Racial/Ethnic Influences on Early Vascular Aging and Cardiac Strain: Role of Cumulative Stress, Inflammatory and Metabolic Burden

种族/民族对早期血管老化和心脏劳损的影响：累积压力、炎症和代谢负担的作用

• 批准号: 10674059
• 负责人: UMA RAO
• 金额: $ 69.59万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10674059
• 关键词: 17 year old; Accounting; Adolescence; Adolescent; Adolescent obesity; Adrenal Glands; Adult; Affect; African American; African American population; Aging; American; Anthropometry; Arteries; Black Populations; Blood Pressure; Blood Vessels; Blood flow; Cardiac; Cardiovascular Diseases; Caucasians; Cause of Death; Cessation of life; Chronic stress; Coping Skills; Data; Development; Diagnosis; Diastole; Diet; Dimensions; Disease; Disease Marker; Early Intervention; Environmental Risk Factor; Ethnic Origin; Ethnic Population; Exhibits; Female; Female Adolescents; Femur; Follow-Up Studies; Genetic; Health; Health Transition; Healthcare; Heart Diseases; Heating; High Prevalence; Hispanic; Hispanic Americans; Human; Hypertension; Hypothalamic structure; Inflammation; Inflammatory; Interruption; Lasers; Latinx; Left Ventricular Mass; Link; Measures; Mediating; Metabolic; Metabolic Marker; Metabolic syndrome; Methods; Mexican Americans; Minority Groups; Minority Women; Morbidity - disease rate; Myocardial; Not Hispanic or Latino; Obesity; Outcome; Peripheral; Persons; Phase; Physiologic pulse; Physiological; Pituitary Gland; Play; Populations at Risk; Prevalence; Prevention Guidelines; Productivity; Race; Research; Risk; Risk Factors; Role; Shapes; Skin; Social support; Stress; Stress and Coping; Structure; System; Systole; Techniques; Testing; Time; United States; Variant; Vascular Endothelium; Woman; adipokines; allostatic load; arterial stiffness; biological adaptation to stress; biopsychosocial; blood pressure elevation; burden of illness; cardiovascular disorder prevention; cardiovascular disorder risk; cardiovascular health; cohort; coping; cost; critical period; disease disparity; disorder risk; emerging adulthood; endothelial dysfunction; ethnic difference; ethnic disparity; ethnic minority; flexibility; follow-up; heart rate variability; high risk population; hypothalamic-pituitary-adrenal axis; indexing; inflammatory marker; men; mortality; mortality risk; preempt; prevent; protective factors; racial difference; racial disparity; racial minority; racial population; response; sex; social disparities; sociocultural determinant; stressor; therapy development; treatment guidelines; volunteer; young adult; young woman

Cardiovascular disease (CVD) is the leading global cause of death, accounting for approximately 18.6 million deaths in 2019. Between 2015 and 2018, 126.9 million American adults had CVD, resulting in an annual cost of $363.4 billion in healthcare, lost productivity and mortality. The CVD burden is not distributed equally among racial/ethnic (R/E) groups: ~60% of African American (AA) adults have CVD compared to ~48% of Hispanic/ Latinx (HL) and Non-Hispanic Whites (NHW). R/E disparities in CVD are likely due to an interplay of genetic and sociocultural factors, which are exacerbated by the chronic stress burden that some R/E groups endure. Chronic stress elicits repeated activation of the stress response systems, increasing allostatic load (AL) and compromising health. High AL may increase risk for early vascular aging (EVA): arterial stiffness, subclinical endothelial dysfunction, hypertension and increased left ventricular mass. R/E disparities in EVA emerge by adolescence, before overt signs of CVD, but no studies simultaneously measured vertically integrated CVD markers early in development. Links between chronic stress, AL and CVD have been proposed but not studied comprehensively. Factors that may protect against CVD in some high-risk groups (e.g., HL) have not been explored across R/E groups. Current CVD prevention and treatment guidelines were developed from data obtained primarily in men, contributing to missed or delayed diagnoses, non-optimal treatment and poor outcomes, especially in R/E minority women. Research on the mechanisms of CVD risk in AA was conducted almost exclusively in men despite high CVD prevalence in both sexes. Importantly, R/E disparities in CVD are more marked in women. CVDs explain 33% of the mortality variation between AA and NHW men but 45% for women. Many CVD risk factors have a higher prevalence (e.g., obesity) or a greater impact in women; for example, chronic stress, which disproportionately affects R/E minorities, is a stronger predictor of CVD-related mortality in women. Our current study measures multidomain CVD risk factors including cumulative stress, hypothalamic-pituitary-adrenal activity, inflammatory markers and obesity indices (anthropometry, adiposity, diet, metabolic markers, and adipokines) in 13 to 17-year-old AA, HL and NHW adolescent girls. We propose a follow-up study of this well-characterized cohort 4 to 6 years later in emerging adulthood, a critical period when physical maturity is largely complete but biopsychosocial risk factors that have longterm implications for CVD emerge. We will determine the magnitude of cumulative stress and AL burden over time, incorporate vertically integrated markers of EVA with state-of-the-art techniques, and examine the effects of cumulative stress, AL and adaptive cultural coping practices on EVA. Characterizing R/E differences in modifiable bio- psychosocial risk and protective factors associated with subclinical CVD during a developmental phase when humans can exert more control over their lives (with increased autonomy but few adult responsibilities) offers an opportunity to preempt the transition from health to disease and reduce CVD disparities in at-risk groups.

心血管疾病（CVD）是全球主要死亡原因，约占1860万人