BIOBEHAVIORAL BASES OF CHD RISK AND MANAGEMENT

申请人（申请人提供）： 该计划项目的竞争性更新包括一个综合的， 多学科计划，包括3个密切相关的项目， 动脉粥样硬化的进展和/或其改善，这是由以下因素支持的： 4个核心单元。项目1，将对有下列情况的青少年进行 持续升高的血压，将检查的影响， 包括饮食、锻炼和压力管理的行为干预 辅导该项目将评估干预措施对以下方面的影响： 心血管危险因素（例如，血脂谱，肥胖，炎症 标志物）和疾病的推定亚临床标志物（例如，左室 质量、内皮功能）。项目2将审查 基于个体和群体的认知行为疗法（CBT） 心肌梗死（AMI）患者的医疗风险增加 AMI后的发病率和死亡率，因为他们在社会上被孤立， 临床抑郁参与者随机接受CBT或常规护理 将根据生物风险因素（例如，脂质， 肥胖、凝血因子）和可能的亚临床疾病标志物 (e.g.,颈动脉内膜中层厚度、冠状动脉钙化）。第三 该项目将在Watanabe遗传性高脂血症兔上进行 （WHHL）将评估以下方面的作用：（a）交感神经系统（SNS）， （B）行为相关的动脉粥样硬化; 调节SNS活性和动脉粥样硬化的进展 社会压力;（c）下丘脑中的催产素（OT）作为社会压力的函数， 环境;（d）OT在下丘脑垂体调节中的作用 肾上腺皮质和SNS活动与 行为相关的动脉粥样硬化这3个项目将分别得到支持 由行政、内分泌和代谢、心血管管理和统计/数据管理部门负责。

PROPOSED PROGRAM (provided by applicant): This program project competitive renewal consists of an integrated, multidisciplinary program including 3 closely related projects examining the progression of atherosclerosis and/or its amelioration, which is supported by 4 core units. Project 1, which would be conducted upon adolescents with persistently elevated blood pressure, would examine the effects of a behavioral intervention involving diet, exercise and stress management counseling. This project would assess the impact of the intervention on cardiovascular risk factors (e.g., lipid profiles, adiposity, inflammatory markers) and putative subclinical markers of disease (e.g., left ventricular mass, endothelial function). Project 2 would examine the effects of individual and group based cognitive behavior therapy (CBT) in acute myocardial infarction (AMI) patients who are at increased risk for medical morbidity and mortality after AMI because they are socially isolated or clinically depressed. Participants randomized into a CBT or usual care condition will be assessed in terms of biological risk factors (e.g., lipids, adiposity, coagulation factors) and possible subclinical markers of disease (e.g., carotid intima-media thickness, coronary calcification). The third project, which will be conducted on Watanabe Heritable Hyperlipidemic Rabbits (WHHL) will assess the role of: (a) the sympathetic nervous system (SNS) in behaviorally-related atherosclerosis; (b) corticotropin-releasing hormone in regulating SNS activity and progression of atherosclerosis during chronic social stress; (c) oxytocin (OT) in the hypothalamus as a function of social environment; and (d) OT in the regulation of hypothalamic pituitary adrenocortical and SNS activity in relation to the progression of behaviorally-related atherosclerosis. These 3 projects will each be supported by Administrative, Endocrinology and Metabolism, Cardiovascular Management and Statistics/Data Management units.