Combat Stress and Cardiovascular Risk Among Aging Men

描述（由申请人提供）：这是第一次重新提交任务编号1 R21 HL 080422 -01，标题为“老年男性的抗压力和心血管风险”。战斗创伤是一种应激源，与较高的心理发病率、负性健康行为相关。尽管压力和心血管疾病（CVD）之间存在联系，但相对较少的研究调查了战斗压力和CVD之间的关系，这些研究一直没有定论，大多基于自我报告的结果。我们建议研究战斗压力和心血管疾病之间的联系（预测中风和冠心病，糖尿病，胆固醇，颈动脉粥样硬化，SBP的风险）使用超过5，来自社区动脉粥样硬化风险研究（ARIC）的300名黑人和白色中年男性在每年的随访中被问及服兵役的情况，从第二次世界大战到越南战争，军队服役的时间跨度很大。这些人将根据他们的军事服务分为三组：没有军事服务的历史，没有战斗的服务历史，和有战斗的服务历史。将使用从基线时获得的标准化测量值获得的CVD风险因素数据制定已建立的CHD和卒中风险预测方程。暴露组之间CVD风险因素和预测风险的差异（如果存在）的程度可以通过心理社会特征（例如社会支持，生命衰竭，特质愤怒），社会经济地位和行为风险特征（例如，吸烟、肥胖、体力活动）进行检查。还将调查不同服役时期的战斗压力-心血管疾病关联的变化。对于在兵役数据收集之前死亡的男性，将从死亡证明中获得退伍军人的身份，以评估退伍军人身份的死亡率差异，并进行敏感性分析，以估计生存偏倚的潜在影响。研究结果将有助于关于兵役和CVD的有限的现存文献。此外，他们可以提供有用的数据，规划公共卫生干预计划，目标是现役军人和退伍军人群体。

DESCRIPTION (provided by applicant): This is a first resubmission of Assignment Number 1 R21 HL080422-01 titled "Combat Stress and Cardiovascular Risk Among Aging Men". Combat trauma is a stressor associated with relatively high rates of psychological morbidity, negative health behaviors. Despite links between stress and cardiovascular disease (CVD), relatively few studies have investigated the association between combat stress and CVD, and these studies have been inconclusive and mostly based on self-reported outcomes. We propose to examine the association between combat stress and CVD (predicted risk of stroke and CHD, diabetes, cholesterol, carotid atherosclerosis, SBP) using extant data from more than 5,300 black and white middle- aged men from the Atherosclerosis Risk in Communities (ARIC) Study who were queried about military service during annual follow-up occurring after the baseline exam. Eras of military service spanned from World War II through the Vietnam War. The men will be divided into three groups based on their military service: no history of military service, history of service without combat, and history of service with combat. Established CHD and stroke risk prediction equations will be formulated using CVD risk factor data obtained from standardized measurements obtained at baseline. The extent to which differences (if extant) in CVD risk factors and predicted risk among exposure groups are explained by variations in psychosocial characteristics (e.g. social support, vital exhaustion, trait anger), socioeconomic status, and behavioral risk profiles (e.g., smoking, obesity, physical activity) will be examined. Variations in the combat stress - CVD association by era of service will also be investigated. For men who died prior to data collection on military service, veteran's status will be obtained from death certificates to assess differences in mortality by veterans status and to perform sensitivity analyses to estimate potential effects of survivorship bias. Study results will contribute to the limited extant literature regarding military service and CVD. Furthermore, they may provide data useful in planning public health intervention programs which target active service and veteran populations.