Sociocultural Stressors, Resilience Factors, and Arterial Stiffness in Perimenopausal Latinas

围绝经期拉丁裔的社会文化压力、弹性因素和动脉僵硬度

• 批准号: 10905161
• 负责人: Yamnia I Cortes
• 金额: $ 66.59万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-08 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10905161
• 关键词: Acceleration; Address; Adverse effects; Biological; Biological Markers; Blood Pressure; Blood Vessels; Body fat; Body mass index; C-reactive protein; Cardiovascular Diseases; Cause of Death; Cessation of life; Compassion; Dehydroepiandrosterone Sulfate; Development; Diabetes Mellitus; Early identification; Event; Family; Femur; Future; Goals; Happiness; Health; Heart Rate; Hormonal; Hydrocortisone; Individual; Intervention; Knowledge; Latina; Latina Population; Latino Population; Link; Lipids; Longevity; Longitudinal, observational study; Measures; Mediating; Menopause; Menstruation; Metabolic syndrome; Mission; Modeling; Modification; National Heart, Lung, and Blood Institute; Obesity; Participant; Perimenopause; Physical activity; Physiologic pulse; Physiological; Population; Prevalence; Psychology; Research; Research Personnel; Risk Factors; Risk Reduction; Role; Shapes; Social support; Stress; Testing; Time; United States; Visit; Waist-Hip Ratio; Woman; Work; aged; allostatic load; arterial stiffness; biopsychosocial; burden of illness; cardiovascular disorder prevention; cardiovascular disorder risk; cardiovascular health; cohort; ethnic discrimination; ethnic minority; experience; fasting glucose; health disparity; improved; innovation; marginalization; middle age; minority health; neighborhood disadvantage; nutrition; optimism; predictive marker; promote resilience; protective factors; psychosocial; resilience factor; social cohesion; social culture; sociocultural determinant; stressor

PROJECT SUMMARY/ABSTRACT There is extensive evidence that the risk of cardiovascular disease (CVD), the leading cause of death for women, increases during perimenopause (PM), a crucial midlife stage of 4-8 years around the final menstrual period characterized by hormonal alterations as well as adverse changes in stress levels and vascular health. Notably, Latinas experience menopause 1-2 years earlier than non-Latina White women and have a greater prevalence of CVD risk factors (e.g., obesity, diabetes), yet remain underrepresented in menopause research. Arterial stiffness is a non-invasive subclinical marker predictive of CVD events that accelerates dramatically during perimenopause. The marginalized status of Latinas in the United States exposes them to sociocultural stressors—including acculturative stress, ethnic discrimination, family obligation stress, and neighborhood disadvantage—shown to increase arterial stiffness. Resilience factors (e.g., self-compassion, positive attitudes towards menopause, social support, social cohesion) have been shown to exert some protection against the adverse changes that occur during perimenopause, including stress and CVD risk. The overall goal of this study is to identify sociocultural stressors associated with arterial stiffness progression in Latinas during perimenopause and evaluate the role of resilience factors (i.e., self-compassion, positive attitude towards menopause, social support, and social cohesion) in these associations. Secondary aims include testing whether allostatic load mediates associations of sociocultural stressors and resilience factors with arterial stiffness progression. To accomplish this goal, we propose a longitudinal observational study with 300 perimenopausal Latinas (aged 40-60). Participants will complete four study visits over 6-month intervals (0, 6, 12, and 18 months). All women will undergo carotid-femoral pulse wave velocity (cfPWV) assessment for arterial stiffness. Culturally-specific measures will be used at each visit to assess sociocultural stressors and resilience factors. The allostatic load will be assessed using 13 biomarkers (e.g., body mass index, waist-hip ratio, blood pressure, heart rate, fasting glucose, lipid profile, C-reactive protein, cortisol, dehydroepiandrosterone sulfate). Relations between sociocultural stressors and resilience factors with arterial stiffness progression will be examined using linear mixed models. This study is the first study to longitudinally examine associations between sociocultural stressors and resilience factors with arterial stiffness in Latinas during perimenopause. The proposed study is a critical first step in better understanding sociocultural risk and protective factors of cardiovascular health in midlife Latinas. Addressing these aims may inform the development of culturally-tailored multilevel psychosocial interventions to reduce the CVD risk of Latinas during perimenopause.

项目概要/摘要 有大量证据表明，心血管疾病 (CVD) 是女性死亡的主要原因， 在围绝经期 (PM) 期间增加，这是中年的一个关键阶段，即末次月经前后 4-8 年 其特点是荷尔蒙变化以及压力水平和血管健康的不利变化。 拉丁裔女性比非拉丁裔白人女性更年期早 1-2 年，且心血管疾病患病率更高 动脉僵硬度是一个危险因素（例如肥胖、糖尿病），但在更年期研究中仍然代表性不足。 预测围绝经期期间急剧加速的 CVD 事件的非侵入性亚临床标志物。 拉丁裔在美国的地位不断下降，使他们面临社会文化压力，包括 文化压力、种族歧视、家庭义务压力和邻里劣势——表明 增加动脉僵硬度（例如自我同情、对更年期的积极态度、 社会支持、社会凝聚力）已被证明可以对不利变化发挥一定的保护作用 围绝经期期间发生的疾病，包括压力和心血管疾病风险。本研究的总体目标是确定。 与拉丁裔围绝经期动脉硬化进展相关的社会文化压力源 评估复原力因素的作用（即自我同情、对更年期的积极态度、社会支持、 和社会凝聚力）在这些协会中的次要目标包括测试非稳态负荷是否具有调节作用。 社会文化压力源和弹性因素与动脉僵化进展的关联。 为了实现这一目标，我们提出了一项针对 300 名围绝经期拉丁裔（40-60 岁）的纵向观察研究。 参与者将在 6 个月的时间间隔（0、6、12 和 18 个月）内完成四次研究访问，所有女性都会这样做。 接受颈动脉-股动脉脉搏波速度 (cfPWV) 评估以了解文化特异性。 每次访问时将使用措施来评估社会文化压力源和恢复力因素。 将使用 13 种生物标志物进行评估（例如体重指数、腰臀比、血压、心率、禁食 葡萄糖、血脂、C-反应蛋白、皮质醇、硫酸脱氢表雄酮）。 将使用线性方法检查社会文化压力源和随动脉僵化进展的弹性因素 这项研究是第一项纵向研究社会文化压力源之间关联的研究。 以及拉丁裔围绝经期动脉僵硬度的恢复因素这项研究是一项至关重要的研究。 更好地了解中年心血管健康的社会文化风险和保护因素的第一步 解决这些目标可能有助于发展适合文化的多层次心理社会。 降低拉丁裔围绝经期心血管疾病风险的干预措施。