Spousal Influences on Subclinical and Clinical Vascular and Myocardial Disease

项目总结/摘要：项目4（负责人：Patel;早期研究者） 配偶的生活方式选择和心理社会特征可能会有力地影响另一方的生活方式。 心血管疾病（CVD）的风险环境。我们有令人信服的初步基线数据， 南亚队列（CARRS）中的心脏代谢风险降低，超重，高血压， 糖尿病和抑郁症的发病率是配偶有同样情况的成年人的两倍。这些 配偶心血管疾病风险的横截面关联提出了一个问题，即心血管疾病的发展是否与 配偶中的一方可以帮助更准确地预测伴侣未来患心血管疾病的风险。识别 特定的配偶对CVD发展的影响机制可能会告知上下文量身定制的，家庭层面的 针对可改变的CVD风险因素的干预措施。在Precision-CARRS项目4中，我们将调查配偶 已经参加CARRS队列的夫妇，以更好地了解配偶对 亚临床和临床血管和心肌疾病的自然史。CARRS是一个大型和多样化的 在印度德里和钦奈居住的21，864名年龄≥ 20岁的南亚成年人的社区队列研究。通过 设计，每个抽样家庭随机选择一名男性和一名女性，在基线时招募， 5，931对夫妻（n= 11，862名成年人;队列的54%），随访长达10年（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 核心）。此外，Project 4还将收集有关睡眠特征、身体活动水平、 饮食和心理社会因素在7天的观察期内使用低负担的mHealth技术 （可穿戴腕带追踪器和智能手机应用程序; n= 1，500对配偶）。分析将说明 个人层面的风险因素，也量化了共同的环境风险因素，如建筑， 环境和空气污染（项目2）在CVD风险的发展。我们的目标是：目标1。评价 配偶对ASCVD危险因素的影响。目标二。确定配偶CVD指标之间的关系 以及亚临床和临床血管疾病和心肌疾病。目标3。评价人际关系 通过检查健康行为和心理社会的日常联系， 在1,500个二对子样本中，这些指标是心血管疾病的危险因素。项目4，由早期阶段领导 研究者通过确定CVD的发展如何从早期风险到临床风险， 明显的疾病-是独立的影响，一个人的配偶。扩大CVD风险评估，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。 准确和早期识别CVD。

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.