on physical measurements such as weight and body composition, as well as lifestyle factors such as dietary and exercise patterns, substance use (tobacco and alcohol), behavioral and psychological variables, medical and family history, and other chemistries (e.g., insulin).  In addition, subclinical atherosclerosis has been measured via echocardiography during Years 5, 10, 25, and 30, a chest CT scan during Years 15, 20, 25, and 35, an abdominal CT scan during Years 25 and 35, and carotid ultrasound during Year 20.  A brain MRI was performed on a subset of participants at Years 25, 30, and 35.  The CARDIA cohort, born between 1955 and 1968, has been influenced substantially by the obesity epidemic at ages younger than participants in other established NHLBI cohorts.  Further investigation of the mechanisms linking obesity to derangements in cardiovascular structure and function and the etiology of clinical events promises to generate important new knowledge to inform health promotion and disease prevention efforts.