The Modifying Role of Resilience on Allostatic Load and Cardiovascular Disease Risk in the Jackson Heart Study.
The Modifying Role of Resilience on Allostatic Load and Cardiovascular Disease Risk in the Jackson Heart Study.
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DOI：
10.1007/s40615-022-01392-6
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发表时间：
2023-10
影响因子：
3.9
通讯作者：
Williams, Karen Patricia
中科院分区：
文献类型：
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作者：
Felix, Ashley S;Nolan, Timiya S;Glover, LaShaunta M;Sims, Mario;Addison, Daniel;Smith, Sakima A;Anderson, Cindy M;Warren, Barbara J;Woods-Giscombe, Cheryl;Hood, Darryl B;Williams, Karen Patricia
我们在杰克逊心脏研究中的2758名非裔美国人中研究了弹性是否改变了非稳态负荷（AL）（应对重复压力源的生理指标）与心血管疾病（CVD）之间的关联。使用代谢、心血管和免疫标志物的生物学测量来量化基线AL。我们构建了一个多维度的弹性措施，社会支持，社交网络，宗教经验，乐观的验证问卷。参与者被随访至2016年，包括中风，冠心病（CHD）和心力衰竭（HF）。我们使用多变量校正、性别分层的考克斯回归来估计二分AL和CVD之间相关性的风险比（HR）和95%置信区间（CI）。高AL与女性CHD（HR = 1.73，95% CI = 1.00，2.99）和女性HF（HR = 1.52，95% CI = 0.98，2.37）和男性HF（HR = 2.17，95% CI = 1.28，3.68）相关。在女性中，韧性并没有改变AL-CVD的关系。在男性中，我们观察到低弹性男性的中风风险较高（HR = 2.21，95%CI = 0.94，5.22），而高弹性男性之间没有相关性。与直觉相反，在高弹性男性亚组中，高AL与较高HF相关（HR = 5.80，95% CI = 2.32，14.47）。未来的研究需要解决不同方面的弹性，以阐明潜在的机制，CVD预防非洲裔美国人。
We examined whether resilience modified associations between allostatic load (AL), a physiological indicator of coping with repeated stressors, and cardiovascular disease (CVD) among 2758 African Americans in the Jackson Heart Study. Baseline AL was quantified using biological measures of metabolic, cardiovascular, and immune markers. We constructed a multidimensional resilience measure using validated questionnaires for social support, social networks, religious experiences, and optimism. Participants were followed until 2016 for stroke, coronary heart disease (CHD), and heart failure (HF). We used multivariable-adjusted, sex-stratified Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between dichotomous AL and CVD. High AL was associated with CHD among women (HR = 1.73, 95% CI = 1.00, 2.99) and HF among women (HR = 1.52, 95% CI = 0.98, 2.37) and men (HR = 2.17, 95% CI = 1.28, 3.68). Among women, resilience did not modify the AL-CVD relationship. Among men, we observed higher stroke risk among men with low resilience (HR = 2.21, 95% CI = 0.94, 5.22) and no association among those with high resilience. Counterintuitively, high AL was associated with greater HF (HR = 5.80, 95% CI = 2.32, 14.47) in the subgroup of men with high resilience. Future studies addressing different facets of resilience are needed to elucidate underlying mechanisms for CVD prevention among African Americans.