CVD and inflammation across the lifespan in HIV infected adults and children

描述：我们对hiv感染人群中心血管疾病（CVD）的流行病学和CVD危险因素的价值如何随着年龄的增长而演变知之甚少。现在，随着有效的抗逆转录病毒疗法的出现，艾滋病毒已成为一种终身疾病，这令人非常关注。如果心血管疾病的危险因素以证据为基础的方式应用于临床风险分层，则需要跨年龄谱的更好的数据。本提案的总体目标是研究艾滋病毒感染者中心血管疾病的决定因素如何随着年龄的增长而变化。先前的队列研究，通过对跨年龄谱的许多队列应用类似的研究方法，已经揭示了年龄对心血管疾病流行病学的影响。人们早就认识到，不仅心血管疾病的风险随着年龄的增长而增加，而且心血管疾病的风险因素在早期和后期生活中也有所不同。例如，在升高的时候

DESCRIPTION: We have little understanding of how the epidemiology of cardiovascular disease (CVD) and the value of CVD risk factors may evolve with aging in the HIV-infected population. Now that HIV has become a lifelong condition with the advent of effective antiretroviral therapy, this is of great concern. If risk factors for CVD are to be applied for cliical risk stratification in a evidence- based fashion, better data are needed across the age spectrum. The overarching goal of this proposal is to study how determinants of CVD change with aging among HIV-infected persons. Prior cohort studies, by applying similar research approaches to many cohorts across the age spectrum, have revealed much about the influence of age on the epidemiology of CVD. As has long been recognized, not only does CVD risk increase with aging, but the risk factors for CVD differ across early and later life. For example, while elevated cholesterol is unquestionably a causal CVD risk factor, in older adult's serum cholesterol levels have a weak, inconsistent relationship with incident and prevalent CVD. Elevated blood pressure (BP) and C-reactive protein, also known CVD risk factors, likewise are profoundly age-dependent. These phenomena have not been studied in the HIV-infected patient population. We plan an R21 proposal that will significantly extend and build upon the NHLBI HIV-CVD Consortium, which includes 9 R01 investigations on atherosclerotic CVD in adults and children with HIV. Coordination is provided by a Data Coordinating Center (DCC), Central Laboratory, and 3 specialized Reading Centers that have measured CVD risk factors, blood biomarkers, and noninvasive vascular images in identical fashion in the Consortium's nearly 5,000 enrolled subjects. Scientific aims will involve the identification of risk factors, including standard clinial CVD risk factors such as lipids, blood pressure and diabetes, as well as novel biomarkers of inflammation and hemostasis that are associated with the presence of subclinical atherosclerosis in patient groups across the lifespan from adolescence, through young-to- middle adulthood and later decades of adulthood.