Intimate Partner Violence and Subclinical Cardiovascular Disease in Midlife Women

中年女性的亲密伴侣暴力和亚临床心血管疾病

• 批准号: 10684180
• 负责人: Karen P Jakubowski
• 金额: $ 17.41万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10684180
• 关键词: Accidents; Adult; Area; Arterial Fatty Streak; Behavioral; Biological; Blood Pressure; COVID-19 pandemic; Cardiovascular Diseases; Carotid Arteries; Carotid Artery Plaques; Cause of Death; Child Abuse; Chronic; Chronic Disease; Chronic stress; Clinical; Cognitive; Data; Development Plans; Dimensions; Disease Outcome; Ecological momentary assessment; Event; Exposure to; Future; Glucose; Health; Insulin; Interpersonal Relations; Intervention; Life; Life Cycle Stages; Link; Lipids; Measurement; Measures; Medicine; Mental Depression; Mental Health; Mentored Patient-Oriented Research Career Development Award; Mentorship; Methods; National Heart, Lung, and Blood Institute; Natural Disasters; Nightmare; Obesity; Outcome; Patient Self-Report; Peptide Initiation Factors; Persons; Physical activity; Population; Post-Traumatic Stress Disorders; Prevalence; Psychosocial Factor; Recording of previous events; Reporting; Research; Research Personnel; Research Support; Risk; Risk Factors; Role; Sampling; Scientist; Sexual abuse; Sleep; Sleeplessness; Smoking; Social Distance; Social Environment; Spouses; Surveys; Testing; Time; Training; Trauma; Trust; Vascular remodeling; Violence; Woman; Women' s Health; Work; actigraphy; aged; cardiovascular disorder risk; cardiovascular health; career; career development; carotid intima-media thickness; contextual factors; critical period; emotional abuse; improved; indexing; interpersonal trauma; intimal medial thickening; intimate partner violence; middle age; physical abuse; poor sleep; psychosocial; recruit; reproductive; research and development; response; sleep onset; sleep quality; social; social determinants; stay-at-home order; substance use; therapy development; trauma exposure; ultrasound; vigilance; young woman

PROJECT SUMMARY/ABSTRACT Dr. Karen Jakubowski is an early career clinical scientist and emerging expert on the relationship of interpersonal trauma to women’s cardiovascular health. The objective of this NHLBI Mentored Patient-Oriented Research Career Development Award (K23) is to study the relation of intimate partner violence (IPV) to subclinical cardiovascular disease (CVD) in midlife women and to test the role of poor sleep as a mechanism linking IPV and subclinical CVD. CVD is the leading cause of death among women. Psychosocial factors, such as childhood abuse and chronic stress in adulthood, have been related to CVD risk. However, IPV, a type of interpersonal trauma reported by over 35% of U.S. women, is poorly understood in relation to CVD. Midlife is a critical time to study relations of IPV to CVD. Midlife is a period of biological and psychosocial transition for women that is often accompanied by accumulating CVD risk. Subclinical CVD measures provide objective indices of CVD risk among midlife women and have not been studied in relation to IPV. Key mechanisms, such as poor sleep, may link IPV to subclinical CVD. Understanding whether and how IPV is related to CVD risk is necessary to develop tailored interventions to improve midlife women’s cardiovascular health. Prior research is limited by a reliance on retrospective self-report measures of CVD and sleep, lack of consideration of contextual factors that initiate and maintain poor sleep in trauma-exposed populations, and a focus on younger women. The proposed training plan will address three training areas: (1) midlife women’s cardiovascular health and measurement of subclinical CVD, (2) IPV and conducting research with trauma-exposed populations, and (3) ecological momentary assessment (EMA) methods and analysis for behavioral sleep medicine research. The Candidate has assembled an interdisciplinary mentorship team to achieve these training aims. The proposed study will investigate the relation of IPV to subclinical CVD in a sample of midlife women with and without a past history of IPV (N=100), using a multidimensional measure of IPV (type, chronicity) and indices of subclinical CVD (carotid intima media thickness and plaque). Women will provide one week of EMA (sleep quality, vigilance) and actigraphy (sleep continuity), which will provide objective indices of sleep and capture momentary social, cognitive, and behavioral factors that initiate and maintain poor sleep in trauma-exposed samples. Study aims are to: (1) Test whether women with a history of IPV show greater subclinical CVD than women without this history; (2) Test whether women with a history of IPV show worse sleep and more vigilance than women without this history; (3) Test whether poor sleep and vigilance are related to subclinical CVD and the role of sleep/vigilance in relations of IPV to subclinical CVD. Results have the potential to elucidate the role of IPV in women’s cardiovascular health and suggest targets for future intervention to reduce CVD risk in midlife women. The proposed research and training aims align with NHLBI’s efforts to identify social determinants of CVD in women. Research and career development activities will prepare the candidate to be an independent investigator and expert in IPV and midlife women’s CVD.

