Childhood Secondhand Smoke and Longitudinal Cardiovascular Risk Profile

描述（由申请人提供）：烟草使用是心血管（C-V）疾病最有效的可避免原因之一。流行病学研究表明，即使是少量的二手烟（SHS）暴露也会增加C-V疾病的风险。然而，儿童期SHS暴露对生命过程中C-V疾病风险的长期影响尚不清楚。重要的是，关于剂量-反应关系、SHS与C-V危险因素的相互作用以及种族（黑人-白人）差异的数据有限。这项拟议的研究旨在检验以下假设：在黑人-白人人群中，儿童期SHS暴露及其对从儿童期到成年期C-V疾病风险的影响因种族而异。为响应FOA（PA-11-244）“二手烟对心血管和肺部疾病机制的影响（R 01）"，拟定的研究针对以下基于假设的具体目的：1）在黑人与白色非吸烟队列中，检查儿童期SHS暴露对儿童至成年期纵向C-V风险变量特征的影响。C-V风险变量包括自儿童期起连续测量的肥胖指标、血糖、胰岛素、血脂和血压，以及成年期测量的炎症、氧化应激和内皮功能标志物; 2）确定儿童期SHS及其与C-V风险变量对成年期非吸烟黑人与白色人亚临床C-V结构/功能变化的联合作用。亚临床C-V结构/功能指标包括颈动脉内膜中层厚度、股动脉脉搏波速度、动脉壁顺应性和左心室几何重构和功能; 3）确定儿童SHS和出生体重对儿童和成人亚临床C-V结构/功能变化的纵向C-V风险变量的联合作用。将使用博加卢萨心脏研究中从儿童期开始随访的纵向队列来检查上述具体目标，该研究是一项自1973年开始的以社区为基础的长期双盲（黑白）C-V疾病流行病学研究。拟定的研究队列由800名白色和800名黑人成人组成，年龄在29-52岁之间，他们已经获得了从儿童期开始连续6次测量的C-V风险因素变量数据和整个队列的出生体重数据，以及50%队列的成年亚临床C-V结构/功能测量数据。拟议研究的结果将进一步深入了解C-V疾病的潜在潜在机制，并有助于在生命早期实施原始预防策略。 公共卫生相关性：吸烟是心血管疾病可避免的原因之一。即使是少量的二手烟暴露也会增加心血管疾病的风险。这项研究的结果将进一步深入了解与儿童时期二手烟暴露长期影响相关的C-V疾病的潜在潜在机制，有助于加强早期预防策略，并促进全面的无烟立法。

DESCRIPTION (provided by applicant): Tobacco use is one of the most potent avoidable causes for cardiovascular (C-V) disease. Epidemiologic studies indicate that even small amounts of secondhand smoke (SHS) exposure increase C-V disease risk. However, the long-term effect of childhood SHS exposure on the life course C-V disease risk is not clear. Importantly, data on dose-response relationship, interaction of SHS with C-V risk factors and racial (black-white) divergence are limited. The proposed research is designed to test the hypothesis that childhood SHS exposure and its impact on C-V disease risk from childhood to adulthood vary by race within a black-white population. In response to the FOA (PA-11-244) "Effects of Secondhand Smoke on Cardiovascular and Pulmonary Disease Mechanisms (R01)", the proposed research is directed to the following hypothesis-based Specific Aims: 1) to examine the impact of childhood SHS exposure on longitudinal C-V risk variables profile from childhood to adulthood in black versus white nonsmoking cohorts. The C-V risk variables include obesity measures, glucose, insulin, lipids and blood pressure measured serially since childhood, and markers of inflammation, oxidative stress and endothelial function measured in adulthood; 2) to determine the independent effect of childhood SHS and its joint effect with C-V risk variables on adult subclinical C-V structure/function changes in black versus white nonsmokers. The subclinical C- V structure/function measures include carotid artery intima-media thickness, aorta-femoral pulse wave velocity, arterial wall compliance, and left ventricular geometric remodeling and function; 3) to determine the joint effect of childhood SHS and birth weight on longitudinal C-V risk variables profile from childhood and adult subclinical C-V structure/function changes in black versus white nonsmokers. The above specific aims will be examined using a longitudinal cohort followed since childhood in the Bogalusa Heart Study, a long-term biracial (black-white) community-based epidemiologic study of C-V disease beginning in childhood since 1973. The proposed study cohort consists of 800 white and 800 black adults, aged 29-52 years, who already have data on C-V risk factor variables measured serially 6 times from childhood and birth weight in the entire cohort and adulthood subclinical C-V structure/function measures on 50% of the cohort. The findings from the proposed research will provide further insights into the potential underlying mechanisms of C-V disease and help in the implementation strategies of primordial prevention in early life. PUBLIC HEALTH RELEVANCE: Cigarette smoking is one of the avoidable causes for cardiovascular disease. Even small amounts of secondhand smoke exposure increase cardiovascular disease risk. Findings from this study will provide further insights into the potential underlying mechanisms of C-V disease associated with the long-term influence of secondhand smoke exposure in childhood, help strengthen the preventive strategies in early life, and promote comprehensive smoke-free legislation.