BIOBEHAVIORAL FACTORS IN ATHEROSCLEROTIC PROGRESSION

描述：初步证据表明， 对心理挑战的过度心血管反应（夸大 “心血管反应性”）可能会增加发生以下疾病的风险： 动脉粥样硬化和冠心病（CHD）。 的程度 过度的反应对疾病产生因果累积影响 这种影响应该主要在那些 暴露于频繁的，持续的压力源， 心血管反应 这种素质的前瞻性测试-压力 理论将需要a）评估日常压力源的有效方法 和B）一种可靠地 记录潜在疾病过程的进展（即， 动脉粥样硬化）。 “社会支持”， 帮助他人，是第二个行为因素， 与CHD相关，缺乏社会支持的个人表现出更差的 在一些研究中预测。 与心血管反应性一样， 社会支持对动脉粥样硬化的影响可能最好的特点是， 通过跟踪个人的日常生活环境， 随着时间的推移疾病的进展。 这些方法没有 到目前为止是可行的。 这项拟议中的研究探讨了心血管反应性的联合影响， 和持续的心理压力，因为它们影响发展， 中年人颈动脉粥样硬化; 社会支持过程对心理应激源和疾病反应影响 将同时进行探索。 样本将被跟踪 在三年的时间里，使用：a）可靠的实验室测量， 心血管反应性; B）真实的动态监测评估 行为压力源、社会互动和心血管反应;以及 c）使用颈动脉造影重复评估亚临床动脉粥样硬化 超声检查 这些最近的测量创新，如在 目前的研究，应大大提高我们目前的理解， 行为过程在冠心病风险中的作用

DESCRIPTION: Preliminary evidence suggests that individuals who show excessive cardiovascular responses to psychological challenge (exaggerated "cardiovascular reactivity") may be at increased risk for the development of atherosclerosis and coronary heart disease (CHD). To the extent that exaggerated reactivity exerts a causal, cumulative influence on disease processes, this effect should be observed primarily among those who are exposed to frequent, ongoing stressors which trigger exaggerated cardiovascular responding. A prospective test of this diathesis-stress theory would require a) a valid method of assessing the daily stressors which evoke cardiovascular activation and b) a strategy for reliably documenting the progression of underlying disease processes (i.e., atherosclerosis) in community samples. "Social support," the availability of assistance from others, is a second behavioral factor which has been linked with CHD, with individuals lacking in social support showing a poorer prognosis in a number of studies. As with cardiovascular reactivity, the influence of social support on atherosclerosis may be best characterized in humans by tracking individuals in their daily life circumstances, and following the progression of disease over time. These approaches have not been feasible until now. The proposed study examines the joint influence of cardiovascular reactivity and ongoing psychological stress as they influence the development of carotid atherosclerosis in a sample of middle aged adults; the effects of social support processes on response to psychological stressors and disease progression will be simultaneously explored. The sample will be followed over a three-year period using: a) reliable laboratory measures of cardiovascular reactivity; b) real time ambulatory monitoring assessments of behavioral stressors, social interactions and cardiovascular responses; and c) repeat assessments of subclinical atherosclerosis using carotid ultrasonography. These recent measurement innovations, as employed in the present study, should significantly enhance our current understanding of the role of behavioral processes in coronary heart disease risk.