This K01 Career Development Award will provide Dr. Jennifer Sumner with the necessary skills to establish an independent research career focused on elucidating the psychological and biological mechanisms by which traumatic experiences contribute to cardiovascular disease (CVD) in women, the leading cause of death worldwide. Posttraumatic stress disorder (PTSD), the quintessential stress-related mental disorder, prospectively predicts increased CVD incidence. However, PTSD is a complex and heterogeneous disorder, and the aspects of PTSD that drive CVD risk are unknown. Mechanistic knowledge, particularly in women, is also lacking. These limitations impede the development of clinical applications to offset CVD risk. The overall aim of this K01 proposal is to begin to test a theoretically based biological model by which a core element of PTSD-posttraumatic fear responses (e.g., hypervigilance, re-experiencing)- relates to CVD and intermediate markers of cardiovascular health in women. Supported by a multidisciplinary team of expert mentors, Dr. Sumner will examine how posttraumatic fear responses (measured across self- report and psychophysiological levels of analysis) relate to cardiovascular health in women. The training plan will provide Dr. Sumner with required background and skills in several domains in order to become an independent investigator with an integrative research program on the mechanisms by which the psychological sequelae of trauma contribute to CVD in women. Through coursework, hands-on training, and mentored meetings, Dr. Sumner will address prior gaps in training and develop skills in 1) cardiovascular, neurological, and clinical epidemiology, 2) quantitative methods for analyzing epidemiologic and longitudinal data, 3) CVD- related physiology and biomarkers, and 4) psychophysiological measures of fear responses. The training plan also includes completion of a Master's of Science degree in Patient-Oriented Research from Columbia University. The proposed research program harnesses two richly characterized ongoing cohort studies to test how posttraumatic fear responses relate to cardiovascular risk in women. Using data from the Nurses' Health Study II (NHS II), a longitudinal epidemiologic study of women's health, Dr. Sumner will determine if self- reported posttraumatic fear symptoms relate to hypertension and CVD incidence and CVD-related biomarkers. In the REactions to Acute Care and Hospitalization (REACH) study, a study of risk for PTSD after acute coronary syndrome and its relation to recurrent cardiac events at New York-Presbyterian Hospital, Dr. Sumner will collect data to test associations between fear responses at multiple levels of analysis-self-report symptoms and psychophysiological indicators (i.e., skin conductance and heart rate)-with hospital readmission and cardiac event recurrence. These research and training activities will inform an R01 application that will comprehensively test the biological mechanisms by which posttraumatic fear symptoms across multiple levels of analysis contribute to CVD in women.

Public Health Relevance

Despite advances in prevention and intervention, cardiovascular disease (CVD) remains the leading cause of death in women. Posttraumatic stress disorder (PTSD) is common in women and is associated with increased risk of CVD, but our understanding of how PTSD contributes to poor cardiovascular health in women is lacking and limits the development of prevention efforts to offset CVD risk. This research will examine the mechanisms underlying the PTSD-CVD relation in women by investigating how a biologically relevant key aspect of PTSD- posttraumatic fear responses-contributes to CVD and intermediate markers of cardiovascular health in women.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Scientist Development Award - Research & Training (K01)
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Special Emphasis Panel (MCBS (OA))
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Ludlam, Shari
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Columbia University (N.Y.)
Public Health & Prev Medicine
Schools of Public Health
New York
United States
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Michopoulos, Vasiliki; Maples-Keller, Jessica; Roger, Elizabeth I et al. (2018) Nausea in the peri-traumatic period is associated with prospective risk for PTSD symptom development. Neuropsychopharmacology :
Sumner, Jennifer A; Chen, Qixuan; Roberts, Andrea L et al. (2018) Posttraumatic stress disorder onset and inflammatory and endothelial function biomarkers in women. Brain Behav Immun 69:203-209
Presciutti, Alex; Sobczak, Evie; Sumner, Jennifer A et al. (2018) The impact of psychological distress on long-term recovery perceptions in survivors of cardiac arrest. J Crit Care 50:227-233
Zhu, Deanna R; Julian, Jacob; Lee, Sung J A et al. (2018) Patterns of peritraumatic threat perceptions in patients evaluated for suspected acute coronary syndrome according to prior and current posttraumatic stress symptoms. Gen Hosp Psychiatry 53:119-124
Meli, Laura; Kautz, Marin; Julian, Jacob et al. (2018) The role of perceived threat during emergency department cardiac evaluation and the age-posttraumatic stress disorder link. J Behav Med 41:357-363
Tanz, Lauren J; Stuart, Jennifer J; Missmer, Stacey A et al. (2018) Cardiovascular biomarkers in the years following pregnancies complicated by hypertensive disorders or delivered preterm. Pregnancy Hypertens 13:14-21
El-Gabalawy, Renée; Blaney, Caitlin; Tsai, Jack et al. (2018) Physical health conditions associated with full and subthreshold PTSD in U.S. military veterans: Results from the National Health and Resilience in Veterans Study. J Affect Disord 227:849-853
Meli, Laura; Alcántara, Carmela; Sumner, Jennifer A et al. (2017) Enduring somatic threat perceptions and post-traumatic stress disorder symptoms in survivors of cardiac events. J Health Psychol :1359105317705982
Sumner, J A; Duncan, L E; Wolf, E J et al. (2017) Letter to the Editor: Posttraumatic stress disorder has genetic overlap with cardiometabolic traits. Psychol Med 47:2036-2039
Sumner, Jennifer A; Kronish, Ian M; Chang, Bernard P et al. (2017) Acute stress disorder symptoms after evaluation for acute coronary syndrome predict 30-day readmission. Int J Cardiol 240:87-89

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