We outline the design and methodology of the PURSE-HIS study in Tamil Nadu, India, to meet the following objectives:

to estimate the prevalence of risk factors for endovascular disease (EVD) among the urban, semi-urban, and rural communities;

to estimate the prevalence of overt EVD in urban, semi-urban, and rural communities;

to estimate the prevalence of subclinical EVD by provocative testing in urban, semi-urban, and rural communities;

to estimate the progression of subclinical and overt EVD in these communities, including an examination of how the risk factor-outcome associations vary across communities;

to develop, implement, and evaluate EVD prevention strategies with an alternative system of medicine and/or recognized allopathic system of medicine.