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Active Studies

1. Determine the prevalence of and risk factors of CV disease in RA women using electron beam computed tomography(EBCT) of the coronaries and aorta and carotid ultrasound;
2. Compare the prevalence of CV disease and associated risk factors in women with RA and those with lupus, a previously studied group also with premature CV disease; and
3. Compare the prevalence of CV disease detected by carotid ultrasound and EBCT in RA women with and without a previous CV event.

1. Examine the effect of changes in body composition on insulin resistance and metabolic control
2. Examine the effect of changes on progression of atherosclerosis in coronary arteries and aorta and
3. Examine whether changes in adiposity reduce levels of inflammatory markers (as risk factors linking obesity and atherosclerosis).

1. Determine risk factors associated with vascular stiffness, by measuring vascular stiffness in three different ways in a variety of populations.
2. Determine the reliability of various measures of arterial stiffness. These comparisons will help researchers establish standards for measurement and reporting vascular stiffness.

This is a coordinated project between the University of Pittsburgh and Rush-Presbyterian-St.Luke's Medical Center in Chicago. Subclinical atherosclerosis will be evaluated in 728 African American and Caucasian women enrolled in the Study of Women Across the Nation (SWAN), a multicenter study characterizing the biological and psychological sequelae of menopause. Serial measures of coronary and aortic calcification (by EBCT), carotid atherosclerosis, endothelial function and aortic stiffening will be performed two years apart. The prevalence and progression of subclinical atherosclerosis will be evaluated in relation to serial measures of ovarian function, psychosocial and behavioral factors, markers of clotting and inflammation as well as traditional cardiovascular risk factors, all collected in SWAN.

The study will evaluate the extent to which diminishing ovarian function affects vascular function and accelerates the development of atherosclerosis in the coronary arteries, aorta, and carotid arteries.

1. That individuals who show exaggerated cardiovascular reactivity to psychological challenge may show an increased rate of disease progression, and
2. That exposure to frequent and intense psychological challenge during daily life, as measured by ambulatory monitoring methods, may exacerbate these effects.
3. That differences in the types and frequency of socially supportive transactions may be associated with altered rates of disease progression.
4. That differences in endothelial functioning and vascular stiffening may mediate some of these observed associations between behavioral factors, on the one hand, and subclinical disease, on the other.

1. Identify the risk factors for premature atherosclerosis and heart disease among women with PCOS.
2. Evaluate progression of vascular disease in this high-risk PCOS population as measured by increased IMT and plaque development since baseline.

1. Evaluate if cervical and endometrial chlamydial PCR, serum chlamydial IgG, and chlamydial heat shock protein will predict vascular stiffness and atherosclerosis severity.
   
   
2. Test if confirmed PID (endometritis and/or upper genital tract chlamydia/gonorrhea), clinical characteristics of PID (cervical and endometrial gonococcal culture, white blood cell count, erythrocyte sedimentation rate, c-reactive protein, cervical hyperemia/friability, leukorrhea, mucopurulent cervicitis, endometritis), and reproductive morbidities (infertility, chronic pelvic pain, and recurrent PID) will predict vascular stiffness and atherosclerosis severity.

1. Adolescents who are from low SES families will report more stressful life circumstances, including unfair treatment and discrimination, will be more mistrustful of others, and more vigilant for possible threat, will exhibit greater vascular resistance responses to stressful tasks; and will have elevated scores for subclinical CV markers, compared to adolescents from higher SES families.
   
   
2. Adolescents who report more stressful life circumstances, unfair treatment, and discrimination and who are high in hostility, vigilance for threat, and CV responses to stress will have elevated scores for subclinical CV markers, i.e. IMT, vascular stiffness, and LVM.

1. Are biological, psychosocial, socio-environmental, and lifestyle-related risk factors for cardiovascular disease correlated with individual differences in brain serotonin (serotonergic responsivity)?
   
   
2. Are individual differences in brain serotonin the, or one of the, causes of clustering of risk factors within individuals?
   
   
3. Do differences in brain serotonin correlate with early vascular disease, measured as carotid artery thickness and endothelial function?

1. Study risk factors for the later complications of diabetes including advanced kidney disease (renal failure), macrovascular complications (including coronary heart disease) and lower extremity arterial disease - complications that could not be studied in the DCCT.
   
   
2. Study the natural history of macro and micro vascular disease in IDDM, which also takes advantage of an "intention-to-treat analysis" based on previous involvement of the study population in the DCCT.

1. We will test the null hypothesis that there are no differences in the prevalence of coronary artery calcification detected by EBCT among men aged 40-49 from populations with different mortality due to CHD despite very similar traditional risk factor profiles.
   
   
2. We will test the null hypothesis that there are no differences in the IMT of carotid artery measured by ultrasound among these four populations.
   
   
3. We will determine the relationship of specific risk factors to coronary and aortic calcification and to carotid IMT. The specific variables of interest include: chemical lipids, NMR lipids, phospholipids, blood pressure, BMI, waist circumference, fasting glucose, insulin, CRP, PAI-1, cigarette smoking, alcohol consumption, and physical activity.

1. The ACE inhibitor, lisinopril, will be superior to the beta-blocker, atenolol, in normalizing regional cerebral blood flow.
   
   
2. The ACE inhibitor, lisinopril, will be superior to the beta blocker, atenolol, in enhancing working memory performance; and that this effect will be larger in those hypertensive patients that prior to treatment show relatively reduced cerebrovascular reserve and working memory capability.