 At baseline, approximately 6,000 COSMOS participants will provide optional blood and urine samples to determine whether the study agents significantly change biomarkers and other risk factors related to cardiovascular disease and cancer. Selected participants will either have specimens collected through mailed specimen collection kits that are returned by the participant, or have blood, urine, blood pressure, and anthropometric measurements collected by technicians from Examination Management Services, Inc. EMSI, a national clinical services provider. A subgroup of those who provide baseline specimens and measurements will be asked to provide follow-up samples and measurements. 