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

项目摘要/摘要 有大量证据表明，心血管疾病(CVD)的风险是女性的主要死亡原因， 围绝经期(PM)的升高，这是一个关键的中年阶段，大约在最后一个月经周期的4-8年 以荷尔蒙变化以及压力水平和血管健康的不利变化为特征。值得注意的是， 拉美裔女性绝经时间比非拉丁裔白人女性早1-2年，心血管疾病的患病率也更高 风险因素(如肥胖、糖尿病)，但在更年期研究中仍未得到充分代表。动脉僵硬是一种 非侵入性亚临床标记物预测围绝经期急剧加速的心血管事件。 拉美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劣势--表现为 增加动脉僵硬。弹性因素(例如，自我同情、对更年期的积极态度、 社会支持、社会凝聚力)已被证明对不利的变化具有一定的保护作用 发生在围绝经期，包括压力和心血管疾病风险。这项研究的总体目标是确定 社会文化应激源与围绝经期和围绝经期拉美妇女动脉僵硬进展相关 评估复原力因素(例如，自我同情、对更年期的积极态度、社会支持、 和社会凝聚力)。次要目标包括测试非稳态负荷是否会影响 社会文化应激源和复原力因素与动脉硬化进展的关系。要完成 为了达到这一目标，我们建议对300名围绝经期拉丁裔妇女(年龄40-60岁)进行纵向观察研究。 参与者将在6个月的间隔(0、6、12和18个月)内完成4次研究访问。所有女性都会 采用颈动脉-股动脉脉搏波速度(CfPWV)评价动脉僵硬程度。特定的文化 将在每次访问时使用措施来评估社会文化应激源和复原力因素。不平衡负荷 将使用13个生物标记物(例如，体重指数、腰臀比、血压、心率、空腹 血糖、血脂、C反应蛋白、皮质醇、脱氢表雄酮硫酸盐)。两者之间的关系 具有动脉僵硬进展的社会文化应激源和弹性因素将使用线性 混合模式。这项研究是第一项纵向考察社会文化应激源之间关系的研究。 以及拉丁美洲围绝经期动脉僵硬的弹性因素。拟议中的研究是一项关键的 更好地了解中年心血管健康的社会文化风险和保护因素 拉丁裔。解决这些目标可能有助于根据文化定制的多层次心理社会的发展 降低围绝经期拉丁裔妇女心血管疾病风险的干预措施。

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.