Hall Meldra, Ofili Elizabeth, Lapu-Bula Rigobert, Alema-Mensah Ernest, Miles-Richardson Stephanie
Master of Public Health Program, Morehouse School of Medicine, Atlanta, GA.
Clinical Research Center, Morehouse School of Medicine, Atlanta, GA.
J Ga Public Health Assoc. 2019 Fall;7(2):139-148. doi: 10.20429/jgpha.2019.070220.
Diminished social support lias shown to lead to worse cardiovascular outcomes and since cardiovascular disease (CVD) is the leading cause of death in the United States (U.S.), it is critical to non-invasively study its precursor- vascular disease (VD). Assessing the impact social support lias on vascular outcomes can unveil potential CVD susceptibilities in at-risk populations. African American women exhibit the greatest burden of CVD morbidity and mortality; therefore, the purpose of tins study is to examine the association between living arrangement/social support and impaired vascular function in asymptomatic African American women.
Vascular function was assessed by a non-invasive screening tool, HDI/PulseWave CR-2000, during screenings at community outreach events on participants clinically free of CVD. Vascular disease was defined as abnormal/impaired vascular function. Living arrangement, a binary variable (living with someone/living alone), was determined by survey responses (N=67) and represented social support. Multivariable analyses were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (95% CIs) to determine the association between living arrangement and vascular disease after controlling for confounders. Analyses were conducted using SAS 9.2.
Of those who lived alone, 82% had vascular disease (p=0.03). After adjusting for family CVD, and other CVD risk factors, those who lived with a spouse/partner or relative were 78% (p=0.04) less likely to develop vascular disease (AOR=0.22; 95% 0=0.05, 0.98).
Our study provides preliminary evidence to suggest that among African American women, clinically free of CVD, living arrangement is associated with vascular disease. While living alone may place individuals at an increased risk of CVD because of the association, living with a spouse/partner or relative may act as a protective factor against vascular disease and reduce the risk of CVD. Public health practitioners may use individuals' living arrangement as preventive measure for CVD risk.
社会支持减少已被证明会导致更差的心血管结局，且由于心血管疾病（CVD）是美国的主要死因，对其前驱疾病——血管疾病（VD）进行非侵入性研究至关重要。评估社会支持对血管结局的影响可以揭示高危人群中潜在的心血管疾病易感性。非裔美国女性的心血管疾病发病率和死亡率负担最重；因此，本研究的目的是探讨生活安排/社会支持与无症状非裔美国女性血管功能受损之间的关联。
在社区外展活动中，通过非侵入性筛查工具HDI/PulseWave CR - 2000对临床无心血管疾病的参与者进行血管功能评估。血管疾病定义为血管功能异常/受损。生活安排是一个二元变量（与他人同住/独自生活），通过调查回答确定（N = 67），代表社会支持。多变量分析用于估计调整后的优势比（AOR）和95%置信区间（95%CI），以确定在控制混杂因素后生活安排与血管疾病之间的关联。分析使用SAS 9.2进行。
独自生活的人中，82%患有血管疾病（p = 0.03）。在调整了家族心血管疾病和其他心血管疾病风险因素后，与配偶/伴侣或亲属同住的人患血管疾病的可能性降低了78%（p = 0.04）（AOR = 0.22；95%CI = 0.05，0.98）。
我们的研究提供了初步证据，表明在临床无心血管疾病的非裔美国女性中，生活安排与血管疾病有关。虽然独自生活可能由于这种关联使个体患心血管疾病的风险增加，但与配偶/伴侣或亲属同住可能作为预防血管疾病的保护因素并降低心血管疾病风险。公共卫生从业者可以将个体的生活安排用作心血管疾病风险的预防措施。
