Pregnancy and beyond: windows into disparities in women's cardiovascular health

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 DESCRIPTION (provided by applicant): Cardiovascular (CV) disease is the leading cause of death among women in the US and a major source of racial/ethnic and socioeconomic disparities in women's health. There is a fundamental gap in our understanding of which biological, behavioral, and psychosocial factors contribute most to disparities in women's CV health. In particular, despite growing evidence that pregnancy can serve as a window into women's later-life CV health; little work has taken advantage of this window to gain insight into race or SES disparities in CV health. The overall goal of this proposal is therefore to identify factors-from pregnancy and across the life-course-and that contribute to racial/ethnic and socioeconomic differences in women's later-life CV health. The proposed work will take advantage of the POUCHMoms study (2011-2014, n=678), a unique longitudinal cohort that includes detailed interview data and biologic samples from 3 key periods in the life- course-pre-pregnancy (assessed retrospectively at pregnancy), pregnancy, and mid-life (assessed once within 7-15 years post-pregnancy)-and is both racially and socioeconomically diverse. The first specific aim of the proposed work is to identify factors within the domains of biology, behavior, and psychosocial influences that can be measured at pregnancy or mid-life and that contribute to race and SES differences in women's CV health indicators (i.e., blood pressure, HTN and pre-HTN, risk scores, and intima-media thickness) at mid-life. Although important knowledge can be gained from the existing POUCHMoms data, continued, more frequent, and less burdensome follow-up of these women is essential to track development of CV risk over the life- course and to understand the temporal ordering of factors contributing to race and SES disparities. Therefore, the second specific aim is to develop and pilot test innovative methods for ongoing data collection in the POUCHMoms cohort using social media and mobile technology. The candidate, Dr. Claire Margerison-Zilko, is an Assistant Professor of Epidemiology at Michigan State University (MSU) and brings to the award strong training and research experience in social and perinatal epidemiology and health disparities research. The proposed NHLBI Mentored Career Development Award (K01) will provide Dr. Margerison-Zilko with additional training in 1) cardiovascular epidemiology and pathophysiology, especially as it relates to women's health during pregnancy; 2) life course approaches to chronic disease research; and 3) use of social media and mobile technologies in health research. The training and mentoring in these areas combined with the proposed research activities will enable Dr. Margerison-Zilko to achieve her long-term goal of building an independent and innovative research program examining racial/ethnic and socioeconomic disparities in women's cardiovascular (CV) health, with a focus on understanding relations between pregnancy and CV health.