Among 171125 participants with a measure of arterial stiffness at baseline, chronic inflammatory disorders (e.g. rheumatoid arthritis, psoriasis, inflammatory bowel disorders) were associated with a 14% increase in the mean arterial stiffness. The findings further indicated a dose-response relationship between arterial stiffness with tertiles of inflammatory biomarkers. For instance, the mean arterial stiffness increased from 11% within the first tertile of leukocytes count to 17% in the second tertile, and 21% in the third tertile. The findings support the use of a stiffness index as means to stratify people with inflammatory disorders according to their potential risk for future CVD events. This suggestion, however, would benefit from future investigations into predictive value of the stiffness index for future risk of major CVD events across different population subgroups.
Chronic inflammatory disorders and cardiovascular disease
Our recent findings published in Circulation indicated an association between several inflammatory disorders with cardiovascular disease (CVD). The study used primary care data with incomplete information on traditional vascular risk factors (ie hypertension, cholesterol) and demographic characteristics. In this study we aim to explore the possibility that the prevalence of inflammatory disorders and their association with incident CVD and mortality events vary across different deprivation and ethnic groups. Secondly, in a subsample of participants (N=190,000) we will test the hypothesis that inflammatory biomarkers and regulatory factors are associated with markers of atherosclerosis (arterial stiffness) and clinical outcomes. Our research is funded by the NIHR Biomedical Research Centre at Guy?s and St Thomas?. We aim to develop our expertise to utilising and analysing the UK Biobank data. The planned analyses will provide new understanding about the role of inflammation in CVD risk across different population subgroups. These findings will help identify the need for more targeted preventative measures. The use of inflammatory and CVD biomarkers will highlight potential mechanisms through which these inflammatory conditions may impact on CVD risk. The findings will facilitate enhanced risk prediction modelling and identify potential therapeutic targets for inflammatory disease patients. In the full UK Biobank cohort, baseline data on inflammatory disorders will be used to assess their prevalence and relationship with subsequent risk of CVD and mortality in subgroups defined by their deprivation and ethnicity. Baseline vascular risk factors (ie smoking, hypertension, cholesterol, diabetes, BMI) will be used as covariates. Additionally, the relationships between inflammatory biomarkers (ie CRP, rheumatoid factor) with inflammatory disorders, as well as with CVD and CVD-related biomarkers (ie arterial stiffness) will be estimated to explore mechanisms through which inflammation influences CVD risk. The impact of genetic regulators of inflammation biomarkers (IRF-5) will be explored. The analyses of inflammatory disorders and risk of CVD and mortality events will be conducted on the full cohort, except those with established CVD at baseline. When available in 2016, the relationships between measured inflammatory biomarkers with CVD will be conducted on the full cohort, except those with established CVD at baseline. The relationships between measured inflammatory biomarkers with CVD-biomarkers will be conducted on the subsample of patients (N=190,000) with a measure of arterial stiffness. We would like to request access to the genotype and primary care data when available, to identify incident cases of disease.
|Lead investigator:||Dr Alexandru Dregan|
|Lead institution:||King's College London|
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