Impact of minority stress on cardiovascular disease risk and resilience

7.项目总结/摘要 该项目是响应NOT-MD-19-001关于性健康和生殖健康研究的特别兴趣通知。 性别少数群体（SGM）。少数性别人群患心血管疾病的风险增加 疾病（CVD）的发病率和死亡率。具体来说，行为风险因素监测系统的数据表明， 与顺性别者相比，少数性别者患心肌梗死的风险增加了一倍以上。 报告说，抑郁症、缺乏身体活动和体重指数（BMI）升高的情况更严重， 所有这些都会增加CVD风险。此外，许多性别少数个体服用激素， 可能会进一步增加他们患CVD的风险。根据少数民族压力理论，偏见和 歧视是心血管疾病风险差异的一个因素。尽管之前的研究发现 少数性别压力和自我报告的心理健康状况较差之间，少数性别压力对身体健康的影响， 尚未在性别少数群体中研究健康结果，包括心血管疾病风险。这个目标 这项研究旨在促进我们对少数民族压力和弹性如何影响CVD风险的理解。担任设定 在美国三个城市（N=390）的性别少数个体的纵向多地点队列中，我们的目标是：（1） 确定少数民族压力与心理健康和心血管疾病风险的关系;（2）确定社会影响 支持，获得护理，以及心理健康和心血管疾病风险的身份发展;（3）确定可改变的 弹性因素可能影响少数民族压力与心理健康和心血管疾病风险的关系， 人口健康差距。除了结构化访谈和生态瞬时评估（EMA）之外， 在基线和2年随访时，我们将收集为期2周的客观测量数据， 血压、睡眠和身体活动的影响。这项研究将提供迄今为止最好的证据， 指导研究人员和临床医生制定干预措施，以减少少数性别人群的心血管疾病差异 并促进他们的长期健康和福祉。

7. PROJECT SUMMARY/ABSTRACT This project is responsive to NOT-MD-19-001 Notice of Special Interest in Research on the Health of Sexual and Gender Minority (SGM) Populations. Gender minority populations are at increased risk for cardiovascular disease (CVD) morbidity and mortality. Specifically, Behavioral Risk Factor Surveillance System data suggest that, compared to cisgender people, gender minorities are at more than double the risk for myocardial infarction and report greater depression, physical inactivity, and elevated body mass index (BMI), as well as poorer access to healthcare, all of which increase CVD risk. Further, many gender minority individuals take hormones, which may further increase their risk of CVD. According to minority stress theory, the negative impact of prejudice and discrimination is one contributor to CVD risk disparities. Although previous studies have found associations between gender minority stress and poorer self-reported mental health, the impact of minority stress on physical health outcomes, including CVD risk, has not been examined in gender minority populations. The goal of this study is to advance our understanding of how minority stress and resilience affect CVD risk. In an established longitudinal, multisite cohort of gender minority individuals in three U.S. cities (N=390), we aim to: (1) determine the association of minority stress with mental health and CVD risk; (2) determine the impact of social support, access to care, and identity development on mental health and CVD risk; and (3) identify modifiable resilience factors that may influence the relationship of minority stress to mental health and CVD risk in this health disparity population. In addition to structured interviews and Ecological Momentary Assessments (EMA) of stress and resilience at baseline and 2-year follow-up, we will collect 2-week bursts of objective measurements of blood pressure, sleep and physical activity. The proposed research will provide the best evidence to date to guide researchers and clinicians working to develop interventions to reduce CVD disparities in gender minority populations, and promote their long-term health and wellbeing.