Biobehavioral Factors in Atherosclerotic Progression

描述(由申请人提供)：越来越多的证据将心理社会因素与动脉粥样硬化的发展联系起来。之前的大部分研究都是在非人类样本中进行的。在亚临床动脉粥样硬化性疾病的非侵入性评估以及精神应激和应激反应的测量方面的最新进展，使我们能够将这种类型的调查扩展到人类社区样本，对风险分层和预防具有重要意义。在我们最初的资助期间，我们招募了367名健康的男性和女性，他们没有心血管疾病病史(50-70岁)。在日常生活中，使用实时电子日记系统评估心理社会需求和社会支持的测量。我们还使用实验室开发的自动测试电池评估了应激相关心血管反应性(CVR)的个体差异。这些心理社会因素如假设的那样，与动态血压(ABP)、颈动脉粥样硬化有关，在某些情况下，还与三年的颈动脉粥样硬化进展有关。在心理社会因素与动脉粥样硬化之间的相关性方面，观察到了许多性别差异。在这个相互竞争的续展申请中，我们建议继续跟踪这个样本，以延长两年半的资助期，目的如下：a)复制和扩展我们关于颈动脉粥样硬化的初步发现，在更长的时间段(总共6年)内，检查心理社会因素如何与健康社区样本中亚临床动脉粥样硬化的长期轨迹有关；b)确定6年时间框架内心理社会因素的变化是否可能与疾病过程中的相应变化有关，这一问题可能对早期干预有影响；C)研究心理社会因素在多大程度上可能与6年随访期内动脉血压的变化有关，并探讨这种变化可能在多大程度上促进动脉粥样硬化的风险；以及d)确定生物因素(特别是自主神经功能的影响)和行为因素(特别是言语攻击中的个体差异)作为可能的决定因素在心理社会因素与亚临床颈动脉疾病进展之间的关系中作为性别差异的可能决定因素。

DESCRIPTION (provided by applicant): Accumulating evidence links psychosocial factors with the development of atherosclerosis. Much of this previous research has been conducted in nonhuman samples. Recent developments in the noninvasive assessment of subclinical atherosclerotic disease, along with the measurement of mental stress and stress responding, have allowed us to extend this type of investigation to human community samples, with important implications for risk stratification and prevention. During our initial funding period, we recruited a sample of 367 healthy men and women with no history of cardiovascular disease (50-70 years of age). Measures of psychosocial demands and social support were assessed during daily life, using a real-time electronic diary system. We also assessed individual differences in stress-related cardiovascular reactivity (CVR) using an automated test battery developed in our laboratory. These psychosocial factors were shown to be associated, as hypothesized, with ambulatory blood pressure (ABP), carotid artery atherosclerosis, by ultrasound, and, in some cases, with three-year carotid artery atherosclerotic progression as well. A number of gender differences in the association between psychosocial factors and atherosclerosis were observed. In this competing renewal application, we propose continuing to follow this sample for an additional 2-1/2 year funding period, with the following aims: a) to replicate and extend our initial findings on carotid atherosclerosis over a longer time course (total of 6 years), examining how psychosocial factors may be linked with the longer term trajectory of subclinical atherosclerosis in a healthy community sample; b) to determine whether changes in psychosocial factors over a 6-year time frame may be associated with commensurate alterations in the course of the disease, a question which may have implications for early intervention; c) to examine the extent to which psychosocial factors may be related to ABP changes over the 6-year follow-up period and to explore the extent to which such changes may contribute to atherosclerotic risk; and d) to determine the role of biological factors (specifically, the effects of autonomic function) and behavioral factors (specifically, the role of individual differences in verbal aggression) as possible determinants accounting for gender differences in the relationship between psychosocial factors and subclinical carotid artery disease progression.