Racial Disparities in Health: The Roles of Stress, Social Relations and the Cardiovascular System

健康方面的种族差异：压力、社会关系和心血管系统的作用

• 批准号: 9353718
• 负责人: KIRA S BIRDITT
• 金额: $ 74.55万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-30 至 2021-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9353718
• 关键词: Accounting; Address; Adult; Affect; African American; Age; Aging; Ambulatory Monitoring; American; Area; Behavioral; Biological; Blood Pressure; Blood Vessels; Cardiac; Cardiovascular Diseases; Cardiovascular system; Chronic stress; Data; Development; Devices; Dimensions; Electrocardiogram; European; Event; Exposure to; Galvanic Skin Response; Gerontology; Health; Health behavior; Heart Rate; Hypertension; Individual; Individual Differences; Intervention; Laboratories; Laboratory Study; Life; Link; Literature; Longevity; Longitudinal Studies; Monitor; Participant; Patient Self-Report; Pattern; Physiological; Population; Population Heterogeneity; Population Study; Public Health; Race; Reaction; Recording of previous events; Reporting; Research; Respondent; Risk; Role; Sampling; Sampling Studies; Social Network; Stress; Testing; Time; United States; Variant; Vascular resistance; age difference; base; coping; experience; health disparity; heart rate variability; metropolitan; monitoring device; mortality; mortality disparity; psychologic; racial difference; racial disparity; racial health disparity; response; social; stress reactivity; stress resilience; stressor; theories; therapy development

Hypertension is the number one cause of racial group disparities in mortality in the U.S. Thus, understanding the mechanisms by which race is linked with the cardiovascular system is key. African Americans (AA) are exposed to more stress across the lifespan and lifetime adversity is associated with cardiovascular disease (CHD) and hypertension. However, mechanisms accounting for the links between long-term stress exposure, hypertension and CHD remain unclear. Cardiovascular reactivity is hypothesized to be a major contender as it predicts increased risk of cardiac events and mortality, especially among people with hypertension. According to existing theories of racial health disparities, stress, and social relations, racial health disparities are due to variations in long-term exposure to stress and stress reactivity (biological, psychological, behavioral) and those race differences are moderated by social relations and age. In response to the FOA Aging Research on Stress and Resilience to Address Health Disparities in the United States (RFA-AG-16-022), the present study seeks to understand how long-term stress exposure links with stress reactivity among AA and EA adults. This study capitalizes the existing longitudinal Social Relations and Health Study (SRS),a regionally representative panel sample of AA and EA individuals from the Detroit metropolitan area who began participating in 1992 (ages 13 to 93) and completed the third wave in 2015 (ages 30 to 95). The proposed study will incorporates two new studies of short-term stress reactivity: 1) a daily stress study and 2) a laboratory stress study. The daily stress study will target 300 participants (50% AA; 50%EA) and will incorporate a 4 day experience sampling study of self-reported stress exposure and reactivity (psychological, behavioral) as well as two ambulatory monitoring devices to assess biological reactivity: 1) a newly developed non-invasive continuous monitoring ring device that provides estimates of vascular resistance and 2) a watch that assesses heart rate, heart rate variability, and galvanic skin response. In the laboratory study we will examine reactivity to standard laboratory stressors among a sample of 50 AA and 50 EA respondents who completed the daily stress study to examine more thoroughly their physiological responses to stress with the same ambulatory ring and watch as well as established continuous monitors. The proposed research addresses three aims: 1) Test links between long- term stress exposure and short-term stress reactivity among EA and AA adults, 2) Examine age differences in long-term stress exposure and short-term reactivity by race, and 3) Determine how long-term social relationships moderate individual differences in stress exposure and reactivity. This project has public health significance as it will identify individuals who are more reactive to stress and the immediate as well as lifespan factors that are associated with greater stress reactivity. A more nuanced understanding of the psychological and biological implications of stress among diverse populations will lead to the development and testing of interventions for reducing stress, later health problems, and health disparities.

高血压是美国种族群体死亡率差异的首要原因。因此，了解 种族与心血管系统的联系机制是关键。非裔美国人 (AA) 是 一生中承受更多压力，一生中的逆境与心血管疾病有关 （冠心病）和高血压。然而，解释长期压力暴露之间联系的机制， 高血压和冠心病尚不清楚。心血管反应性被认为是一个主要的竞争者，因为它 预测心脏事件和死亡的风险增加，尤其是高血压患者。根据 根据现有的种族健康差异、压力和社会关系理论，种族健康差异是由于 长期暴露于压力和压力反应性（生物、心理、行为）的变化以及那些 种族差异受到社会关系和年龄的调节。回应 FOA 压力老化研究 和解决美国健康差异的弹性 (RFA-AG-16-022)，本研究寻求 了解 AA 和 EA 成年人的长期压力暴露与压力反应性之间的关系。这项研究 利用现有的纵向社会关系和健康研究（SRS），一个具有区域代表性的小组 来自底特律大都市区的 AA 和 EA 个体样本，这些个体于 1992 年开始参与（年龄 13 到 93 岁），并于 2015 年完成第三波（30 岁到 95 岁）。拟议的研究将纳入两项新的 短期应激反应性研究：1) 日常应激研究和 2) 实验室应激研究。每天的压力 研究将针对 300 名参与者（50% AA；50% EA），并将纳入为期 4 天的经验抽样研究 自我报告的压力暴露和反应性（心理、行为）以及两次动态监测 评估生物反应性的装置：1）新开发的无创连续监测环装置 提供血管阻力的估计值，2) 评估心率、心率变异性的手表， 和皮肤电反应。在实验室研究中，我们将检查对标准实验室压力源的反应 在完成每日压力研究的 50 名 AA 和 50 名 EA 受访者样本中，以检查更多信息 使用相同的动态戒指和手表彻底了解他们对压力的生理反应 建立连续监测器。拟议的研究涉及三个目标：1）测试长期之间的联系 EA 和 AA 成年人的长期压力暴露和短期压力反应性，2) 检查 EA 和 AA 成年人的年龄差异 不同种族的长期压力暴露和短期反应性，以及 3) 确定长期社交 关系调节了压力暴露和反应的个体差异。该项目具有公共卫生 意义重大，因为它将识别出对压力和即时以及寿命更敏感的个体 与更大的应激反应相关的因素。对心理有更细致的理解 压力对不同人群的生物学影响将导致开发和测试 旨在减轻压力、减轻日后健康问题和健康差异的干预措施。