Sociocultural Stressors, Resilience Factors, and Arterial Stiffness in Perimenopausal Latinas

项目概要/摘要 有大量证据表明，心血管疾病（CVD）的风险，女性死亡的主要原因， 在围绝经期（PM）期间增加，PM是最后一次月经期前后4-8年的关键中年阶段 其特征在于激素变化以及压力水平和血管健康的不利变化。值得注意的是， 拉丁裔女性的绝经期比非拉丁裔白色女性早1-2年，且心血管疾病的患病率更高 风险因素（例如，肥胖、糖尿病），但在更年期研究中仍然代表性不足。动脉硬化是一种 非侵入性亚临床标志物，可预测围绝经期期间急剧加速的CVD事件。 拉丁裔在美国的边缘化地位使他们面临社会文化压力，包括 文化适应压力、种族歧视、家庭责任压力和邻里关系不和谐--显示出 增加动脉硬度。复原力因素（例如，自我关怀，对更年期的积极态度， 社会支持，社会凝聚力）已被证明可以发挥一些保护作用，防止不利的变化， 发生在围绝经期，包括压力和CVD风险。本研究的总体目标是确定 与拉丁裔妇女围绝经期动脉硬化进展相关的社会文化压力源， 评估弹性因素的作用（即，自我关怀，对更年期的积极态度，社会支持， 社会凝聚力）。次要目的包括测试非稳态负荷是否介导 社会文化压力源和弹性因素与动脉硬化进展的关系。完成 为此，我们提出了一个纵向观察研究与300围绝经期拉丁（年龄40-60）。 受试者将在6个月的时间间隔（0、6、12和18个月）内完成4次研究访视。所有女人都会 接受颈动脉-股动脉脉搏波速度（cfPWV）评估动脉硬度。文化特异性 每次访问都将采用一些措施来评估社会文化压力因素和复原力因素。非稳态负荷 将使用13种生物标志物（例如，体重指数，腰臀比，血压，心率，空腹 葡萄糖、血脂、C-反应蛋白、皮质醇、硫酸脱氢表雄酮）。关系 社会文化压力源和弹性因素与动脉硬化进展将检查使用线性 混合模型这项研究是第一个纵向研究社会文化压力之间的关联 和弹性因素与围绝经期拉丁人动脉僵硬度的关系。这项研究是一项关键的 更好地了解中年心血管健康的社会文化风险和保护因素的第一步 拉丁裔实现这些目标可能会为发展适合文化的多层次社会心理学提供信息。 干预措施，以减少围绝经期拉丁美洲人的心血管疾病风险。

PROJECT SUMMARY/ABSTRACT There is extensive evidence that the risk of cardiovascular disease (CVD), the leading cause of death for women, increases during perimenopause (PM), a crucial midlife stage of 4-8 years around the final menstrual period characterized by hormonal alterations as well as adverse changes in stress levels and vascular health. Notably, Latinas experience menopause 1-2 years earlier than non-Latina White women and have a greater prevalence of CVD risk factors (e.g., obesity, diabetes), yet remain underrepresented in menopause research. Arterial stiffness is a non-invasive subclinical marker predictive of CVD events that accelerates dramatically during perimenopause. The marginalized status of Latinas in the United States exposes them to sociocultural stressors—including acculturative stress, ethnic discrimination, family obligation stress, and neighborhood disadvantage—shown to increase arterial stiffness. Resilience factors (e.g., self-compassion, positive attitudes towards menopause, social support, social cohesion) have been shown to exert some protection against the adverse changes that occur during perimenopause, including stress and CVD risk. The overall goal of this study is to identify sociocultural stressors associated with arterial stiffness progression in Latinas during perimenopause and evaluate the role of resilience factors (i.e., self-compassion, positive attitude towards menopause, social support, and social cohesion) in these associations. Secondary aims include testing whether allostatic load mediates associations of sociocultural stressors and resilience factors with arterial stiffness progression. To accomplish this goal, we propose a longitudinal observational study with 300 perimenopausal Latinas (aged 40-60). Participants will complete four study visits over 6-month intervals (0, 6, 12, and 18 months). All women will undergo carotid-femoral pulse wave velocity (cfPWV) assessment for arterial stiffness. Culturally-specific measures will be used at each visit to assess sociocultural stressors and resilience factors. The allostatic load will be assessed using 13 biomarkers (e.g., body mass index, waist-hip ratio, blood pressure, heart rate, fasting glucose, lipid profile, C-reactive protein, cortisol, dehydroepiandrosterone sulfate). Relations between sociocultural stressors and resilience factors with arterial stiffness progression will be examined using linear mixed models. This study is the first study to longitudinally examine associations between sociocultural stressors and resilience factors with arterial stiffness in Latinas during perimenopause. The proposed study is a critical first step in better understanding sociocultural risk and protective factors of cardiovascular health in midlife Latinas. Addressing these aims may inform the development of culturally-tailored multilevel psychosocial interventions to reduce the CVD risk of Latinas during perimenopause.