Malan Leoné, Hamer Mark, Frasure-Smith Nancy, Steyn Hendrik S, Malan Nicolaas T
Hypertension in Africa Research Team (HART), North-West University, Potchefstroom Campus, South Africa,
Hypertension in Africa Research Team (HART), North-West University, Potchefstroom Campus, South Africa, Department of Epidemiology and Public Health, University College London, London, UK.
Int J Epidemiol. 2015 Dec;44(6):1814-22. doi: 10.1093/ije/dyu199. Epub 2014 Oct 24.
Adapting to an over-demanding stressful urban environment may exhaust the psychophysiological resources to cope with these demands, and lead to sympathetic nervous system dysfunction. The evidence that an urban-dwelling lifestyle may be detrimental to the cardiometabolic health of Africans motivated the design of the Sympathetic activity and Ambulatory Blood Pressure in African Prospective cohort study. We aimed to determine neural mechanistic pathways involved in emotional distress and vascular remodelling. The baseline sample included 409 teachers representing a bi-ethnic sex cohort from South Africa. The study was conducted in 2008-09 and repeated after 3-year follow-up in 2011-12, with an 87.8% successful follow-up rate. Seasonal changes were avoided and extensive clinical assessments were performed in a well-controlled setting. Data collection included sociodemographics, lifestyle habits, psychosocial battery and genetic analysis, mental stress responses mimicking daily life stress (blood pressure and haemostatic, cardiometabolic, endothelial and stress hormones). Target organ damage was assessed in the brain, heart, kidney, blood vessels and retina. A unique highly phenotyped cohort is presented that can address the role of a hyperactive sympathetic nervous system and neural response pathways contributing to the burden of cardiometabolic diseases in Africans.
适应过度紧张的城市环境可能会耗尽应对这些需求的心理生理资源，并导致交感神经系统功能障碍。城市生活方式可能对非洲人的心脏代谢健康有害这一证据促使了非洲前瞻性队列研究中交感神经活动与动态血压的设计。我们旨在确定参与情绪困扰和血管重塑的神经机制途径。基线样本包括409名代表来自南非的双族裔性别队列的教师。该研究于2008 - 2009年进行，并在2011 - 2012年进行了3年随访后重复进行，随访成功率为87.8%。避免了季节性变化，并在严格控制的环境中进行了广泛的临床评估。数据收集包括社会人口统计学、生活方式习惯、心理社会测评和基因分析、模拟日常生活压力的精神应激反应（血压和止血、心脏代谢、内皮和应激激素）。在脑、心脏、肾脏、血管和视网膜中评估靶器官损伤。本文展示了一个独特的高度表型化队列，该队列可以阐明活跃的交感神经系统和神经反应途径在导致非洲人心脏代谢疾病负担方面的作用。
