Nocturnal Blood Pressure and Posttraumatic Stress Disorder in African Americans

非裔美国人的夜间血压和创伤后应激障碍

• 批准号: 7995532
• 负责人: THOMAS A MELLMAN
• 金额: $ 3.06万
• 依托单位: HOWARD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-05 至 2012-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7995532
• 关键词: Adolescent; Adrenergic Agents; African; African American; American; Anger; Arousal; Behavioral; Blood Pressure; Cardiovascular Physiology; Cardiovascular system; Chronic; Chronic stress; Clinical; Communities; Data; Enrollment; Epidemiologic Studies; Equilibrium; European; Evaluation; Exposure to; Fright; Future; Genetic; Goals; Health; Heart Rate; Hour; Hypertension; Laboratory Procedures; Life Style; Link; Medical; Minority; Modeling; Monitor; Morbidity - disease rate; Neighborhoods; Organ; Participant; Pathway interactions; Phase; Physiological; Polysomnography; Post-Traumatic Stress Disorders; Preventive; Preventive Intervention; Procedures; Recruitment Activity; Research; Risk; Risk Factors; Role; Sampling; Severities; Sleep; Sleep disturbances; Stress; Stress and Coping; Sympathetic Nervous System; Symptoms; Trauma; Violence; Woman; adrenergic; coping; experience; indexing; men; mortality; noradrenergic; public health relevance; racism; response; salt intake; sleep onset; stressor; young adult

DESCRIPTION (provided by applicant): Emerging evidence implicates posttraumatic stress disorder (PTSD) as a risk factor for medical morbidity including cardiovascular conditions. African Americans have higher rates of HTN and its consequences than Americans of European ancestry. Clinical and epidemiological studies that indicate a relationship between PTSD and HTN had substantial minority participation while the subjects of a large study that failed to find this relationship were predominately white. An absence of the normal "dip" of blood pressure (BP) at night is an important risk factor for HTN and for its end-organ complications. "Non-dipping" of nocturnal BP is common among people of African descent. A study of African American adolescents found an association between "non-dipping" and exposure to violence. Research findings implicate sympathetic nervous system (SNS) activity and alpha1-adrenergic mechanisms in non-dipping of nocturnal BP and in the sleep disturbance of PTSD. Our pilot data supports a relationship between PTSD and nocturnal BP non-dipping in a group of young adult African Americans. The goal for the present study is to more definitively evaluate this relationship and characterize the contributions of sleep factors, nocturnal SNS activity, chronic stress, coping responses, and behavioral/life style factors. This will be accomplished by recruiting healthy young adult African American men and women. The initial study phase will screen for trauma exposure and PTSD symptoms. From the initial phase participants we will select a group for laboratory procedures that is balanced for the presence or absence of lifetime PTSD. The procedures include polysomnographic evaluation, and 2, 24 hour blood pressure, heart rate, and activity monitoring recordings conducted a week apart. As the relationship between BP non-dipping and PTSD, and the role of contributing factors are elucidated, we plan to develop preventive interventions. PUBLIC HEALTH RELEVANCE: Trauma exposure is common among urban residing African Americans who also disproportionately experience hypertension and consequent cardiovascular morbidity and mortality. This study will elucidate a mechanism by which trauma exposure through PTSD effects cardiovascular morbidity that has preventive implications.

描述（由申请人提供）：新兴证据暗示创伤后应激障碍（PTSD）是包括心血管疾病在内的医疗发病率的危险因素。与欧洲血统的美国人相比，非洲裔美国人的HTN发生率及其后果更高。临床和流行病学研究表明，PTSD和HTN之间的关系是少数群体参与的，而一项未能发现这种关系的大型研究的受试者主要是白人。晚上缺乏血压（BP）正常的“浸入”是HTN及其最终器官并发症的重要危险因素。夜间BP的“非浸入”在非洲血统中很常见。一项对非裔美国青少年的研究发现，“非浸水”与暴力暴露之间存在关联。研究发现暗示了交感神经系统（SNS）活性和α1-肾上腺素能机制在夜间BP和PTSD的睡眠障碍中。我们的飞行员数据支持了一群年轻的非裔美国人的PTSD和夜间BP非倾销之间的关系。本研究的目的是更明确地评估这种关系，并表征睡眠因素，夜间SNS活动，慢性压力，应对反应以及行为/生活方式因素的贡献。这将通过招募健康的年轻成年非裔美国人男女来实现。最初的研究阶段将筛查创伤暴露和PTSD症状。从初始阶段参与者中，我们将选择一个用于实验室程序的组，该程序在存在或不存在寿命PTSD的情况下保持平衡。这些程序包括多个学术评估，以及24小时的血压，心率和活动监测记录相隔一周。随着BP非倾角与PTSD之间的关系以及促成因素的作用被阐明，我们计划开发预防性干预措施。公共卫生相关性：在居住的非洲裔美国人的城市中，创伤暴露很常见，他们也不成比例地经历高血压以及随之而来的心血管发病率和死亡率。这项研究将阐明一种机制，通过这种机制，通过PTSD影响心血管发病率，具有预防性影响。