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

点击翻译按钮获取中文摘要

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.