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:
- 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;
- 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
- 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 |
|
|
Interview |
Confounder |
|
|
Interview |
Mediator / Confounder |
|
|
Interview |
Confounder |
|
|
Interview |
Mediator / Confounder |
|
|
Interview |
|
| Psychological/functional constructs |
- General psychological distress
|
Interview |
Risk factor |
- CES-D (depressive symptoms)
|
Interview |
Risk factor |
|
|
Interview |
Risk factor |
|
|
Interview |
Risk factor |
- SCID (psychiatric diagnoses including PTSD)
|
Interview |
Risk factor |
|
|
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 |
|
|
Interview |
Control factor (condounder/ antecendent) |
|
|
Interview |
Control factor (condounder/ antecendent) |
- Traditional health practices
|
Interview |
Control factor (mediator) |
|
CVD risk factors |
|
|
Clinical measurement |
Control factor (mediator) |
|
|
Clinical measurement |
Control factor (mediator) |
|
|
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) |
|
|
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.