CORONARY HEART DISEASE & STROKE IN PEOPLE AGED 65-84

冠状动脉心脏疾病

• 批准号: 6159019
• 负责人: LINDA P FRIED
• 金额: $ 30万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1988
• 资助国家: 美国
• 起止时间: 1988-06-01 至 2005-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6159019
• 关键词: age difference; arrhythmia; atherosclerosis; cardiovascular disorder epidemiology; carotid artery; clinical research; coronary disorder; diabetes mellitus; disabling disease; disease /disorder proneness /risk; exercise; gender difference; health care service utilization; human mortality; human old age (65+); human subject; hypercholesterolemia; longitudinal human study; myocardial infarction; myocardial ischemia /hypoxia; psychological stressor; racial /ethnic difference; smoking; social support network; stroke

The Cardiovascular Health Study is a population-based, longitudinal study of risk factors for the development and progression of coronary heart disease and stroke in adults over the age of 65 years. Both risk factors established in middle-aged population and suspected risk factors are examined and include hypercholesterolemia, hypertension, glucose intolerance and diabetes, and cigarette smoking. Since atherosclerosis is prevalent in the elderly, the study focuses on factors thought to induce clinically overt disease. It does so in two ways: (1) It assesses the prediction of clinical disease from non-invasive measure of preclinical disease, such as carotid atherosclerosis, left ventricular impairment, and arrhythmias of episodes of myocardial ischemia. (2) Since cardiovascular events may occur in elderly people as a result of health or life circumstances which may have changed in the months preceding the event, the study contacts participants at frequent intervals to evaluate their status with respect to concurrent disease, social support networks, stressful life situations, diet, physical activity, and other risk factors. The study has three secondary objectives pertaining to the elderly populations: (1) to evaluate the factors associated with preclinical cardiovascular disease such as carotid atherosclerosis, left ventricular impairment and episodes of arrhythmia or myocardial ischemia; (2) to evaluate predictors of disability, institutionalization and mortality in participants who have coronary heart disease or stroke; and (3) to measure the utilization and impact of medical care services for coronary heart disease and stroke. Currently, risk associations are identified with clinical disease by the accumulation of events. Risk estimates are compared in subgroups of participants, such as women versus men, African-American versus Caucasian, those older versus younger than 75 years, or those with versus without prevalent clinical or subclinical disease. Risk estimates are compared in subtypes of disease, such as fatal versus non-fatal myocardial infarction, symptomatic versus silent myocardial ischemia, or fatal versus non-fatal stroke. Estimates are compared of longer-term (5-10 year) versus short-term (1-3 year) CVD risk. The study is also; determining whether presence or progression of subclinical disease (abnormalities detected non-invasively without signs or symptoms) are better predictors of clinical disease than traditional risk factors; identifying determinants of change in subclinical disease; identifying characteristics of subgroups at low risk for developing CVD (in whom preventive measures may be unnecessary). The contractor serves as a Field Center for the study. The duties of the Field Centers include recruitment of an appropriate cohort, cohort interviews and clinical examinations, surveillance of the cohort, and data analysis.

心血管健康研究是一项以人群为基础的纵向研究， 冠状动脉疾病发生和进展的危险因素研究 65岁以上的成年人心脏病和中风。两种风险 在中年人群中建立的因素和疑似危险因素 包括高胆固醇血症、高血压、血糖 不耐症和糖尿病，以及吸烟。由于动脉粥样硬化 在老年人中普遍存在，研究重点是被认为 引起临床上明显疾病。它以两种方式这样做：（1）它评估 通过非侵入性测量来预测临床疾病 临床前疾病，如颈动脉粥样硬化、左心室 损伤和心肌缺血发作的心律失常。（二） 由于心血管事件可能发生在老年人中， 健康或生活情况可能在几个月内发生变化 在活动之前，研究人员经常与参与者联系， 间隔时间以评价其关于并发疾病的状态， 社会支持网络，紧张的生活状况，饮食，身体 活动和其他风险因素。 这项研究有三个与老年人有关的次要目标 人群：（1）评估与临床前 心血管疾病，如颈动脉粥样硬化、左心室 心律失常或心肌缺血的损害和发作;（2） 评估残疾、机构收容和死亡率的预测因素 患有冠心病或中风的参与者;以及（3） 测量冠心病患者医疗保健服务的利用和影响 心脏病和中风。 目前，风险协会是由临床疾病确定的， 事件的积累。风险估计值在以下亚组中进行比较： 参与者，如女性与男性，非洲裔美国人与 高加索人，年龄大于75岁与年龄小于75岁的患者，或 与没有流行的临床或亚临床疾病相比。风险估计 在疾病的亚型中进行比较，例如致命与非致命 心肌梗死，症状性与无症状性心肌缺血， 或致命性与非致命性中风。估计数与长期估计数进行比较， (5-10短期（1-3年）CVD风险。 这项研究也是;确定是否存在或进展的 亚临床疾病（非侵入性检测到的异常，无体征 或症状）是临床疾病的更好的预测比传统的 确定亚临床疾病变化的决定因素; 确定CVD低风险亚组的特征 (in预防措施可能是不必要的）。 承包商作为研究的现场中心。的职责 现场中心包括招募适当的队列，队列 访谈和临床检查，队列监测，以及 数据分析