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

描述（由申请人提供）：试点A：心血管疾病（CVD）影响1200万人 在美国的人。虽然CVD多年来有所下降，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。心血管疾病占非洲裔美国人和白人之间预期寿命差异的三分之一以上。疾病控制和预防中心的Mensah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，获得护理和护理质量是对消除差异贡献最大的两个领域。然而，护理的内容和质量可能会因医生的偏见、公开或感知的歧视以及性别而有所不同。感知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，已经提出了将心理社会压力与不良CVD结果联系起来的病理生理学，但在很大程度上是未知的。例如，有证据表明，心理社会因素， 例如工作压力和抑郁，导致血液中炎症标志物（例如：C反应蛋白）水平升高。研究发现，某些歧视的经历可能会导致血压升高，这表明了一种生理反应。没有研究专门调查是否经历感知歧视，低社会支持和控制感差与较高水平的炎症标志物和升高的钙评分（通过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.