Growing evidence suggests that cardiovascular disease (CVD) morbidity and mortality may be predicted not only by established risk factors such as cholesterol level, hypertension, cigarette smoking, and hyperglycemia, but also by a set of emerging risk factors. These include the inflammatory markers, C reactive protein and interleukin 6, metabolic syndrome, and mild renal insufficiency. A project called HeartSCORE funded by the Commonwealth of Pennsylvania (Steven Reis, PI) is evaluating these emerging risk factors as well as coronary calcification, and brachial artery diameter in a population-based sample of 1000 African Americans and 1000 Caucasians. Our proposed project will build on this invaluable resource by examining another set of novel risk factors for CVD thought to be upstream from the more proximal, emerging risk factors: sleep disordered breathing (SDB) and psychosocial stress. Our project will evaluate whether links of both SDB and psychosocial stress with CVD risk may be due to their effects on nocturnal physiology, namely altered nonSDB sleep characteristics, nighttime elevation in blood pressure relative to daytime BP (termed nondipping), elevated urinary catecholamines and cortisol, and impaired autonomic tone. Thus, the general aim of this study is to understand the nocturnal psychophysiological underpinnings of cardiovascular morbidity and mortality. To address this general aim, we will study a multi-ethnic sample of 225 individuals drawn from two of the groups in the larger HeartSCORE design: (1) those who have high/moderate (hereafter labeled high) or (2) low Framingham risk equation scores, with no history of stroke, myocardial infarction, or interventional cardiology procedures in either group. The two groups will be matched on gender, race, and age. The proposed study will include two nights of polysomnography (PSG) conducted in participants' homes, two 24-hour periods of ambulatory blood pressure (ABP) monitoring, overnight urine collections on PSG night 2 and ABP night 2, wrist actigraghy on 10 nights, and assessment of self-report and other physiological indices. The study will provide novel data testing the relationships of daytime stressful events, SDB, and other nocturnal physiological measures with the emerging risk factors and subclinical CVD measured in HeartSCORE. ? ?

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Project (R01)
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Study Section
Biobehavioral Mechanisms of Emotion, Stress and Health Study Section (MESH)
Program Officer
Jobe, Jared B
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University of Pittsburgh
Schools of Medicine
United States
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Matthews, Karen A; Patel, Sanjay R; Pantesco, Elizabeth J et al. (2018) Similarities and differences in estimates of sleep duration by polysomnography, actigraphy, diary, and self-reported habitual sleep in a community sample. Sleep Health 4:96-103
Roumelioti, Maria-Eleni; Argyropoulos, Christos; Pankratz, Vernon Shane et al. (2016) Objective and subjective sleep disorders in automated peritoneal dialysis. Can J Kidney Health Dis 3:6
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Matthews, Karen A; Strollo Jr, Patrick J; Hall, Martica et al. (2011) Associations of Framingham risk score profile and coronary artery calcification with sleep characteristics in middle-aged men and women: Pittsburgh SleepSCORE study. Sleep 34:711-6
Beatty, Danielle L; Hall, Martica H; Kamarck, Thomas A et al. (2011) Unfair treatment is associated with poor sleep in African American and Caucasian adults: Pittsburgh SleepSCORE project. Health Psychol 30:351-9
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Mezick, Elizabeth J; Hall, Martica; Matthews, Karen A (2011) Are sleep and depression independent or overlapping risk factors for cardiometabolic disease? Sleep Med Rev 15:51-63
Owens, Jane F; Buysse, Daniel J; Hall, Martica et al. (2010) Napping, nighttime sleep, and cardiovascular risk factors in mid-life adults. J Clin Sleep Med 6:330-5
Mezick, Elizabeth J; Matthews, Karen A; Hall, Martica et al. (2010) Low life purpose and high hostility are related to an attenuated decline in nocturnal blood pressure. Health Psychol 29:196-204

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