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

产品说明：我们对心血管疾病（CVD）的流行病学和CVD危险因素的价值如何随着HIV感染人群的老龄化而演变的了解甚少。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，这是一个非常令人关切的问题。如果心血管疾病的危险因素以循证的方式应用于临床危险分层，则需要更好的跨年龄谱的数据。该提案的总体目标是研究心血管疾病的决定因素如何随着艾滋病毒感染者的老龄化而变化。先前的队列研究，通过将类似的研究方法应用于年龄范围内的许多队列，揭示了年龄对CVD流行病学的影响。正如人们长期以来所认识到的那样，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晚期的生活中也有所不同。例如，虽然提高了 胆固醇无疑是心血管疾病的一个危险因素，在老年人的血清胆固醇水平与心血管疾病的发生和流行有一个弱的，不一致的关系。血压（BP）和C反应蛋白升高，也是已知的CVD风险因素，同样具有深刻的年龄依赖性。这些现象尚未在艾滋病毒感染者群体中进行研究。我们计划一项R21提案，该提案将大大扩展并建立在NHLBI HIV-CVD联盟的基础上，该联盟包括9项关于成人和儿童艾滋病毒感染者动脉粥样硬化CVD的R 01研究。协调由数据协调中心（DCC）、中心实验室和3个专门的阅读中心提供，这些中心以相同的方式测量了联盟近5,000名入组受试者的CVD风险因素、血液生物标志物和无创血管图像。科学目标将涉及风险因素的识别，包括标准的临床CVD风险因素，如血脂，血压和糖尿病，以及与患者群体中亚临床动脉粥样硬化的存在相关的炎症和止血的新型生物标志物，从青春期，到中年和成年后的几十年。

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.