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."""""""" ? ? ?