Multilevel determinants of cardiovascular disease risk in African Americans

非裔美国人心血管疾病风险的多层次决定因素

• 批准号: 8229047
• 负责人: Katherine L Tucker
• 金额: $ 22万
• 依托单位: NORTHEASTERN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-03-06 至 2014-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8229047
• 关键词: Abdomen; Address; Adipose tissue; Affect; African American; Age; Area; Atherosclerosis; Behavior; Behavioral; Calcium; Cardiovascular Diseases; Cause of Death; Characteristics; Chronic Disease; Clinical; Coronary artery; Coronary heart disease; Data; Databases; Death Rate; Development; Diet; Dietary Assessment; Dietary Intervention; Dietary Practices; Dietary intake; Disease; Dyslipidemias; Eating; Enrollment; Environment; Environmental Risk Factor; Factor Analysis; Food; Frequencies; Future; Health; Heart; Heart Diseases; High Prevalence; Hypertension; Individual; Intervention; Knowledge; Measures; Methods; Minority; Mississippi; Morbidity - disease rate; Nature; Neighborhoods; Not Hispanic or Latino; Nutritional Study; Outcome; Pattern; Policies; Population; Prospective Studies; Public Health; Questionnaires; Recommendation; Recruitment Activity; Research; Research Personnel; Restaurants; Risk Factors; Role; Site; Socioeconomic Status; Target Populations; United States; United States National Institutes of Health; Visceral; Vital Status; base; cardiovascular disorder prevention; cardiovascular disorder risk; cohort; design; disability; fast food; follow-up; health disparity; heart disease risk; high risk; improved; indexing; intervention program; longitudinal design; mortality; multilevel analysis; novel; population based; prevent; prospective; subcutaneous; surveillance data

DESCRIPTION (provided by applicant): Cardiovascular disease (CVD) is the leading cause of death and disability in the United States (US). National data show that African Americans carry an undue burden of this chronic disease, indicating the presence of significant health disparities. Surveillance data also show extensive geographical disparities, wherein Southern states, where a majority of African Americans reside, have the highest age-adjusted rates of morbidity and mortality from heart disease. CVD, like most non-communicable diseases, is multifactorial in nature- determined by biologic, behavioral and environmental factors. While much recent research has focused on the influences of neighborhood characteristics on health and health-related behaviors, few studies have examined their role in predominantly high-risk minority populations like African Americans. And those that have show a lack of clarity and consistency on the role of neighborhood characteristics in health and health-related behaviors. Diet is a significant predictor of CVD and coronary heart disease (CHD) risk and recently, the study of dietary patterns has emerged as a promising area in nutrition research. Dietary interventions have also emphasized the role of dietary patterns in reducing the risk of CVD. However, for nutritional interventions to be effective, they must consider existing dietary patterns followed by their target population. Dietary intake patterns of Africans Americans are significantly different from the general US population. No studies that we are aware have examined the relationship between neighborhood characteristics and dietary patterns and CVD risk in large southern African American populations. In this study, we propose to address this significant gap, by conducting a study to: a) determine the associations between neighborhood characteristics and individual dietary patterns. Neighborhood characteristics examined include neighborhood socio-economic status, availability of and proximity to fast food restaurants, food stores, and parks and recreational facilities, while individual-level dietary patterns include a priori (2005-Healthy Eating Index) and a posteriori (factor analysis derived) dietary patterns; b) determine whether neighborhood characteristics and individual dietary patterns are associated with sub-clinical atherosclerosis; c) describe the relationships between neighborhood characteristics and individual dietary patterns, with: i) incident CHD, ii) hypertension, iii) dyslipidemia, and iv) abdominal subcutaneous and visceral adipose tissue in an NIH-supported, largest single-site, population- based, prospective, observational, all African American cohort, located in Jackson, Mississippi, the Jackson Heart Study. We plan to examine these relationships using neighborhood and dietary data that have been collected at baseline, and outcomes assessed at baseline, 4- and 5- y follow-up of the Jackson Heart Study. We believe that the results of the proposed study will fill a critical gap in knowledge and will help clinicians and policymakers design effective and targeted intervention programs and policy recommendations to prevent the onset and delay the progression of CVD in an under-studied, high-risk minority population. PUBLIC HEALTH RELEVANCE: Cardiovascular disease is the leading cause of morbidity and mortality in United States and affects African Americans disproportionately. It is therefore critical that we have a better understanding of the factors influencing cardiovascular disease risk in African Americans. Neighborhood characteristics and diet are examples of such potentially modifiable factors, and the study of these relationships is likely to guide the development of improved interventions and policy recommendations to ameliorate these health disparities.

描述（由申请人提供）：心血管疾病（CVD）是美国死亡和残疾的主要原因（美国）。国家数据显示，非裔美国人承担这种慢性疾病的不适当负担，表明存在重大健康差异。监视数据还显示出广泛的地理差异，其中大多数非裔美国人居住的南部州的发病率和死亡率最高。与大多数非传染性疾病一样，CVD本质上是多因素 - 由生物学，行为和环境因素决定。尽管最近的许多研究集中在邻里特征对健康和健康相关行为的影响，但很少有研究研究它们在像非裔美国人这样的主要高风险少数群体中的作用。那些对邻里特征在健康和健康相关行为中的作用缺乏明确和一致性的人。饮食是CVD和冠状动脉疾病（CHD）风险的重要预测指标，最近，饮食模式的研究已成为营养研究中有希望的领域。饮食干预措施还强调了饮食模式在降低CVD风险中的作用。但是，为了使营养干预措施有效，他们必须考虑现有的饮食模式，其次是目标人群。非洲人的饮食摄入模式与美国普通人群显着不同。我们知道的没有研究研究过邻里特征与饮食模式与CVD风险之间的关系。在这项研究中，我们建议通过进行一项研究来解决这一显着差距：a）确定邻里特征与个体饮食模式之间的关联。所检查的邻里特征包括社区社会经济地位，与快餐店，食品商店以及公园和休闲设施的可用性以及邻近性，而个人饮食模式包括先验性的饮食方式（20055年健康的饮食指数）和后验（因子分析）饮食模式； b）确定邻里特征和个体饮食模式是否与亚临床动脉粥样硬化有关； c) describe the relationships between neighborhood characteristics and individual dietary patterns, with: i) incident CHD, ii) hypertension, iii) dyslipidemia, and iv) abdominal subcutaneous and visceral adipose tissue in an NIH-supported, largest single-site, population- based, prospective, observational, all African American cohort, located in Jackson, Mississippi, the Jackson Heart Study.我们计划使用在基线时收集的邻里和饮食数据来检查这些关系，并在杰克逊心脏研究的基线，4和5 y随访时评估结果。我们认为，拟议的研究的结果将填补知识的关键差距，并将帮助临床医生和决策者设计有效的，有针对性的干预计划和政策建议，以防止在不足的高风险少数族裔中发作和延迟CVD的发展。 公共卫生相关性：心血管疾病是美国发病率和死亡率的主要原因，并且对非裔美国人的影响不成比例。因此，至关重要的是，我们对影响非裔美国人心血管疾病风险的因素有更好的了解。邻里特征和饮食是这种潜在可修改因素的例子，对这些关系的研究很可能指导开发改进的干预措施和政策建议，以减轻这些健康差异。