Biobehavioral Factors in Atherosclerotic Progression

描述（由申请人提供）：越来越多的证据表明，心理社会因素与动脉粥样硬化的发展有关。以前的大部分研究都是在非人类样本中进行的。最近的发展，在无创评估亚临床动脉粥样硬化疾病，沿着测量精神压力和压力反应，使我们能够扩大这种类型的调查，以人类社区样本，具有重要意义的危险分层和预防。在我们最初的资助期间，我们招募了367名健康男性和女性，没有心血管疾病史（50-70岁）。社会心理需求和社会支持的措施进行了评估，在日常生活中，使用实时电子日记系统。我们还使用我们实验室开发的自动测试组合评估了应激相关心血管反应性（CVR）的个体差异。这些心理社会因素被证明与动态血压（ABP），颈动脉粥样硬化，超声检查，在某些情况下，与三年颈动脉粥样硬化进展以及相关的假设。在社会心理因素和动脉粥样硬化之间的关联中观察到了一些性别差异。在这个竞争性的更新申请中，我们建议在另外的2年半的资助期内继续跟踪这个样本，目的如下：a）在更长的时间内复制和扩展我们关于颈动脉粥样硬化的初步发现（共6年），研究心理社会因素如何与健康社区样本中亚临床动脉粥样硬化的长期轨迹相关联; B）确定6年时间内心理社会因素的变化是否可能与疾病进程的相应变化有关，这个问题可能对早期干预产生影响; c）检查6年随访期间心理社会因素与ABP变化相关的程度-并探讨这些变化可能导致动脉粥样硬化风险的程度;以及d）确定生物因素的作用（特别是自主功能的影响）和行为因素（具体而言，言语攻击的个体差异的作用）作为可能的决定因素，解释心理社会因素和亚临床颈动脉疾病进展之间的关系的性别差异。

DESCRIPTION (provided by applicant): Accumulating evidence links psychosocial factors with the development of atherosclerosis. Much of this previous research has been conducted in nonhuman samples. Recent developments in the noninvasive assessment of subclinical atherosclerotic disease, along with the measurement of mental stress and stress responding, have allowed us to extend this type of investigation to human community samples, with important implications for risk stratification and prevention. During our initial funding period, we recruited a sample of 367 healthy men and women with no history of cardiovascular disease (50-70 years of age). Measures of psychosocial demands and social support were assessed during daily life, using a real-time electronic diary system. We also assessed individual differences in stress-related cardiovascular reactivity (CVR) using an automated test battery developed in our laboratory. These psychosocial factors were shown to be associated, as hypothesized, with ambulatory blood pressure (ABP), carotid artery atherosclerosis, by ultrasound, and, in some cases, with three-year carotid artery atherosclerotic progression as well. A number of gender differences in the association between psychosocial factors and atherosclerosis were observed. In this competing renewal application, we propose continuing to follow this sample for an additional 2-1/2 year funding period, with the following aims: a) to replicate and extend our initial findings on carotid atherosclerosis over a longer time course (total of 6 years), examining how psychosocial factors may be linked with the longer term trajectory of subclinical atherosclerosis in a healthy community sample; b) to determine whether changes in psychosocial factors over a 6-year time frame may be associated with commensurate alterations in the course of the disease, a question which may have implications for early intervention; c) to examine the extent to which psychosocial factors may be related to ABP changes over the 6-year follow-up period and to explore the extent to which such changes may contribute to atherosclerotic risk; and d) to determine the role of biological factors (specifically, the effects of autonomic function) and behavioral factors (specifically, the role of individual differences in verbal aggression) as possible determinants accounting for gender differences in the relationship between psychosocial factors and subclinical carotid artery disease progression.