Spousal Influences on Subclinical and Clinical Vascular and Myocardial Disease

项目摘要/摘要：项目4(负责人：Patel；早期调查员) 配偶的生活方式选择和心理社会特征可能会对另一方的 心血管疾病的危险环境。我们从该中心获得了令人信服的初步基线数据 南亚队列心脏代谢风险降低(CARRS)：超重、高血压、 糖尿病和抑郁症在配偶患有相同疾病的成年人中的发病率是前者的两倍。这些 配偶心血管疾病风险的横断面关联引发了以下问题：心血管疾病的发生 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 特定配偶对心血管疾病发展的影响机制可能会为特定背景的、家庭层面的 针对可改变的心血管疾病危险因素的干预措施。在Precision-CARRS的项目4中，我们将调查配偶 已经在CARRS队列中登记的二人组，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病史。CARS是一个庞大而多样的 以社区为基础的21,864名南亚成年人，年龄20岁，居住在印度德里和金奈。通过 设计，在每个抽样家庭中随机选择一个男人和女人，在基线上招募，产生 5,931对配偶(n=11,862名成年人；占队列的54%)，随访时间长达10年(中位数：5年)。 通过Precision-CARRS，我们将利用传统动脉粥样硬化性心血管疾病(ASCVD)风险的重复测量 自基线以来收集的因素，亚临床和临床心血管疾病的新表型(CVD表型 核心)。此外，项目4将收集有关睡眠特征、体力活动水平、 使用低负担的mHealth技术进行为期7天的观察期内的饮食和心理社会因素 (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的作用，如 环境与空气污染(项目2)发展中的心血管疾病风险。我们的目标是：目标1.评估 配偶对ASCVD危险因素的影响。目的2.确定配偶心脑血管疾病测量之间的关系 以及亚临床和临床的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中的日常联系来研究配偶影响的机制 在1,500个二元样本中，作为心血管疾病风险因素的措施。项目4，由早期阶段牵头 研究员，通过确定心血管疾病的发展-从早期风险到临床，增加了Precision-CARRS 显性疾病--受配偶的独立影响。将心血管疾病风险评估扩展至包括 配偶的心血管疾病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、早期识别脑血管病。

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.