Environmental Toxicants, Race, and Cardiovascular Disease Risk in Children

环境毒物、种族和儿童心血管疾病风险

• 批准号: 8373250
• 负责人: BROOKS B. GUMP
• 金额: $ 47.95万
• 依托单位: SYRACUSE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-02-08 至 2016-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8373250
• 关键词: Accounting; Acute; Address; Affect; African American; American; Blood; Blood Pressure; Blood Vessels; Cardiac; Cardiovascular Diseases; Cardiovascular Physiology; Cardiovascular system; Cause of Death; Child; Clinical; Congestive Heart Failure; Coronary Arteriosclerosis; Data; Disadvantaged; Discrimination; Disease; Disease Outcome; Economics; Environment; Epidemiologic Studies; European; Exposure to; Family; Genetic; Health; Hypertension; Intake; Lead; Left; Left Ventricular Hypertrophy; Left Ventricular Mass; Measurement; Measures; Mediating; Methods; Modeling; Morbidity - disease rate; Outcome; Pattern; Physiologic pulse; Population; Potassium; Poverty; Prevalence; Psychological Stress; Race; Regulation; Relative (related person); Research; Risk; Risk Factors; Role; Social Controls; Socioeconomic Status; Sodium; Stress; Stroke; Sum; Testing; Thick; Toxic Environmental Substances; Trace metal; United States; Vascular resistance; Ventricular; acute stress; arterial stiffness; blood lead; bone; cardiovascular disorder risk; cohesion; early childhood; ethnic difference; health disparity; hemodynamics; interpersonal conflict; lead exposure; mortality; programs; psychologic; psychosocial; public health relevance; racial difference; racial discrimination; response; social; theories; young adult

DESCRIPTION (provided by applicant): Cardiovascular disease (CVD) remains the leading cause of death in the United States and disables 10 million Americans each year. However, CVD risk in the US is higher for African Americans (AAs) relative to European Americans (EAs). In addition to R/E differences in CVD risk, there is extensive data demonstrating that, relative to EAs, AAs have higher rates of poverty and a corresponding increase in exposure to environmental toxicants, including lead (Pb), both in their blood and in their bones. Moreover, studies suggest a positive association between Pb and blood pressure, left ventricular hypertrophy, and CVD mortality. The current proposal addresses the question of whether R/E differences in CVD are partially a consequence of corresponding differences in exposure to Pb from the environment. Furthermore, this proposal considers whether these effects might be amplified by R/E differences in psychosocial background, including social control motives, background stress, and racial discrimination. Specifically, our proposal focuses on whether R/E differences in Pb exposure might produce differing rates of CVD risk through underlying alterations in cardiovascular responses to acute psychological stress, a mechanism whereby the psychosocial environment can affect CVD risk. In recent research (Gump, et al., 2011), increasing blood Pb was associated with alterations in cardiac autonomic regulation reflecting "co-inhibition" of both sympathetic and parasympathetic activity that is typically associated with greater vascular resistance, a cardiovascular pattern we had already observed in children with heightened early childhood blood Pb (Gump, et al., 2005). This vascular response to stress has also been shown to be associated with greater left ventricular mass, a significant predictor of cardiovascular morbidity. Interestingly, a number of studies have noted that AAs respond to psychological stress with a vascular pattern relative to EAs typical cardiac response and are more likely than EAs to develop left ventricular hypertrophy at similar levels of blood pressure, and have greater arterial stiffness as reflected by faster pulse wave velocity. In sum, there is evidence that: 1) AAs (relative to EAs) have higher levels of blood Pb, 2) AAs (relative to EAs) typically respond to stress with a more vascular pattern, as well as greater arterial stiffness and left ventricular mass, and 3) increasing Pb is associated with a heightened vascular response to acute stress. This accumulated evidence provides strong support for testing the hypothesis that R/E differences in Pb exposure might account for R/E differences in cardiovascular patterns of response to acute stress and R/E differences in left ventricular mass and arterial stiffness.

描述（由申请人提供）：心血管疾病（CVD）仍然是美国死亡的主要原因，每年使1000万美国人致残。然而，在美国，非洲裔美国人（AAs）的CVD风险高于欧洲裔美国人（EAs）。除了CVD风险的R/E差异外，还有大量数据表明，相对于 EA和AA的贫困率更高，接触环境毒物的比例也相应增加，包括血液和骨骼中的铅（Pb）。此外，研究表明铅与血压、左心室肥大和心血管疾病死亡率呈正相关。目前的建议解决的问题，是否在CVD的R/E的差异部分是相应的差异，从环境中暴露于铅的后果。此外，本建议考虑这些影响是否可能被放大的R/E的心理社会背景，包括社会控制动机，背景压力和种族歧视的差异。具体来说，我们的建议集中在是否R/E铅暴露的差异可能会产生不同的心血管疾病的风险率通过潜在的改变心血管反应急性心理应激，一种机制，即心理社会环境可以影响心血管疾病的风险。在最近的研究中（Gump等人，2011），增加的血液Pb与心脏自主调节的改变相关，反映了交感神经和副交感神经活动的“共抑制”，其通常与更大的血管阻力相关，这是我们已经在具有升高的早期儿童血液Pb的儿童中观察到的心血管模式（Gump等人，2005年）。这种血管对压力的反应也被证明与更大的左心室质量相关，这是心血管发病率的重要预测因素。有趣的是，许多研究已经注意到，相对于EA典型的心脏反应，AA以血管模式对心理应激作出反应，并且在相似的血压水平下，AA比EA更有可能发生左心室肥大，并且具有更大的动脉僵硬度，这反映在更快的脉搏波速度上。总而言之，有证据表明：1）AA（相对于EA）具有更高的血液铅水平，2）AA（相对于EA）通常以更多的血管模式以及更大的动脉僵硬度对压力做出反应， 左心室质量，和3）增加铅与急性应激血管反应升高。这些积累的证据为检验以下假设提供了强有力的支持：铅暴露的R/E差异可能解释了心血管对急性应激反应模式的R/E差异以及左心室质量和动脉僵硬度的R/E差异。