Stress, Sleep and Emerging CVD Risk Factors

压力、睡眠和新出现的心血管疾病危险因素

• 批准号: 6760524
• 负责人: KAREN MATTHEWS
• 金额: $ 69.19万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-08-01 至 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6760524
• 关键词: arteriosclerosis; bronchus circulation; cardiovascular disorder risk; catecholamines; clinical research; cortisol; electroencephalography; gender difference; human subject; patient monitoring device; patient oriented research; psychological stressor; racial /ethnic difference; sleep apnea; sleep disorders; stress

DESCRIPTION (provided by applicant): Growing evidence suggests that cardiovascular disease (CVD) morbidity and mortality may be predicted not only by established risk factors such as cholesterol level, hypertension, cigarette smoking, and hyperglycemia, but also by a set of emerging risk factors. These include the inflammatory markers, C reactive protein and interleukin 6, metabolic syndrome, and mild renal insufficiency. A project called HeartSCORE funded by the Commonwealth of Pennsylvania (Steven Reis, PI) is evaluating these emerging risk factors as well as coronary calcification, and brachial artery diameter in a population-based sample of 1000 African Americans and 1000 Caucasians. Our proposed project will build on this invaluable resource by examining another set of novel risk factors for CVD thought to be upstream from the more proximal, emerging risk factors: sleep disordered breathing (SDB) and psychosocial stress. Our project will evaluate whether links of both SDB and psychosocial stress with CVD risk may be due to their effects on nocturnal physiology, namely altered nonSDB sleep characteristics, nighttime elevation in blood pressure relative to daytime BP (termed nondipping), elevated urinary catecholamines and cortisol, and impaired autonomic tone. Thus, the general aim of this study is to understand the nocturnal psychophysiological underpinnings of cardiovascular morbidity and mortality. To address this general aim, we will study a multi-ethnic sample of 225 individuals drawn from two of the groups in the larger HeartSCORE design: (1) those who have high/moderate (hereafter labeled high) or (2) low Framingham risk equation scores, with no history of stroke, myocardial infarction, or interventional cardiology procedures in either group. The two groups will be matched on gender, race, and age. The proposed study will include two nights of polysomnography (PSG) conducted in participants' homes, two 24-hour periods of ambulatory blood pressure (ABP) monitoring, overnight urine collections on PSG night 2 and ABP night 2, wrist actigraghy on 10 nights, and assessment of self-report and other physiological indices. The study will provide novel data testing the relationships of daytime stressful events, SDB, and other nocturnal physiological measures with the emerging risk factors and subclinical CVD measured in HeartSCORE.

描述（由申请人提供）：越来越多的证据表明，心血管疾病（CVD）的发病率和死亡率不仅可以通过已确定的风险因素（如胆固醇水平、高血压、吸烟和高血糖症）预测，还可以通过一组新出现的风险因素预测。这些包括炎症标志物、C反应蛋白和白细胞介素6、代谢综合征和轻度肾功能不全。由宾夕法尼亚州联邦资助的一个名为HeartSCORE的项目（Steven Reis，PI）正在评估这些新出现的风险因素以及冠状动脉钙化和肱动脉直径，这些风险因素包括1000名非洲裔美国人和1000名白人。我们提出的项目将建立在这一宝贵的资源，通过检查另一组新的CVD风险因素，这些风险因素被认为是更近端的上游，新兴的风险因素：睡眠呼吸障碍（SDB）和心理社会压力。我们的项目将评估SDB和心理社会压力与CVD风险的联系是否可能是由于它们对夜间生理的影响，即改变非SDB睡眠特征，夜间血压相对于白天血压升高（称为非下降），尿儿茶酚胺和皮质醇升高，以及自主神经张力受损。因此，本研究的总体目的是了解夜间心血管疾病发病率和死亡率的心理生理基础。为了实现这一总体目标，我们将研究从较大HeartSCORE设计中的两组中抽取的225名个体的多种族样本：（1）具有高/中度（下文标记为高）或（2）低Fragrance风险方程评分的患者，两组中均无卒中、心肌梗死或介入心脏病学手术史。两组将在性别、种族和年龄上进行匹配。拟议的研究将包括在参与者家中进行的两个夜晚的多导睡眠图（PSG），两个24小时的动态血压（ABP）监测，PSG第2夜和ABP第2夜的夜间尿液收集，10个夜晚的腕关节活动图，以及自我报告和其他生理指标的评估。该研究将提供新的数据，测试日间压力事件、SDB和其他夜间生理指标与HeartSCORE中测量的新兴风险因素和亚临床CVD的关系。