Psychobehavioral factors, arterial stiffness, and blood pressure in Korean Americans

High levels of psychological stress and a high prevalence of hypertension (HTN) have been reported in Korean Americans (KAs). Immigration may be one source of stress which contributes to HTN in KAs. Arterial stiffness is another cardiovascular condition which is also related to both stress and hypertension. Traditionally, arterial stiffness was viewed as the result of HTN, but longitudinal studies have shown that arterial stiffness may itself predict progression of HTN in non-hypertensive people. Thus, this study explored the associations among stressors (acculturation and time in the U.S.), psychobehavioral responses (psychological stress, chronic active coping, and stress emotions of anger, anxiety, and depression), and physiological responses (blood pressure and arterial stiffness) in KAs. In this study, a convenient sample of 102 KAs (aged 21-60 years, 60% women) was recruited. Subjects were asked to complete the seven psychobehavioral scales and a demographic questionnaire. Physiological data including weight, height, blood pressure (BP), and arterial stiffness were also measured. The collected data were analyzed using SAS (version 9.2). Descriptive analysis, Pearson correlation, and multiple regressions were used to analyze the data. Age and mean arterial pressure (MAP) were the major determinants of arterial stiffness as measured by carotid-femoral pulse wave velocity (cfPWV) and augmentation index adjusted at heart rate 75 (AI_75). When age and MAP were controlled, state anger and state & trait anxiety significantly and independently predicted levels of cfPWV. Women had a significantly higher AI_75 than men. Perceived stress significantly predicted AI_75 after controlling age, MAP, and gender. Anger, anxiety, and perceived stress were related to arterial stiffness but not BP. Age was an independent predictor of cfPWV but not of BP; thus, age-associated increases in BP reported in previous studies may actually be the effect of age-associated increases and related effects of PWV on BP. More studies are needed to compare psychobehavioral factors and arterial stiffness in KAs and other racial groups, and to explore specific mechanisms by which psychobehavioral factors are implicated in the pathological process of arterial stiffness

Pulse Wave Velocity in Korean American Men and Women

Arterial stiffness is an important clinical marker of cardiovascular diseases. Although many studies have been conducted on different racial groups, less is known about arterial stiffness in Asian Americans. Korean Americans constitute the fifth largest subgroup in the Asian American population and reportedly have a noticeably high prevalence of hypertension. The aims of this study were to assess arterial stiffness and blood pressure and to examine the effect of age and gender on arterial stiffness and blood pressure in 102 Korean American men and women aged 21 to 60 years. The values of arterial stiffness for Korean Americans in this study were compared to published reference values for other racial and ethnic groups. Arterial stiffness was measured by carotid-femoral pulse wave velocity, which is the gold standard for determining arterial stiffness. Findings indicated that aging was an important determinant of arterial stiffness, which increased linearly with age. Although there was no gender difference observed in arterial stiffness, the effect of age on arterial stiffness was greater in women than in men. After adjusting for covariates including age, body mass index, and smoking, multiple regression models showed that arterial stiffness and gender were significant predictors of systolic and diastolic blood pressure. The comparisons of these findings to those from several other studies that used the same method to measure arterial stiffness showed that Korean Americans may have levels of arterial stiffness that are similar to or slightly higher than those of other racial groups. Considering that arterial stiffness is an independent predictor of future development of hypertension, more studies are required to examine cardiovascular risk of this understudied group

Visit-to-Visit Blood Pressure Variability and Sleep Architecture

Visit‐to‐visit blood pressure (BP) variability (BPV) is an independent risk factor of cardiovascular disease (CVD). Sleep architecture characterizes the distribution of different stages of sleep and may be important in CVD development. We examined the association between visit‐to‐visit BPV and sleep architecture using in‐lab polysomnographic data from 3,565 patients referred to an academic sleep center. BPV was calculated using the intra‐individual coefficient of variation of BP measures collected 12 months before the sleep study. We conducted multiple linear regression analyses to assess the association of systolic and diastolic BPV with sleep architecture—rapid eye movement (REM) and non‐rapid eye movement (NREM) sleep duration. Our results show that systolic BPV was inversely associated with REM sleep duration (p = .058). When patients were divided into tertile groups based on their BPV, those in the third tertile (highest variability) spent 2.7 fewer minutes in REM sleep than those in the first tertile (lowest variability, p = .032), after adjusting for covariates. We did not find an association of systolic BPV with other measures of sleep architecture. Diastolic BPV was not associated with sleep architecture either. In summary, our study showed that greater systolic BPV was associated with lower REM sleep duration. Future investigation is warranted to clarify the directionality, mechanism, and therapeutic implications

Psychological stress and arterial stiffness in Korean Americans

Arterial stiffness is identified as a causative factor for hypertension. The purpose of this study was to explore the relationship between psychological stress and arterial stiffness in Korean Americans

Factors Influencing Sleep Quality among Female Staff Nurses during the Early COVID-19 Pandemic in the United States

