Psychosocial Factors & Stroke Risk in a Biracial Population

心理社会因素

基本信息

批准号：
7845792
负责人：
SUSAN A EVERSON-ROSE
金额：
$ 21.9万
依托单位：
UNIVERSITY OF MINNESOTA
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-07-01 至 2011-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7845792
关键词：
Acute myocardial infarction Address Adult African American Age Aging Alzheimer&apos s Disease Cardiovascular Diseases Carotid Atherosclerotic Disease Caucasians Caucasoid Race Cause of Death Cerebrovascular Disorders Chicago Chronic Chronic stress Classification Clinical Data Data Collection Data Sources Databases Diagnosis Discrimination Elderly Environment Funding Future Health Hostility Hypertension Incidence Individual Infarction Interview Investigation Ischemic Stroke Lesion Life Location Longitudinal Studies Magnetic Resonance Imaging Mediating Medicare Medicare claim Neighborhoods Neurologic Examination Not Hispanic or Latino Obesity Outcome Parents Participant Pathology Population Populations at Risk Protocols documentation Psychosocial Factor Research Research Personnel Risk Risk Factors Role Sample Size Sampling Series Side Stress Stroke Stroke prevention Structure Testing United States Work age related cigarette smoking cohort cost depressive symptoms disability indexing modifiable risk mortality novel population based programs prospective psychosocial racial difference white matter

项目摘要

DESCRIPTION (provided by applicant): Stroke mortality is the 3rd leading cause of death in the U.S. and a leading cause of long-term disability. Several stroke risk factors have been identified, but the role of psychosocial factors in stroke risk is poorly understood. Depressive symptoms, hostility, and stressful conditions are associated with cardiovascular diseases (CVD), but systematic investigation of these factors in relation to stroke incidence and mortality has been mostly lacking. We propose to conduct a prospective analysis of the relationship between psychosocial risk factors and stroke incidence and mortality, focusing on a comprehensive set of both well-established and novel psychosocial risk factors for CVD. We will examine these risk factors in a population-based study of older Blacks and (non-Hispanic) Whites. Blacks have almost double the risk of incident stroke compared with Whites and tend to have a significantly more adverse psychosocial risk profile. The proposed work will take advantage of existing data from the NIH-funded Chicago Health and Aging Project (CHAP; RO1 AG11101), an ongoing, longitudinal study of risk factors for Alzheimer's disease and age-related chronic conditions. Through the parent CHAP study, we have access to Medicare Claims files and mortality data to ascertain outcomes for the proposed study. This is an excellent opportunity to utilize a rich and unique data source to address important research questions on stroke risk in an at-risk population in a highly cost-effective manner. We propose 3 specific aims: 1) to determine whether psychosocial risk factors (depressive symptoms, perceived stress, hostility, and perceived discrimination) are associated with increased risk of incident stroke and stroke mortality; 2) to determine whether living in stressful neighborhoods increases the likelihood of incident stroke and stroke mortality; and 3) to compare Blacks and Whites on risk for stroke and examine the degree to which racial differences in stroke risk are mediated by psychosocial risk factors. Secondarily, we will conduct sensitivity analyses to examine the association of psychosocial factors and risk of ischemic strokes, clinically diagnosed stroke from the subset of CHAP participants who have undergone detailed structured clinical interviews or MRI scans, and MRI-identified white matter hyperintensities and cortical and subcortical infarcts. The proposed study stands to identify potentially modifiable risk factors for stroke and thus has important potential for future efforts in stroke prevention.

描述（由申请人提供）：中风死亡率是美国第三大死亡原因，也是长期残疾的主要原因。已经确定了几种中风危险因素，但心理社会因素在中风风险中的作用却知之甚少。抑郁症状、敌意和压力状况与心血管疾病（CVD）相关，但大多缺乏对这些因素与中风发病率和死亡率相关的系统研究。我们建议对心理社会危险因素与卒中发病率和死亡率之间的关系进行前瞻性分析，重点关注一整套已确定的和新型的心血管疾病心理社会危险因素。我们将在一项针对老年黑人和（非西班牙裔）白人的基于人群的研究中检查这些风险因素。与白人相比，黑人发生中风的风险几乎是白人的两倍，而且往往有明显更不利的心理社会风险状况。拟议的工作将利用 NIH 资助的芝加哥健康与老龄化项目（CHAP；RO1 AG11101）的现有数据，该项目是一项针对阿尔茨海默病和与年龄相关的慢性病风险因素的持续纵向研究。通过母版 CHAP 研究，我们可以访问医疗保险索赔文件和死亡率数据，以确定拟议研究的结果。这是利用丰富而独特的数据源以极具成本效益的方式解决高危人群中风风险的重要研究问题的绝佳机会。我们提出了 3 个具体目标：1）确定心理社会风险因素（抑郁症状、感知压力、敌意和感知歧视）是否与中风事件和中风死亡率增加相关； 2) 确定生活在压力大的社区是否会增加中风发生的可能性和中风死亡率； 3) 比较黑人和白人的中风风险，并检查心理社会风险因素介导中风风险的种族差异的程度。其次，我们将进行敏感性分析，以检查心理社会因素与缺血性中风风险之间的关联，从经过详细结构化临床访谈或 MRI 扫描的 CHAP 参与者亚组中临床诊断的中风，以及 MRI 识别的白质高信号和皮质和皮质下梗死。拟议的研究旨在确定中风的潜在可改变危险因素，因此对未来预防中风的努力具有重要潜力。