Alcohol Consumption and Cardiovascular Health Among Older Couples: The Roles of Genetics and Marital Quality

由于人口迅速老龄化和婴儿潮一代更频繁和更重的饮酒， 预计有酗酒问题的老年人人数将出现惊人的增长。与此同时， 在美国，超过50%的55岁以上的成年人患有高血压（HTN）和心血管疾病（CVD）。 仍然是全国的主要死因饮酒与高血压和心血管疾病密切相关， 酒精是预防和管理老年人HTN的关键。尽管少量饮酒会导致 心脏保护作用，生理变化，慢性疾病和药物使用可以使即使是很小的 大量的酒精对老年人的心血管健康有害。婚姻是一个关键的背景 用于检测酒精使用及其对心血管健康的影响。超过60%的老年人已婚， 夫妻经常进行类似的（即，和谐的）饮酒行为，可能有利于婚姻质量， 建立或维持有问题的饮酒模式。此外，已经确定CVD及其 生物风险因素具有中度至高度遗传性，表明它们受遗传影响。 然而，我们对夫妻之间酒精使用的变化知之甚少，因为他们在一起的年龄或年龄。 婚姻和遗传因素，可能使个人和夫妇更有弹性或更容易患上心血管疾病。 为了响应利用现有数据加快药物滥用研究的步伐（PAR-16-234）， 拟议的项目将使用全国代表性的纵向数据，从一个最大的研究，老年人 夫妇（N = 8，545已婚/同居夫妇; 17，090人），以实现以下目标：1）确定 随着时间的推移，老年夫妇的酒精使用模式以及 2）确定个人和伴侣饮酒对心血管疾病的影响 随着时间的推移，老年夫妇的健康和死亡率，3）确定遗传和婚姻风险， 与老年夫妇中酒精相关的心血管健康和死亡率相关的因素，以及4） 开发和验证创新的预后模型，以识别高风险的个人和夫妇 心血管健康状况差和死亡率低的原因。确定风险最高的个人和夫妇， 对酒精相关的心血管健康问题的适应能力和新的预后模型的开发将 为设计和测试干预措施提供关键见解，以减少这些主要的公共卫生威胁， 不断增长的老年人口。

Due to rapid population aging and more frequent and heavier drinking among the baby boom generation, an alarming rise is expected in the number of older adults with alcohol-related problems. At the same time, more than 50% of adults over age 55 in the U.S. have hypertension (HTN) and cardiovascular disease (CVD) remains the nation's leading cause of death. Alcohol use is strongly related to HTN and CVD, and moderation of alcohol is key for preventing and managing HTN in older adults. Although low levels of alcohol use can have cardioprotective effects, physiological changes, chronic illnesses, and medication use can make even small amounts of alcohol detrimental for cardiovascular health among older individuals. Marriage is a critical context for examining alcohol use and its effects on cardiovascular health. Over 60% of older adults are married and couples often engage in similar (i.e., concordant) drinking behaviors that can benefit marital quality, potentially establishing or maintaining problematic drinking patterns. Further, it is well established that CVDs and their biological risk factors are moderately to highly heritable, indicating that they are influenced by genetics. However, we know little about how alcohol use changes among couples as they age together or the marital and genetic factors that may make individuals and couples more resilient or vulnerable to CVD. In response to Accelerating the Pace of Drug Abuse Research Using Existing Data (PAR-16-234), the proposed project will use nationally representative longitudinal data from one of the largest studies of older couples (N = 8,545 married/cohabiting couples; 17,090 individuals) to address the following aims: 1) Identify alcohol use patterns among older couples over time and the demographic and contextual predictors of those patterns, 2) Determine the implications of individual and partner alcohol use for cardiovascular health and mortality among older couples over time, 3) Identify genetic and marital risk and protective factors linked to alcohol-related cardiovascular health and mortality among older couples, and 4) Develop and validate an innovative prognostic model to identify individuals and couples at high risk for poor cardiovascular health and mortality. Identifying individuals and couples who are most at risk or resilient to alcohol-related cardiovascular health problems and development of new prognostic models will generate key insights for designing and testing interventions to reduce these major public health threats among the growing population of aging adults.