Childhood adversity and Cardiovascular Health among Puerto Rican youth.

波多黎各青年的童年逆境和心血管健康 夏奇拉·F·苏利亚 拉丁裔是美国最大、增长最快的少数民族群体， 生活贫困的相关后果; 32%的人肥胖，22%的人患有高血压。波多黎各女性 肥胖、高血压和高胆固醇血症的发病率比其他任何拉丁裔亚群都高。 最近的研究表明，儿童期的逆境与心血管疾病有关， 成年然而，适应和应对行为，使那些暴露在逆境中的儿童， 心血管预后不良的风险仍然很大程度上未被探索。了解童年的逆境 影响肥胖、血压和炎症，以及了解潜在的调节剂， 在心血管疾病发展之前，这些协会的介质直接解决了 NHLBI的战略计划，以促进在疾病出现症状之前进行早期干预， 尽可能长时间的正常工作。这项建议的目标是进行心血管健康 对生活在两种不同环境中的1,200名波多黎各年轻人（18-23岁）进行了评估：南布朗克斯， 纽约和圣胡安，波多黎各。将招募的样本是Boricua青年研究的一部分， 纵向（4波数据）基于人群的研究，当参与者 5 - 13岁（上次完成评估时依从率高于80%）。在这个独特的 一个同质拉丁亚组（波多黎各人）在两种情况下，我们建议检查：1）关系 童年逆境（负面生活事件，父母监禁，精神病理学和物质使用， 儿童虐待）和心血管健康的某些指标（肥胖、血压和全身性 炎症）; 2）儿童精神和物质使用障碍的中介作用;以及3） 社会文化因素所起的作用，包括环境、社会支持、文化适应和利用保健 服务该研究小组在研究健康的社会决定因素，压力对健康的影响， 健康，以及青少年健康。Dr. Suglia（PI）进行了可行性研究（K 01 HL 103199） 在纽约州南布朗克斯和波多黎各的圣胡安的BYS参与者（N=103; 17-23岁）中， 证明了心血管健康数据收集的良好可行性以及高患病率 关注的心血管健康指标（肥胖=30%;血压升高=22%和高全身性 炎症=23%）。将研究扩展到更大的样本（N= 1，200）将允许更高的精度， 心血管措施的估计，以及儿童的介质和修饰剂的检查 逆境和心血管健康协会，可以针对年轻人的预防工作 波多黎各人（可能还有其他拉丁美洲人）在患心血管疾病之前的年轻人。

Childhood Adversity and Cardiovascular Health among Puerto Rican youth Shakira F Suglia Latinos, the largest and fastest growing ethnic minority group in the United States, are vulnerable to the health related consequences of living in poverty; 32% are obese and 22% have hypertension. Puerto Rican women have the highest rate of obesity, hypertension and hypercholesterolemia than any other Latino subgroup. Recent research has demonstrated that childhood adversity is associated with cardiovascular disease in adulthood. However, adapting and coping behaviors that prime those exposed to adversity in childhood to develop poor cardiovascular outcomes remain largely unexplored. Understanding how childhood adversity affects obesity, blood pressure and inflammation as well as understanding the potential modifiers and mediators of these associations prior to the development of cardiovascular disease directly addresses the strategic plan of NHLBI to promote early intervention before symptoms of disease appear so as to preserve normal function as long as possible. The goal of this proposal is to conduct a cardiovascular health assessment of 1,200 Puerto Rican young adults (ages 18-23) living in two different contexts: the South Bronx, NY and San Juan, Puerto Rico. The sample to be recruited is part of the Boricua Youth Study (BYS), a longitudinal (4 waves of data) population-based study that started collecting information when participants were 5 – 13 years old (compliance rate higher than 80% in the last completed assessment). In this unique sample of a homogeneous Latino subgroup (Puerto Ricans) in two contexts, we propose to examine: 1) the relation between childhood adversity (negative life events, parental incarceration, psychopathology and substance use, child maltreatment) and selected indicators of cardiovascular heath (obesity, blood pressure and systemic inflammation) in young adulthood; 2) the mediating effect of child mental and substance use disorders; and 3) the role played by socio-cultural factors, including context, social support, acculturation and use of health services. The research team has expertise in the study of social determinants of health, the effects of stress on health, as well as on adolescent health. Dr. Suglia (PI) has conducted a feasibility study (K01 HL103199) among BYS participants (N=103; 17-23 years old) in the South Bronx, NY and San Juan, Puerto Rico and has demonstrated good feasibility of cardiovascular health data collection as well as a high prevalence of cardiovascular health indicators of interest (obesity=30%; elevated blood pressure=22% and high systemic inflammation=23%). Extending the study to a larger sample (N=1,200) will allow higher precision in the estimate of cardiovascular measures, as well as the examination of mediators and modifiers of the childhood adversity and cardiovascular health association that can be targeted for prevention efforts among young Puerto Rican (and possibly other Latino) youth prior to the development of cardiovascular disease.