Social, Genetic Determinants of Blood Pressure in Underserved African Americans

服务不足的非洲裔美国人血压的社会、遗传决定因素

• 批准号: 8727184
• 负责人: Sandra Marie Coulon
• 金额: $ 1.21万
• 依托单位: UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-16 至 2014-10-15
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8727184
• 关键词: Adrenal Glands; Adult; Affect; African; African American; Age; Biological; Biological Assay; Blood Pressure; Cardiovascular Diseases; Cause of Death; Censuses; Chronic Disease; Clinical; Clinical Trials; Communities; Complex; Crime; DNA; Data; Development; Direct Costs; Disease; Economic Burden; Elderly; Environmental Risk Factor; Equation; Ethnic group; Etiology; European; Experimental Models; Facilities and Administrative Costs; Funding; Genes; Genetic; Genetic Determinism; Genetic Polymorphism; Genomics; Glucocorticoid Receptor; Glucocorticoids; Health; Hormones; Hydrocortisone; Hypertension; Hypothalamic structure; Individual; Investigation; Laboratories; Life Style; Link; Low income; Measurement; Measures; Mediating; Medical Economics; Minority; Modeling; Neurosecretory Systems; Outcome; Participant; Pharmaceutical Preparations; Physiological; Pituitary Gland; Polymerase Chain Reaction; Population; Population Study; Prevalence; Prevention; Prevention approach; Prevention program; Prevention strategy; Public Policy; Questionnaires; Receptor Gene; Research; Risk; Risk Factors; Saliva; Salivary; Sampling; Single Nucleotide Polymorphism; Social status; Social support; Socioeconomic Factors; Socioeconomic Status; Specific qualifier value; Statistical Models; Stress; Swab; System; Testing; United States; United States National Institutes of Health; biological adaptation to stress; biopsychosocial; design; environmental stressor; experience; gene environment interaction; gene interaction; health disparity; hypothalamic-pituitary-adrenal axis; innovation; insight; mortality; prevent; psychosocial; receptor function; response; selective prevention; sex; social; theories

DESCRIPTION (provided by applicant): High blood pressure (BP) is present in up to 78% of older adults in the United States, is more prevalent in African Americans than other ethnic groups, and is a leading cause of cardiovascular disease mortality. Social- environmental stress and social support factors, such as individual socioeconomic status (SES), have been linked to high BP, as have related physiological mechanisms such as hypothalamic-pituitary-adrenal (HPA) secretion of glucocorticoid stress hormones (e.g. cortisol), and genetic factors such as polymorphisms in glucocorticoid receptor (GR) genes. However, few studies have integrated these factors in African Americans, and social-environmental factors have often been measured at the individual- but not at the community-level, giving little insight into community factors (e.g. community SES) relevant to population-level efforts to understand BP regulatory mechanisms and health disparities. Investigating how these factors interact to influence BP outcomes may afford a better understanding of BP etiology and contribute to successful prevention efforts. Additionally, ecological, psychosocial, and biological theories of health may guide such an integrated investigation. Thus, the aim of the proposed study is to examine how community-level social- environmental factors interact with GR polymorphisms to predict cortisol and high BP, and whether cortisol mediates the association of social-environmental factors with BP as an underlying physiologic mechanism, as has been well established in clinical and experimental models. Data for each variable will be collected within an existing sample of older adult African Americans (N=434; Mage=51.2 years) nested within three communities as part of the on-going NIH-funded PATH trial. The PI of the trial, Dr. Dawn Wilson, is the primary sponsor of this application. Participants will attend health screenings during which data for target variables will be collected. Social-environmental variables will include census-derived community-level SES, community crime rates, and community connectedness measured via questionnaire. Saliva samples will allow measurement of morning and afternoon cortisol as a marker of basal HPA functioning and stress. Genomic DNA for three single nucleotide polymorphisms (SNPs) previously linked to social-environmental and physiologic mechanisms of high BP (Bcl1, rs 41423247; FKBP5, rs1360780; 92, rs6198) will be extracted from buccal swab samples and assayed via polymerase chain reaction, under the guidance of Dr. Matthew Kostek, a co-sponsor of this application. Structural equation modeling and regression will be applied to test stated study aims and hypotheses, with relevant covariates such as BP medication status, age, and sex included in statistical models. Potential clustering by community will be controlled by examining intra-class correlation coefficients. Thus, through the integrated study of social-environmental, physiologic, and genetic factors, this investigation will contribute to a comprehensive conceptualization of high BP and disparity in underserved African American populations, and has the potential to inform innovative prevention approaches and public policy.

描述（由申请人提供）：高血压（BP）在美国多达78％的老年人中存在，在非裔美国人中比其他种族更为普遍，并且是心血管疾病死亡率的主要原因。社会环境压力和社会支持因素（例如个体社会经济地位（SES））与BP相关，以及相关的生理机制，例如下丘脑 - 垂体 - 肾上腺肾上腺肾上腺（HPA）分泌糖皮质激素胁迫激素（例如皮质醇）（例如皮质醇）（例如皮质醇）和遗传因素（例如polymphorporportss）。但是，很少有研究将这些因素整合到非洲裔美国人中，而社会环境因素通常是在个体上进行的，但在社区层面上却没有衡量，几乎没有对社区因素（例如社区SES）的见解（例如，社区SES）与人口级别有关的努力，以了解BP监管机制和健康差异。研究这些因素如何相互作用以影响BP结果可能会更好地了解BP病因，并有助于成功的预防工作。另外，健康，心理和生物学理论可以指导这种综合研究。因此，拟议的研究的目的是研究社区级的社会环境因素如何与GR多态性相互作用，以预测皮质醇和高BP，以及皮质醇是否介导了社会环境因素与BP作为基本生理机制的社会环境因素的关联，并且在临床和实验模型中已得到很好的建立。作为正在进行的NIH资助路径试验的一部分，将收集每个变量的数据（n = 434; mage = 51.2岁）的现有样本（n = 434; mage = 51.2岁）。试验的PI Dawn Wilson博士是该应用程序的主要赞助商。参与者将参加健康筛查，在此期间将收集目标变量的数据。社会环境变量将包括人口普查衍生的社区级别的SES，社区犯罪率和通过问卷调查衡量的社区联系。唾液样品将允许测量早晨和下午的皮质醇作为基础HPA功能和压力的标志。先前与高BP的社会环境和生理机制相关的三种单个核苷酸多态性（SNP）的基因组DNA（Bcl1，Rs 41423247; FKBP5，RS1360780; 92; 92，RS6198）将通过Buccal Same的指导序列置于placcal samples tive tive tivanbal sampals sampleans tabbal sampleans。 Matthew Kostek，该应用程序的共同发起人。结构方程建模和回归将应用于测试既定的研究目的和假设，以及相关的协变量，例如BP药物状态，年龄和性别，包括统计模型中。社区的潜在聚类将通过检查类内相关系数来控制。因此，通过对社会环境，生理和遗传因素的综合研究，这项研究将有助于对贫乏服务不足的非裔美国人人口中高BP和差异的全面概念化，并有可能为创新的预防方法和公共政策提供信息。