The overall objective of the proposed research is to examine the synergistic effects of socioeconomic status (SES) and psychosocial risk factors (e.g., depression, hostility, social isolation) on biological and behavioral factors suspected or known to contribute to atherogenesis. Specifically, we proposed to test two hypotheses; first, that a factor-analytically defined psychosocial risk factor (PRF), defined by depression, hostility, and social isolation, is associated with increased stress-induced biological hyperactivity and risky health behaviors and, secondly, that SES moderates the strength of these relationships such, that among low SES individuals, the PRF is more strongly associated with stress-induced biological hyperreactivity and rksky health behaviors. In testing these two hypotheses, will assess various biological mechanisms that are suspected of directly or indirectly promoting and/or hastening atherosclerotic plaque development. The biological mechanisms to be assessed in this project include; a) behaviorally-induced cardiovascular responsivity; b) endocrine correlates of sympathetic nervous system (SNS) and hypothalamic-pituitary-adrenocortical (HPA) activation; c) hemostatic factors such as lipids, lipoproteins, and coagulation factor (fibrinogen), d) platelet activation factors (platelet factor 4, beta-thromboglobullin; and e) immune cytokines and adhesion molecule (ICAM) gene expression on circulating mononuclear phagocytes. If we find that PRF is more strongly associated with stress-indiced biological changes in low SES versus high SES individuals it will support our hypothesis that SES moderates the strength of the association between PRF and known or suspected pathogenic mechanisms. Given that the interaction between PRF and SES is the best predictor of all cause mortality in several studies, evidence for its association with pathogenic mechanisms of coronary heart disease (CHD) has significnt implications in our understanding of underlying biological mechanisms contributing to the relationship of SES, psychosocial factors, and CHD, as well as identifying potential areas of interventions.
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