Cardiovascular Diseases Clinical Trial
Official title:
Arterial Endothelial Function--An Epidemiologic Study
To determine if risk factors measured in childhood can predict the development of atherosclerotic coronary and carotid artery disease in adulthood.
BACKGROUND:
Many young adult subjects have some degree of atherosclerotic coronary and carotid artery
disease and experience no symptoms. As time passes, many die suddenly and unexpectedly and
only limited therapeutic process begins in youth, a measure of the early manifestations of
atherosclerosis may have the potential of identifying subjects at risk for premature
coronary and carotid occlusive vascular disease when therapeutic options can be
administered. Impaired brachial artery flow mediated dilatory (FMD) capacities have been
shown to exist in children and young adults with hypercholesterolemia, hyperhomocysteinemia,
diabetes and in those who smoke. Impaired brachial artery FMD has been shown to related to
impaired endothelial function, which is an early manifestation of the atherosclerotic
process. If impaired brachial artery FMD is a predictor of the process, then it may be used
to non-invasively assess atherosclerosis early in its development and to evaluate the effect
of therapeutic interventions.
DESIGN NARRATIVE:
In this longitudinal study using previously studied members of the Muscatine study,
measurements are made of contemporaneous risk factors, and brachial artery FMD, along with
coronary artery calcification (CAC) and carotid artery intimal-medial thickness (IMT) (the
latter two established measures of early atherosclerosis) and again three years later. The
effort is designed to examine the following hypotheses: 1) Established risk factor levels
measured in childhood, adulthood and across the years form childhood through adulthood are
predictive of brachial artery flow mediated dilatory (FMD) capacities; 2) Putative risk
factor levels measured in adulthood are related to the degree of brachial artery FMD, CAC
and carotid artery IMT; 3) Brachial artery FMD, CAC and carotid artery IMTare related in
adults; and 4) Brachial artery FMD is predictive of increased carotid artery IMT.
;
Observational Model: Cohort, Time Perspective: Prospective
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