BIOBEHAVIORAL FACTORS IN ATHEROSCLEROTIC PROGRESSION

描述：初步证据表明， 心血管对心理挑战的过度反应(夸张 “心血管反应性”)的风险可能增加。 动脉粥样硬化与冠心病。在某种程度上， 过度的反应性对疾病产生因果的、累积的影响。 过程中，这种影响应该主要观察到那些 暴露在频繁的、持续的压力中，这些压力会引发夸张 心血管反应。对这一素质的前瞻性测试--压力 理论需要a)评估日常应激源的有效方法 这会引起心血管激活，以及b)一种可靠的 记录潜在疾病过程的进展(即， 动脉粥样硬化)。“社会支持”，可获得性 来自他人的帮助是第二个行为因素 与CHD有关，缺乏社会支持的人表现得更差 在多项研究中预测。与心血管反应性一样， 社会支持对动脉粥样硬化的影响最好的特征可能是 人类通过跟踪个人的日常生活情况，以及 随着时间的推移疾病的发展。这些方法并没有 一直到现在都是可行的。 这项拟议的研究考察了心血管反应性的联合影响。 和持续的心理压力，因为它们影响着 中年成人样本中颈动脉粥样硬化的影响 心理压力源和疾病反应的社会支持过程 进展将同时进行探索。样品将会被跟踪 在三年期间使用：a)可靠的实验室措施 心血管反应性；b)实时动态监测评估 行为应激源、社会互动和心血管反应；以及 C)使用颈动脉重复评估亚临床动脉粥样硬化 超声波检查。这些最新的测量创新，如在 目前的研究，应该大大提高我们目前对 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.