Cardiovascular disease, perceived discrimination, social support, sense of contro

描述(申请人提供)：飞行员A：心血管疾病(CVD)影响1200万人 在美国的人们。尽管多年来心血管疾病有所下降，但这些比率因种族和民族而异，仍然是所有成年人的主要杀手。有证据表明，在预防、治疗和控制心血管疾病方面存在不平等现象。在非裔美国人和白人之间的预期寿命差异中，心血管疾病占了三分之一以上。疾病控制和预防中心的门萨博士提出的消除心血管疾病差异的行动框架提供了十个重点领域，其中获得护理的机会和护理质量是在消除差异方面做出最大贡献的两个领域。然而，由于医生的偏见、公开的或感知到的歧视以及性别，护理的内容和质量可能会有所不同。感觉到的歧视和缺乏社会支持会增加心理社会压力，这与心血管疾病的不良后果有关。尽管如此，将心理社会应激与不利的心血管疾病结局联系起来的病理生理学已经被提出，但在很大程度上是未知的。例如，有证据表明，心理社会因素， 如工作压力和抑郁，会导致血液中炎症标志物(例如：C反应蛋白)水平的增加。研究发现，某些歧视经历可能会导致血压升高，这表明这是一种生理反应。目前还没有专门的研究调查知觉歧视、低社会支持和控制感差是否与较高水平的炎症标志物和较高的钙分(由电子束计算机断层扫描确定)相关，这两者都是心血管疾病的独立风险因素。

DESCRIPTION (provided by applicant): PILOT A: Cardiovascular disease (CVD) affects 12 million people in the United States. Although CVD has decreased over the years, these rates have varied by race and ethnicity, remaining the primary killer of all adults. Evidence exists of the inequalities in the prevention, treatment, and control of CVD. CVDs account for more than one third of the differences in the life expectancy between African Americans and whites. A proposed framework for action to eliminate CVD disparities by Dr. Mensah of the Centers for Disease Control and Prevention provides ten focal areas, with access to care and quality of care as the two areas that have the most to contribute in eliminating disparities. However, the content and quality of care may differ as a result of physician bias, overt or perceived discrimination, and gender. Perceived discrimination and lack of social support increases psychosocial stress, which has been associated with adverse outcomes in CVD. Nonetheless, the pathophysiology that links psychosocial stress with adverse CVD outcomes has been suggested, but is largely unknown. For example, evidence suggests that psychosocial factors, such as work stress and depression, contribute to an increased level of inflammatory markers (ex: C-reactive protein) in the bloodstream. Studies have found that certain experiences of discrimination may contribute to elevated blood pressures, suggesting a physiologic response. No studies have specifically investigated if experiencing perceived discrimination, low social support, and poor sense of control is associated with higher levels of inflammatory markers and elevated calcium scores (determined by electron beam computed tomography), both of which are independent risk factors for cardiovascular disease.