项目总结/摘要 博士凯伦·雅库博夫斯基是一位早期职业临床科学家，也是人际关系方面的新兴专家。 创伤对女性心血管健康的影响。本NHLBI指导的以患者为导向的研究的目标 职业发展奖（K23）是研究亲密伴侣暴力（IPV）与亚临床的关系， 中年女性心血管疾病（CVD），并测试睡眠不足作为IPV连接机制的作用 和亚临床CVD。心血管疾病是妇女死亡的主要原因。社会心理因素，如童年 成年期的虐待和慢性压力与心血管疾病风险有关。然而，IPV，一种人际关系 超过35%的美国女性报告的创伤与CVD的关系知之甚少。中年是一个关键时期， 研究IPV与CVD的关系。中年是女性生理和心理社会的过渡时期， 伴随着CVD风险的累积。亚临床CVD测量提供了CVD风险的客观指标， 中年妇女，尚未研究与IPV的关系。关键机制，如睡眠不好，可能与IPV有关 亚临床心血管疾病了解IPV是否以及如何与CVD风险相关是必要的， 改善中年妇女心血管健康的干预措施。先前的研究受到依赖于 心血管疾病和睡眠的回顾性自我报告措施，缺乏对启动和 在创伤暴露人群中保持睡眠不佳，并关注年轻女性。拟议的培训计划 将涉及三个培训领域：（1）中年妇女的心血管健康和亚临床心血管疾病的测量， (2)IPV和对创伤暴露人群进行研究，以及（3）生态瞬时评估 (EMA)行为睡眠医学研究的方法和分析。候选人已经召集了一个 跨学科导师团队，以实现这些培训目标。这项研究将探讨 在有或无IPV既往史的中年女性样本（N=100）中，使用 IPV（类型、慢性）和亚临床CVD（颈动脉内膜中层厚度）指数的多维测量 和斑块）。女性将提供一周的EMA（睡眠质量，警惕性）和活动记录仪（睡眠连续性）， 它将提供客观的睡眠指数，并捕捉瞬间的社会，认知和行为因素， 在创伤暴露样本中引发并维持不良睡眠。研究目的是：（1）测试女性是否患有 有IPV病史妇女亚临床CVD发生率高于无IPV病史的妇女;（2）检测有IPV病史的妇女是否存在亚临床CVD， 有IPV病史者睡眠质量差，警觉性高;（3）检测是否存在睡眠质量差 和警觉性与亚临床CVD有关，睡眠/警觉性在IPV与亚临床CVD关系中的作用。 研究结果有可能阐明IPV在女性心血管健康中的作用，并为IPV的靶点提供建议。 未来的干预措施，以减少中年妇女的心血管疾病风险。拟议的研究和培训目标与 NHLBI努力确定妇女心血管疾病的社会决定因素。研究和职业发展活动 将准备候选人是一个独立的调查员和专家在IPV和中年妇女的心血管疾病。