Spousal Influences on Subclinical and Clinical Vascular and Myocardial Disease

配偶对亚临床和临床血管和心肌疾病的影响

• 批准号: 10333819
• 负责人: Shivani A Patel
• 金额: $ 34.09万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-15 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10333819
• 关键词: Adult; Affective; Age; Air; Air Pollution; Algorithms; Asia; Atherosclerosis; Behavior; Behavioral; Blood; Blood Glucose; Blood Pressure; Body mass index; Cardiomyopathies; Cardiovascular Diseases; Cessation of life; Characteristics; Cholesterol; Clinical; Communities; Data; Development; Diabetes Mellitus; Diet; Disease; Early Diagnosis; Early identification; Ecological momentary assessment; Education; Enrollment; Environment; Environmental Exposure; Environmental Risk Factor; Family; Fasting; Funding; Future; Geography; Health; Health behavior; Household; Hypertension; Incidence; India; Individual; Intervention; Investigation; Lead; Life Style; Marriage; Measures; Mental Depression; Myocardial Infarction; National Heart, Lung, and Blood Institute; Natural History; Outcome; Overweight; Pathway interactions; Phenotype; Physical activity; Polysomnography; Population Heterogeneity; Psychosocial Factor; Recording of previous events; Research; Research Personnel; Resource Sharing; Risk; Risk Assessment; Risk Factors; Risk Reduction; Role; Sampling; Science; Sleep; Socioeconomic Factors; South Asian; Spouses; Stress; Stroke; Technology; Time; Vascular Diseases; Woman; aged; base; behavioral outcome; built environment; cardiometabolic risk; cardiovascular disorder prevention; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; clinical risk; cohort; contagion; coronary calcium scoring; design; disease phenotype; experience; improved; longitudinal analysis; longitudinal design; mHealth; man; novel; population based; prediction algorithm; psychosocial; real time monitoring; recruit; risk prediction; risk prediction model; risk stratification; smartphone Application; social; social determinants; synergism

PROJECT SUMMARY/ABSTRACT: Project 4 (Lead: Patel; Early Stage Investigator) Spouse lifestyle choices and psychosocial characteristics may powerfully influence the other spouse’s cardiovascular disease (CVD) risk milieu. We have compelling preliminary baseline data from the Center for cArdiometabolic Risk Reduction in South Asia Cohort (CARRS) that the odds of overweight, hypertension, diabetes, and depression are twice as high in adults who have a spouse with those same conditions. These cross-sectional associations of spousal CVD risks raise questions regarding whether development of CVD in one spouse can assist in more precisely predicting future risk of CVD in the partner. Identifying the mechanisms of specific spousal influences on CVD development may inform contextually-tailored, family-level interventions to target modifiable CVD risk factors. In Project 4 of Precision-CARRS, we will investigate spouse dyads already enrolled in the CARRS cohort to better understand the independent influence of spouses on the natural history of subclinical and clinical vascular and myocardial disease. CARRS is a large and diverse community-based cohort of 21,864 South Asian adults aged ≥ 20 years residing in Delhi and Chennai, India. By design, one randomly selected man and woman per sampled household were recruited at baseline, yielding 5,931 spouse dyads (n= 11,862 adults; 54% of the cohort), followed for up to 10 years (median: 5 years). Through Precision-CARRS, we will utilize repeated measures of traditional atherosclerotic CVD (ASCVD) risk factors collected since baseline, novel phenotyping of subclinical and clinical CVD disease (CVD phenotyping Core). In addition, Project 4 will collect new, real-time data on sleep characteristics, physical activity levels, diet, and psychosocial factors over a 7-day observation period using low-burden mHealth technologies (wearable wristband tracker and smartphone application; n=1,500 spousal dyads). Analyses will account for individual-level risk factors and also quantify the role of shared environmental risk factors such as built environment and air pollution (Project 2) in the development of CVD risk. Our aims are to: Aim 1. Evaluate spousal influences on ASCVD risk factors. Aim 2. Determine the relationship between spousal CVD measures and subclinical and clinical vascular disease and myocardial disease. Aim 3. Evaluate interpersonal mechanisms of spousal influences by examining day-to-day associations in health behaviors and psychosocial measures that are risk factors for CVD in a subsample of 1,500 dyads. Project 4, led by an Early Stage Investigator, adds to Precision-CARRS by identifying how the development of CVD—from early risk to clinically manifest disease—is independently influenced by one’s spouse. Expanding CVD risk assessment to include spouse’s CVD related behaviors and outcomes will highlight pathways for risk reduction and may inform more precise and early identification of CVD.

项目摘要/摘要：项目 4（负责人：Patel；早期研究员） 配偶的生活方式选择和心理社会特征可能会强烈影响另一方的 心血管疾病 (CVD) 风险环境。我们有来自该中心的令人信服的初步基线数据 南亚队列心脏代谢风险降低 (CARRS) 表明超重、高血压、 配偶患有相同疾病的成年人患糖尿病和抑郁症的几率是其两倍。这些 配偶 CVD 风险的横断面关联提出了以下问题： 配偶一方可以帮助更准确地预测伴侣未来患 CVD 的风险。识别 特定配偶对 CVD 发展影响的机制可能会根据具体情况、家庭层面提供信息 针对可改变的 CVD 危险因素的干预措施。 Precision-CARRS项目4，我们将调查配偶 已经加入 CARRS 队列的夫妻可以更好地了解配偶对家庭的独立影响 亚临床和临床血管和心肌疾病的自然史。 CARRS 是一个庞大且多样化的 基于社区的队列，由居住在印度德里和金奈的 21,864 名 20 岁以上南亚成年人组成。经过 设计中，每个样本家庭在基线时随机选择一名男性和一名女性，得出 对 5,931 名配偶（n= 11,862 名成年人；占队列的 54%）进行了长达 10 年的随访（中位数：5 年）。 通过 Precision-CARRS，我们将利用传统动脉粥样硬化 CVD (ASCVD) 风险的重复测量 自基线以来收集的因素、亚临床和临床 CVD 疾病的新表型（CVD 表型 核）。此外，项目 4 将收集有关睡眠特征、体力活动水平、 使用低负担移动医疗技术在 7 天观察期内的饮食和心理社会因素 （可穿戴腕带跟踪器和智能手机应用程序；n=1,500 配偶）。分析将考虑 个人层面的风险因素，并量化共同环境风险因素的作用，例如建筑 CVD风险发展中的环境和空气污染（项目2）。我们的目标是： 目标 1. 评估 配偶对 ASCVD 危险因素的影响。目标 2. 确定配偶 CVD 措施之间的关系 以及亚临床和临床血管疾病和心肌疾病。目标 3. 评估人际关系 通过检查健康行为和心理社会的日常关联来研究配偶影响的机制 在 1,500 对子样本中作为 CVD 风险因素的测量值。项目 4，由早期阶段领导 研究人员通过确定 CVD 的发展（从早期风险到临床）对 Precision-CARRS 进行了补充 明显的疾病——独立地受到配偶的影响。扩大 CVD 风险评估范围，包括 配偶的 CVD 相关行为和结果将突出降低风险的途径，并可能提供更多信息 准确、早期识别 CVD。