Low CV Risk, Ages 25-44 & CV/non-CV Outcomes, Ages 65+

描述(由申请人提供)：背景：已经证明，2010年国家政策建议和目标(SBP/DBP&lt；120/&lt；80 mmHg，血清总胆固醇&lt；200毫克/dl，体重指数&lt；25公斤/m2，不吸烟，没有糖尿病，没有心肌梗塞病史)中，低风险(LR)，即所有容易测量的主要风险因素的有利水平，CHD/CVD是罕见的(地方性，非流行病)，估计寿命增加几年，老年人的医疗费用显著降低。仍然需要弥合重大的知识差距，特别是关于青年和中年早期的低风险与实现无心血管疾病健康老龄化的相关性，即不仅临床和非侵入性可检测到的亚临床心血管疾病较少，可能与心血管疾病有关的炎性标志物水平更有利，以及体能和身体功能水平较高。关于这些问题的数据并不存在。目的：一般：以有效和成本效益高的方式扩展芝加哥心脏协会(CHA)的数据库研究，用新的数据在有关青年/中年早期存在的低风险(LR)数十年后果的知识方面做出进一步的重大贡献，特别是它与使老年人免受非侵入性可检测到的亚临床CHD/CVD、CHD/CVD风险的炎症标志物以及身体表现和功能损害的相关性-无论在性别上还是在不同种族的SES阶层中，包括已经长寿(75岁以上)的人。为实现目标(一般和具体)，1967-73年CHA队列基线年龄为25-44岁的加权随机抽样--低风险(n=600)和非低风险(n=900)--将于2006-2009年在65-79岁时进行检查。具体目标：评估基线LR状态(年龄25-44岁)与：1)65-79岁亚临床动脉粥样硬化性疾病的存在和程度；2)65-79岁心血管疾病相关炎症标志物水平；3)65-79岁客观测量的体能/功能水平的长期关系。4)确定当前亚临床动脉粥样硬化性疾病和炎症标志物在解释年轻时的LR特征与老年时的体能/功能之间的关系方面的作用。意义：来自拟议研究的预期新数据可以帮助澄清和提供战略优先事项，以实现2010年健康人的两个主要目标：“提高健康生活的质量和年数”和“消除健康差距”。

DESCRIPTION (provided by applicant): Background: It has been demonstrated that with low risk (LR), i.e., favorable levels of all readily measurable major risk factors, as defined in national policy recommendations and objectives for 2010 (SBP/DBP <120/<80 mmHg, serum total cholesterol <200 mg/dl, BMI<25 kg/m2, no smoking, no diabetes, no MI history), clinical CHD/CVD is rare (endemic, not epidemic), estimated longevity is increased by several years, and medical care costs in older persons are sizably reduced. Significant knowledge gaps remain to be closed, especially on the relevance of low risk in young adulthood and early middle age for achieving CVD-free healthy aging, i.e., not only less clinical but also less non- invasively detectable subclinical CVD, more favorable levels of inflammatory markers possibly related to CVD, and higher levels of physical performance and physical functioning. Data do not exist on these matters. Aims: General: To expand ~ in an efficient and cost-effective way - the database of the Chicago Heart Association (CHA) Study with new data to make a further major contribution in knowledge about the decades-long consequences of low risk (LR) present in young adulthood/early middle-age, particularly its relevance for achieving freedom in older age from non-invasively detectable subclinical CHD/CVD, inflammatory markers of CHD/CVD risk, and impairment of physical performance and functioning -- in both genders and across SES strata of varied ethnicity including people already long- lived (ages 75+). To achieve Aims (General and Specific), weighted random samples of the CHA cohort baseline ages 25-44 in 1967-73 - low risk (n=600) and not low risk (n=900) - are to be examined in 2006-2009 at ages 65-79. Specific Aims: Assess long-term relationship of baseline LR status (ages 25-44) with: 1) presence and extent of subclinical atherosclerotic disease at ages 65-79; 2) levels of CVD- related markers of inflammation at ages 65-79; 3) levels of objectively measured physical performance/function at ages 65-79. 4) Determine role of current subclinical atherosclerotic disease and inflammatory markers in accounting for associations of LR profile at younger age with physical performance/function at older age. Significance: The expected new data from the proposed research can serve to clarify and inform strategic priorities for attaining the two stipulated Healthy People 2010 primary goals, "increase quality and years of healthy life" and "eliminate health disparities."