Despite declines in age-adjusted cardiovascular (CVD) mortality, the incidence of coronary heart disease (CHD)/ stroke is almost twice as high in African American (AA) women compared to non-Hispanic White (NHW) women. The additional burden of CHD/stroke disease borne by AA women is attributed to factors such as socioeconomic status, psychosocial stress, and greater number of risk factors. Economically disadvantaged AA women experience higher levels of chronic stress than NHW women. Yet, little is known about how prior life adversity, such as childhood maltreatment, chronic/perceived stress, perceived discrimination, subjective socio-economic status (SSS), and socioeconomic status (SES) contribute to the disparity in CHD/stroke disease between AA and NHW women. Further, proinflammatory processes are known to contribute to CHD/stroke and compelling evidence demonstrates that adverse prior life experiences result in epigenetic alterations (i.e., changes in DNA methylation), which, in turn, increase stress reactivity and proinflammatory cytokine production. The purpose of this three-year mentored research development application is to provide the necessary training and experience to allow for an independent career in which the psychosocial and proinflammatory mechanisms that underlie CHD/stroke disease disparities can be identified. The training objectives are to: (1) Expand knowledge of the relationships among prior life adversity, proinflammatory stress response, and global DNA methylation status in relation to CHD/stroke disease disparities;(2) Acquire new knowledge and research skills in study design, recruitment, data collection, and interpretation of data as it relates to prior life adversity, proinflammatory stress response, and global DNA methylation in minority women at risk for CHD/stroke;(3) Obtain hands-on training and gain knowledge in the laboratory analysis and interpretation of salivary cortisol, proinflammatory cytokines, and global DNA methylation;and (4) Develop advanced statistical expertise in modeling. To accomplish these objectives and provide a foundation for a sustained research career, the candidate will conduct a study comparing 46 AA and 46 NHW at risk for CHD/stroke in order to (1) Determine the extent to which prior life adversity contributes to CHD/stroke risk and the proinflammatory response (IL-6) to acute stress in AA compared to NHW women at risk for CHD/stroke, (2) Determine the degree to which prior life adversity predicts global DNA methylation status in AA and NHW women at risk for CHD/stroke, and (3) Evaluate global DNA methylation status as a predictor of the proinflammatory response (IL-6) to acute stress in AA and NHW women at risk for CHD/stroke. The significance of this study lies in its potential to clarify mechanisms of CHD/stroke disease susceptibility and to determine the possible basis for the health disparity exhibited by disadvantaged, minority women. Findings will inform the development of novel risk profiles to identify those at most risk for CHD/stroke burden.
African American women suffer twice as many ischemic cardiac events and strokes as do non-Hispanic White women. Prior life adversity is linked to increased proinflammatory risk and may contribute to CHD/stroke disease disparities. It is expected that findings from this study will inform the development of novel risk profiles for CHD/stroke and lead to earlier identification and targeting of interventions to reduce disease burden.