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既定的危险因素如胆固醇水平、高血压、吸烟和高血糖来预测，还可以通过一系列新出现的危险因素来预测。这些指标包括炎症标志物、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）正在以1000名非裔美国人和1000名白种人为样本，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。我们提出的项目将建立在这一宝贵资源的基础上，通过研究另一组新的心血管疾病风险因素，这些风险因素被认为是更近的、新出现的风险因素的上游：睡眠呼吸障碍（SDB）和社会心理压力。我们的项目将评估SDB和社会心理压力与CVD风险之间的联系是否可能是由于它们对夜间生理的影响，即非SDB睡眠特征的改变，夜间相对于白天血压的升高（称为不降血压），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心血管发病率和死亡率的夜间心理生理基础。为了解决这一总体目标，我们将研究来自两个较大HeartSCORE设计组的225名多种族样本：(1)具有高/中等（以下标记为高）或(2)低Framingham风险方程评分的人群，两组均无中风、心肌梗死或介入性心脏病治疗史。这两组将根据性别、种族和年龄进行匹配。该研究将包括在参与者家中进行2晚的多导睡眠描记（PSG）， 2个24小时的动态血压（ABP）监测，PSG第2晚和ABP第2晚的夜间尿液采集，10晚的手腕活动描记，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来测试白天应激事件、SDB和其他夜间生理指标与HeartSCORE中测量的新出现的危险因素和亚临床CVD之间的关系。