Weight-Related Measures and CVD in African American and White Adults

描述（由申请人提供）：本申请涉及广泛的挑战领域（04）：临床研究和特定的挑战主题，04-HL-104：“对现有数据进行二次分析，以回答重要的临床和预防医学研究问题。在这个主题中，我们讨论了感兴趣的一个示例领域：“重要人口统计分组的分析”。非洲裔美国人的预期寿命比白人短，患许多慢性病的几率也更高。2005年，非裔美国人的预期寿命男性为69.5岁，女性为76.5岁，而白人分别为75.7岁和80.8岁。重要的是要了解可改变的风险因素，如肥胖，在生产中所观察到的发病率和死亡率的过度负担的作用。对非裔美国人肥胖后果的研究表明，与白人相比，相关的合并症存在显着差异。然而，很少有纵向研究研究硬终点，如冠心病（CHD）和心血管疾病（CVD）或总死亡率。此外，我们对体重变化的后果的理解是有限的，特别是在非洲裔美国人中。我们将使用基于人群的非裔美国人和白色男性和女性的样本来研究肥胖相关指标与致命性和非致命性冠心病（CHD）、心血管疾病（CVD）和全因死亡率的相关性。我们将确定和比较（种族性别组）与体重指数（BMI）和腰围相关的风险。我们还将检查与长期体重变化（至少超过23年）相关的风险，并将这种风险与接近事件发生时发生的短期体重变化的风险区分开来。这些目标将通过分析社区动脉粥样硬化风险研究（ARIC）的现有数据来实现。这项研究收集了超过15,000名参与者的信息，其中包括4,000多名非洲裔美国人。参与者在四个诊所进行了研究，并测量了一系列生理和行为风险因素。在超过17.5年的随访中，可获得关于生命状态和CHD和卒中事件的标准化信息。ARIC研究可以说提供了目前可用于研究非裔美国人肥胖相关风险和硬心血管终点的最佳数据集，并提供了机会，以促进我们对风险增加的人群中这一重要公共卫生问题的理解。这项工作的结果将立即产生影响，因为它们将用于为NHLBI降低心血管风险临床指南提供背景信息，并将补充目前在非洲裔美国人中可用的稀疏信息。这项研究将研究超重和肥胖的中年人是否比正常体重的中年人更容易患心脏病或死亡。我们还将评估成年中期或25岁以后的体重变化是否会增加患心脏病或死亡的可能性。将在非洲裔美国妇女、非洲裔美国男子、白色妇女和白色男子之间进行比较。

DESCRIPTION (provided by applicant): This application addresses broad Challenge Area (04): Clinical Research and specific Challenge Topic, 04-HL-104: "Perform secondary analyses of existing data to answer important clinical and preventive medicine research questions." Within this topic we address one of the example areas of interest: "Analyses of important demographic subgroups". African Americans have a shorter life expectancy than Whites and suffer higher rates of many chronic diseases. Life expectancy for African Americans in 2005 was 69.5 years for males and 76.5 years for females compared to 75.7 and 80.8 years, respectively, for Whites. It is important to understand the role that modifiable risk factors, such as obesity, play in the production of the observed excess burden of morbidity and mortality. Studies of the consequences of obesity in African Americans indicate marked differences in the associated co-morbidities compared to Whites. However, few longitudinal studies have studied hard endpoints such as coronary heart disease (CHD) and cardiovascular disease (CVD) or total mortality. In addition, our understanding of the consequences of changes in weight is limited, particularly in African Americans. We will use a population-based sample of African American and White men and women to examine associations of an obesity-related measure with fatal and non-fatal coronary heart disease (CHD), cardiovascular disease (CVD) and all-cause mortality. We will determine and compare (among ethnic-gender groups) the risks associated with body mass index (BMI) and waist circumference. We will also examine risks associated with long term weight change (over a minimum of 23 years) and distinguish this risk from that of short-term weight change that occurs close to the time of event. These aims will be met through the analyses of extant data from the Atherosclerosis Risk in Communities Study (ARIC). This study has collected information on over 15,000 participants including over 4,000 African Americans. Participants were studied in four clinic visits and a range of physiologic and behavioral risk factors were measured. Standardized information on vital status and incident CHD and stroke events is available with over 17.5 years of follow-up. The ARIC study arguably provides the best data set currently available for studies of obesity- related risk and hard cardiovascular endpoints in African Americans, and affords the opportunity to advance our understanding of this important public health problem in a population that is at increased risk. The results of this work will have immediate impact as they will be used to provide background information for the NHLBI Clinical Guidelines for Cardiovascular Risk Reduction, and will supplement the sparse information currently available in African Americans. This study will examine whether overweight and obese middle-aged adults are more likely to develop heart disease or die compared to normal weight middle-aged adults. We will also evaluate if the amount of weight change during middle-adulthood or since age 25 increases the likelihood of developing heart disease or dying. Comparisons will be made between African American women, African American men, White women and White men.