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University of Colorado Denver

Centers for American Indian and Alaska Native Health
 
 
 

NCAIANMHR

Healing Hearts


PROJECT TITLE
Healing Hearts

FUNDING SOURCE
NHLB/NIH

DATES OF FUNDING
2003-2008

PRINCIPAL INVESTIGATOR(S)
Spero M. Manson, PhD.

CENTER STAFF INVOLVED
Doug Bremmer, Viola Vaccarino, Jack Goldberg, Dedra Buchwald, John Carroll, Lisa Bighorn

 
SPECIFIC AIMS/RESEARCH GOALS:
This study has 3 Specific Aims:

  1. to determine whether individuals with PTSD, compared to those without PTSD, show greater evidence of subclinical CVD, including a lower coronary flow reserve, and an increased carotid intima-media thickness;
  2. to ascertain whether HRV is lower in individuals with PTSD compared to those without PTSD, a reduction in HRV is a risk factor for coronary arrhythmias and sudden death; and
  3. to investigate the role of lifestyle (e.g., smoking, alcohol use, exercise, obesity, oral health), cultural (e.g., acculturation, religiosity), and biological (e.g., blood pressure, blood lipid and glucose concentrations) mediators in the relationship of PTSD with coronary flow reserve and HRV.

 

RESEARCH DESIGN: N/A

 

PARTICIPANTS: 
The proposed study will examine the association between PTSD and subclinical CVD in AIs.  The SUPERPFP database will be used to identify a group of Northern Plains AIs who were free from CVD and had a DSM-IV diagnosis of lifetime PTSD in the initial study conducted from (1997-1999).  A comparison group of Northern Plains AIs matched on age, sex and tribe, without CVD or PTSD will be randomly selected from the same database.  Each selected individual will be invited to undergo a comprehensive clinical and laboratory evaluation to assess the nature and extent of current CVD risk factors, current CVD, and determine if markers of subclinical disease are present more frequently among individuals with PTSD than among those free from PTSD after controlling for various demographic, clinical, and cultural factors.

 

MEASURES:

Sociodemographic Information
  • Age
Interview Confounder
  • Blood Quantum
Interview Mediator / Confounder
  • Education
Interview Confounder
  • Marital Status
Interview Mediator / Confounder
  • Social Support
Interview  
Psychological/functional constructs
  • General psychological distress
Interview Risk factor
  • CES-D (depressive symptoms)
Interview Risk factor
  • Trauma Inventory
Interview Risk factor
  • Hostility / Aggression
Interview Risk factor
  • SCID (psychiatric diagnoses including PTSD)
Interview Risk factor
  • SF-36 (health status)
Interview Mediator / Confounder
History of CVD Interview Secondary outcome

Behavioral risk factors

Smoking

Interview Control factor (mediator)
Physical activity Interview Control factor (mediator)
Alcohol consumption Interview Control factor (mediator)
Dietary intake Interview Control factor
(confounder/ antecendent)
Family history Interview Control factor
(condounder/ antecendent)
Cultural factors
  • Acculturation
Interview Control factor
(condounder/ antecendent)
  • Ceremonial tobacco use
Interview Control factor
(condounder/ antecendent)
  • Traditional health practices
Interview Control factor (mediator)

CVD risk factors

  • Blood pressure
Clinical measurement Control factor (mediator)
  • Anthropometric measures
Clinical measurement Control factor (mediator)
  • Blood lipids
Laboratory measurement Control factor (mediator)
  • Blood glucose, insulin, HbA1c

Laboratory
measurement

Control factor (mediator)
  • Fibrinogen, C-reactive protein, P-selectin
Laboratory measurement Control factor (mediator)
  • Homocysteine
Laboratory measurement Control factor (mediator)
  • Current diabetes, hypertension
Interview Secondary analyses
Current use of medications Interview Control factors/ secondary analyses
Neurohormonal factors
  • Plasma ACTH, cortisol, DHEA-S
Laboratory measurement Control factor (mediator)
  • Plasma norepinephrine, epinephrine
Laboratory measurement Control factor (mediator)
Coronary flow reserve PET myocardial
perfusion imaging
Primary outcome
HVR 24-hour ECG monitoring Primary outcome
Carotid intima-media thickness B-mode ultrasound Secondary outcome

 

PUBLICATIONS:
None at this time.

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