PSYCHOBIOLOGICAL PATHWAYS--RISKS FOR SUBCLINICAL CARDIOVASCULAR DISEASE

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DESCRIPTION (adapted from investigator's abstract): The primary aims of Project 3: Psychobiological Pathways: Risks for Subclinical CVD are to evaluate the influence of chronic burdens and resources, cardiovascular responses to acute stressors, and neuroendocrine activation on subclinical cardiovascular disease (CVD) in middle-aged women. Noninvasive measures of subclinical CVD can now be made reliably, are related to clinical events, and can be used to investigate new putative risk factors or to test models of the influences of risk factors. We are proposing to test the Center's shared pathways model in the context of the Healthy Women Study's current objectives to determine the risk factors for subclinical CVD. This is an ongoing epidemiological study of initially healthy women begun in 1983. Very detailed measurements of cardiovascular risk factors and psychosocial characteristics, including some measures of chronic burdens and resources similar to those proposed to be used in the Center. Recently ultrasound measures of carotid disease and coronary and aortic calcification measured by electron beam computed tomography (EBCT) have been added to the protocol and these measures will be administered twice three years apart over the next 5 years in 350 women. In the present Center project, we propose to conduct the following as well: a) administration of Center psychosocial measures; b) thorough evaluation of cardiovascular reactivity to psychological stress via impedance cardiography; c) 24 hour urine collection for catecholamine assays; and d) salivary cortisol measured periodically throughout one day. Understanding the development of subclinical CVD and the associated psychological, behavioral, and biological processes should lead to prevention or reduction of clinical cardiovascular disease among women. This study will be the first to track progression of calcification by EBCT and carotid plaque in younger postmenopausal women in relation to psychobiological pathways.