Sex Differences in Social, Behavioral, and Metabolic Risk Factors for Cardiovascular Diseases Among US Adults
Description: Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality among both women and men in the US, but declines in CVD mortality rates have plateaued since 2011. As the American Heart Association initiative "Life’s Essential 8" summarizes, modifiable risk factors for CVD include diet, physical activity, nicotine exposure, sleep patterns, overweight, diabetes, high blood pressure (BP) and dyslipidemia. Furthermore, social determinants of health, behavioral, and metabolic risk factors interplay with each other and increase CVD risk. Studies show that men develop CVD at a younger age than women, but are at lower risk of stroke and myocardial infarction at older ages. Hormonal differences may be protective for CVD risk among women compared with men, and women also have unique risk factors for CVD. However, a recent study shows that BP progresses more rapidly in women than in men after adjusting for other risk factors, beginning as early as the third decade of life, and persists with aging. Underlying reasons for sex differences in CVD events are poorly understood. We propose a study investigating sex differences in associations of social, behavioral, and metabolic risk factors with CVD events comprehensively and simultaneously. We will rigorously harmonize and efficiently leverage decades of follow-up for CVD events from 7 community-based, prospective cohort studies in the National Heart, Lung, and Blood Institute (NHLBI) BioLINCC repository with longitudinal risk factor assessments. We will quantify sex differences in associations of social, behavioral, and metabolic risk factors with incident CVD (myocardial infarction, stroke, heart failure, and CVD deaths) and all-cause mortality (Aim 1); examine the extent to which baseline risk factors explain sex differences in incident CVD and all-cause mortality (Aim 2); and study sex differences in longitudinal trajectories of continuous risk factors (Aim 3) among 30,447 NHLBI pooled cohort participants. Survival analysis, Poisson regression, and cutting-edge methods including multiple mediation analysis and age-based trajectory analysis will be used to investigate these aims. The proposed study is poised to yield important insights into the underlying reasons for sex differences in CVD events, aid in developing intervention strategies for women and men beyond lifestyle changes and medical treatment, and improve early detection and targeted prevention for women and men at high risk for CVD.
Funder: American Heart Association
Amount: $65,110
Funding type: training
Funder scheme: Predoctoral Fellowship
Start date: 2023-01-01
End date: 2024-12-31
Investigators: Ling Tian, Ling Tian
Institution: Tulane University Health Sciences Center
Funded outputs count: 3
Funder award ID: 23PRE1010975
OpenAlex ID: G2391878360