The Contribution of Chronic Stress and Psychosocial Resources on Aging in Young and Early Midlife Black Women

项目摘要 在美国，黑人男性和女性在年轻时患上高血压（HTN）， 患病率最高，为58%和57%，而年龄匹配的白色男性和女性为51%和41%。早期 在35 - 44岁的早期中年黑人妇女（BW）中发生HTN也与HTN的较高负担有关， 介导的器官损伤和心血管疾病（CVD）的发病率和死亡率。这些的确切原因 不同的结果仍然是未知的，但可能是由于不同压力源的更大负担，即，种族歧视， 无论社会经济地位如何，BW经历的性别、财务、工作和社会网络（SEP）， 导致风化和加速的生物老化。社会和环境影响的影响 理论上，应激源可以克服BW中内源性雌激素的心脏保护作用， 是将压力与加速衰老过程和心血管健康状况不良联系起来的关键机制的基础， 这个亚组。慢性压力被认为是加速衰老和与年龄有关的疾病的潜在危险因素， 虽然衰老被认为是CVD的一个潜在危险因素，并与动脉僵硬度有关，但 亚临床心血管疾病和死亡风险。越来越多的证据表明，缓和资源，如弹性， 逆境中成功适应的过程或结果，可能会改变 慢性压力和衰老然而，复原力不一定都是有益的，而且可能会加剧不利影响。 压力与国家护理研究所高度优先关注的社会决定因素保持一致， 健康，强调社会不平等和健康公平的体现，K23培训的目的是 这项混合方法的横断面研究n = 85 BW是：1）检查慢性应激之间的关联 总体压力负荷（CSB）和每种压力源分别对生物年龄（BA）和颈动脉股动脉脉搏波的影响 根据社会经济地位（SEP）分层的速度（cf-PWV）; 2）检查SEP和弹性对 BA和cf-PWV以及弹性是否改变CSB和BA之间的效果，以及动脉僵硬度3） 使用半结构化访谈描述CSB的感知来源以及它们如何影响弹性， 由BA和cf-PWV的最高（n = 9）和最低（n = 9）组合三分位数组成的18名女性的子样本。 K23奖期间的具体培训活动是获得：1）心理神经免疫学，压力， 2）进行和解释cf-PWV测量; 3）放血、实验室分析处理和储存; 4)熟练掌握混合方法研究的技能; 5）进行先进的生物统计线性 回归方法来测量生物老化。我的长期目标是应用知识和技能 在此K23下获得，以建立纵向队列，检查SEP，慢性应激和健康的作用 保护性资源可能会随着时间的推移增强或减轻生理失调和CVD风险。

Project Abstract In the United States, Black men and women develop hypertension (HTN) at younger ages and have the highest prevalence, 58% and 57%, compared to aged-matched White men and women 51% and 41%. Early onset HTN among early midlife Black women (BW) 35-44 years old is also linked to a higher burden of HTN- mediated organ damage and cardiovascular disease (CVD) morbidity and mortality. The exact cause of these disparate outcomes remains unknown but may be due to a greater burden of distinct stressors, i.e., racial, gender, financial, job, and social network, experienced by BW regardless of socioeconomic position (SEP), causing weathering and accelerated biological aging. The impact of social and environmentally influenced stressors are theorized to override the cardioprotective effects of endogenous estrogen in BW and may also underlie a key mechanism linking stress to acceleration of the aging process and poor cardiovascular health in this subgroup. Chronic stress is considered a potent risk factor of accelerated aging and age-related diseases, while aging is considered a potent risk factor of CVD and is linked with arterial stiffness, a predictive marker of subclinical CVD and mortality risk. Mounting evidence suggests that moderating resources such as resilience, the process or outcome of successful adaptation despite adversity, may modify the relationship between chronic stress and aging. Yet, resilience may not be uniformly beneficial and may enhance the adverse effects of stress. Aligned with the National Institute of Nursing Research high-priority focus on social determinants of health with an emphasis on the embodiment of social inequalities and health equity, the K23 training aims of this mixed-method cross sectional study of n=85 BW are: 1) Examine the associations between chronic stress burden (CSB) overall and each stressor separately on biologic age (BA) and carotid femoral pulse wave velocity (cf-PWV) stratified by socioeconomic position (SEP); 2) Examine the effects of SEP and resilience on BA and cf-PWV and whether resilience modifies the effect between CSB and BA, as well as arterial stiffness 3) Describe perceived sources of CSB and how they influence resilience using semi-structured interviews with a subsample of 18 women consisting of the highest (n=9) and lowest (n=9) combined tertiles for BA and cf-PWV. Specific training activities during the K23 award are to obtain: 1) expertise in psychoneuroimmunology, stress, and health; 2) conduct and interpret cf-PWV measurements; 3) Phlebotomy, lab assay processing and storage; 4) proficiency and acquisition of skills in mixed-methodology research; 5) conduct advanced biostatistical linear regression methods to measure biological aging. My long-term goal is to apply the knowledge and skills obtained under this K23 to establish a longitudinal cohort examining the role of SEP, chronic stress, and health protective resources that may enhance or mitigate physiologic dysregulation and CVD risk over time.