# Cardiovascular health assessment & outcomes of systemic lupus erythematosus: bridging pediatric and adult- onset disease

> **NIH NIH K23** · BOSTON CHILDREN'S HOSPITAL · 2024 · $168,016

## Abstract

PROJECT SUMMARY/ABSTRACT
Pediatric-onset systemic lupus erythematosus (pSLE) carries a high risk of cardiovascular disease mediated
by chronic inflammation and premature atherosclerosis, but responsive surrogate outcome measures of
cardiovascular (CV) risk are currently lacking. Loss of nocturnal blood pressure (NBP) decline by ambulatory
blood pressure monitoring (ABPM) is common in children with pSLE, and has potential as an early, modifiable,
non-invasive measure of vascular health. Loss of NBP decline predicts CV events in adults and may be a
marker of endothelial dysfunction, which precedes structural changes in atherosclerosis. More importantly,
cardiovascular risk associated with NBP decline is potentially reversible with renin-angiotensin-system (RAS)
blockade. In order to determine the role of NBP decline as an outcome measure in pSLE, this proposal seeks
to first understand which mechanisms of increased cardiovascular risk contribute to loss of NBP decline, and
how NBP decline relates to endothelial function or other measures of subclinical atherosclerosis. Responsive
outcome measures would enable studies of interventions to improve vascular health. Potential pharmacologic
interventions include RAS blockade, which targets endothelial function without increasing infections from
immune suppression. There is, however, a paucity of data to guide the use of RAS blockade in pSLE.
 The objectives of this proposal are to: 1) identify the major factors that contribute to loss of NBP decline
in pSLE; 2) determine whether loss of NBP decline is associated with endothelial dysfunction and could serve
as a CV risk marker or potential treatment target; and 3) determine whether RAS blockade is associated with a
decreased risk of CV events in adolescents or young adults with SLE. We will perform a prospective
longitudinal study of children with SLE recruited to undergo serial ABPM, peripheral endothelial function testing
and comprehensive vascular profiles. We will also perform a retrospective analysis using advanced
pharmacoepidemiologic methods to estimate the effect of RAS blockade on the risk of cardiovascular events
among adolescents and adults in a large electronic health record database.
 K23 Candidate Dr. Chang completed a Master of Science in Clinical Epidemiology at the University of
Pennsylvania (UPenn) and has been appointed as an Assistant Professor at the Children’s Hospital of
Philadelphia (CHOP). The proposed research and training plan will provide her with the necessary experience
conducting prospective patient-oriented research, expand her expertise in non-invasive vascular assessment
and cardiovascular outcomes research, and provide advanced training in pharmacoepidemiologic methods, to
become an expert in early identification and prevention of cardiovascular complications of child-onset
rheumatic disease. She has established a strong multidisciplinary mentoring team that, together with the vast
resources at CHOP and UPenn, will faci...

## Key facts

- **NIH application ID:** 10844640
- **Project number:** 5K23HL148539-05
- **Recipient organization:** BOSTON CHILDREN'S HOSPITAL
- **Principal Investigator:** Joyce Chun-Ling Chang
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $168,016
- **Award type:** 5
- **Project period:** 2020-08-01 → 2025-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10844640

## Citation

> US National Institutes of Health, RePORTER application 10844640, Cardiovascular health assessment & outcomes of systemic lupus erythematosus: bridging pediatric and adult- onset disease (5K23HL148539-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10844640. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*