Combat Stress and Cardiovascular Risk Among Aging Men

描述（由申请人提供）：这是第一次重新提交的课题编号1 R21 HL080422-01，题为“老年男性的战斗压力和心血管风险”。战斗创伤是一种压力源，与相对较高的心理发病率和负面健康行为有关。尽管压力和心血管疾病（CVD）之间存在联系，但相对较少的研究调查了战斗压力和CVD之间的关系，这些研究都是不确定的，而且大多基于自我报告的结果。我们建议使用来自社区动脉粥样硬化风险研究（ARIC）的5300多名黑人和白人中年男性的现有数据来检查战斗压力与CVD（预测中风和冠心病、糖尿病、胆固醇、颈动脉粥样硬化、收缩压）之间的关系，这些男性在基线检查后的年度随访期间被问及服役情况。服兵役的时期从第二次世界大战一直到越南战争。他们将按照兵役经历分为“没有兵役经历”、“没有战斗经历”、“有战斗经历”等3组。建立的冠心病和脑卒中风险预测方程将使用基线时标准化测量获得的心血管疾病危险因素数据来制定。将检查暴露组中CVD风险因素和预测风险的差异（如果存在）在多大程度上可以通过社会心理特征（如社会支持、生命衰竭、特质性愤怒）、社会经济地位和行为风险特征（如吸烟、肥胖、体育活动）的差异来解释。战斗应力- CVD关联随服役时代的变化也将被研究。对于在收集兵役数据之前死亡的男性，将从死亡证明中获得退伍军人身份，以评估退伍军人身份对死亡率的差异，并进行敏感性分析，以估计生存偏差的潜在影响。研究结果将有助于有限的现存文献关于兵役和心血管疾病。此外，它们可能为规划针对现役军人和退伍军人的公共卫生干预方案提供有用的数据。

DESCRIPTION (provided by applicant): This is a first resubmission of Assignment Number 1 R21 HL080422-01 titled "Combat Stress and Cardiovascular Risk Among Aging Men". Combat trauma is a stressor associated with relatively high rates of psychological morbidity, negative health behaviors. Despite links between stress and cardiovascular disease (CVD), relatively few studies have investigated the association between combat stress and CVD, and these studies have been inconclusive and mostly based on self-reported outcomes. We propose to examine the association between combat stress and CVD (predicted risk of stroke and CHD, diabetes, cholesterol, carotid atherosclerosis, SBP) using extant data from more than 5,300 black and white middle- aged men from the Atherosclerosis Risk in Communities (ARIC) Study who were queried about military service during annual follow-up occurring after the baseline exam. Eras of military service spanned from World War II through the Vietnam War. The men will be divided into three groups based on their military service: no history of military service, history of service without combat, and history of service with combat. Established CHD and stroke risk prediction equations will be formulated using CVD risk factor data obtained from standardized measurements obtained at baseline. The extent to which differences (if extant) in CVD risk factors and predicted risk among exposure groups are explained by variations in psychosocial characteristics (e.g. social support, vital exhaustion, trait anger), socioeconomic status, and behavioral risk profiles (e.g., smoking, obesity, physical activity) will be examined. Variations in the combat stress - CVD association by era of service will also be investigated. For men who died prior to data collection on military service, veteran's status will be obtained from death certificates to assess differences in mortality by veterans status and to perform sensitivity analyses to estimate potential effects of survivorship bias. Study results will contribute to the limited extant literature regarding military service and CVD. Furthermore, they may provide data useful in planning public health intervention programs which target active service and veteran populations.