Progression of sub-clinical Atherosclerosis

描述（由申请人提供）：通过颈动脉超声无创测量，心血管事件与颈动脉壁内膜中层厚度（IMT）增加之间存在强相关性。颈动脉IMT被认为是亚临床心血管疾病的替代指标。我们建议确定亚临床心血管疾病（IMT变化）在8至10年内的进展率。将在200：5-2007年重复对该队列中约2800 - 3000名在1995-98年临床访视时进行基线IMT测量的成员进行成像和IMT测量。该项目的主要目的是研究主要假设：1。在50年的时间里，传统心血管危险因素的中期暴露与颈动脉IMT的进展率呈正相关。2.基线颈动脉IMT和基线访视前20年的心血管风险因素累积暴露是8 - 10年后亚临床疾病进展的更好预测因子，而不是风险因素中期暴露。3.新的危险因素如C反应蛋白和同型半胱氨酸比传统危险因素更能影响颈动脉粥样硬化的进展。本申请将在Frachial Study数据库中添加亚临床心血管疾病部位特异性变化的表型标志物。这补充了正在进行的关于亚临床心血管疾病进展及其与早发心血管事件家族史和基因标记物相关性的研究。

DESCRIPTION (provided by applicant): Strong associations exist between cardiovascular events and increased carotid artery wall intima-media thickness (IMT) as measured non-invasively by carotid ultrasound. Carotid IMT is accepted as a surrogate marker of sub-clinical cardiovascular disease. We propose to determine the rate of progression of sub-clinical cardiovascular disease (change in IMT) over a period of 8 to 10 years. Imaging and IMT measurements of approximately 2800 to 3000 members of this cohort having had baseline IMT measurements at their 1995-98 clinic visit will be repeated in 200:5-2007. The principal aims of the project are to study the primary hypotheses that: 1. Interim exposure to traditional cardiovascular risk factors measured over 50 years is positively associated with the progression rate of carotid IMT. 2. Baseline carotid IMT and cumulative exposure to cardiovascular risk factors 20 years before the baseline visit are a better predictor of progression of sub-clinical disease after 8 to 10 years than the interim exposure to risk factors. 3. Novel risk factors such as C-reactive protein and homocysteine affect progression of carotid atherosclerosis more than traditional risk factors. This application will add a phenotypic marker of site-specific change in sub-clinical cardiovascular disease to the Framingham Study database. This complements ongoing research on the progression of sub-clinical cardiovascular disease and its associations with family history of premature cardiovascular events and genomic markers.