This study aimed to assess the overall level of sleep quality among female staff nurses in the United States during the early COVID-19 pandemic. It also aimed to examine factors associated with sleep quality and its seven subcomponents: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, use of sleeping medications, and daytime dysfunction. A descriptive, correlational, and cross-sectional study design was used. We performed descriptive, and regression analyses with a sample of 215 female staff nurses enrolled in post-licensure online nursing programs at a southeastern state university. Data collection was conducted using an online survey from April to May 2020. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Nurses working part time (p = 0.02), with lower perceived physical health (p = 0.01), a lower self-care self-regulation score (p < 0.001), and higher work stress (p < 0.05) showed poorer sleep quality. Factors associated with subcomponents of sleep quality varied. Poor sleep quality among nurses during the COVID-19 pandemic was reported. Various factors, including work environmental factors were associated with the sleep quality in this sample. Hospital administrators should consider developing intervention programs for improving the work environment, which would impact sleep quality, health status, and job performance

Abstract P588: The Association of Anthropometric Measures With Risk for Pre-HF

Byline: Jill H Esquivel, Univ of Virginia, Charlottesville, VA; Jeongok G Logan, Univ of Virginia, Charlottesvle, VA; Daniela Sotres-Alvarez, UNC Chapel Hill, CHAPEL HILL, NC; Sonia Ponce, UNIVERSITY OF CALIFORNIA SAN DIEGO, La Jolla, CA; Matthew A Allison, Univ of California San Diego, La Jolla, CA; Barry E Hurwitz, UNIVERSITY OF MIAMI, Miami, FL; Robert Kaplan, Albert Einstein College of Medicine, Bronx, NY; Carmen R Isasi, ALBERT EINSTEIN COLLEGE MEDICINE, Bronx, NY; Jainwen Cai, Univ of North Carolina, Chapel Hill, NC; Martha L Daviglus, UNIVERSITY ILLINOIS CHICAGO, Chicago, IL; Mayank M Kansal, Univ of Illinois at Chicago, Chicago, IL; Carlos J Rodriguez, Albert Einstein Sch of Medicine, Bronx, NY Introduction: Obesity is an epidemiologic challenge and a key risk factor for heart failure (HF). Pre-heart failure (pre-HF) has been recognized as an important entity to prevent progression to clinical HF. Defining the long-term effect of obesity on pre-HF is essential for understanding of HF risk and prevention. Purpose: To determine the prospective association of obesity on the incidence of pre-HF (defined as the presence of abnormal cardiac structure or function among persons without clinical HF). Methods: Data from 1580 individuals without HF and with anthropometric data from the population-based Echocardiographic-Study of Latinos were included. Pre-HF was defined as: 1) Systolic dysfunction - LV ejection fraction (LVEF) 10 and left atrial volume index (LAVI) >34 mL/m2; or 3) LV remodeling - LV mass index (LVMI)> 115gm/m2, >95gm/m2 (male and female, respectively) and relative wall thickness (RWT) >0.42. Anthropometric data were: (body mass index {BMI}, waist circumference {WC}, waist-to-hip ratio {WHR}, fat mass {FM) and free fat mass {FFM}). Echocardiographic and anthropometric data were collected twice, on average 4.3 years apart, and analyzed using survey-weighted multivariable-adjusted regression models. Incident pre-HF was determined among participants Results: Mean age of 56 (42-74) years and 1048 (66%) were female. Baseline mean BMI was 29.9 kgm2, FM kg 28.3, FFM kg 50.1, WC 99.7cm, and WHR 0.94. Baseline BMI, FFM, FM, WC and WHR were significantly higher in individuals with prevalent pre-HF (all p<0.007). Longitudinal data showed that WC and WHR were associated with greater probability of incident pre-HF (WC and WHR p<0.0006. Regression models showed BMI, WC, WHR and FFM were associated with increased odds of incident Pre-HF (Table 1).Professiona

Abstract WP378: Sleep Duration and Aortic Stiffness: the Multi-Ethnic Study of Atherosclerosis

Large-arterial stiffness is recognized as a subclinical marker of cardiovascular disease (CVD). Self-reported short and long habitual sleep duration has been implicated in increased arterial stiffness. However, studies that use objective assessments of sleep duration while accounting for confounding effects of sleep apnea are scarce. We examined the association between habitual sleep duration, as assessed by actigraphy, and magnetic resonance imaging (MRI)- based aortic stiffness, controlling for other CV risk factors including sleep apnea. Method: We included participants in the Multi-Ethnic Study of Atherosclerosis who had undergone MRI assessment of aortic distensibility and a sleep study. Sleep duration was assessed by wrist actigraphy for 7-days and aortic stiffness by aortic pulse wave velocity (aPWV), ascending aorta distensibility (AAD), and descending aorta distensibility (DAD) using MRI. Multiple linear regressions were used to evaluate the association between sleep duration (defined as: short: 8 hours) and aPWV, AAD, or DAD, adjusting for demographic, life style factors, common cardiovascular risk, and apnea-hypopnea index. Results: The sample consisted of 908 participants (Mean age 68.4±9.1 years, 55.3% women). There was a significant linear trend of increased aPWV across short, normal, and long sleep durations (8.4 ± 3.6 vs. 8.7 ± 4.2 vs. 9.9 ± 4.9, respectively, p=0.008). In multivariable model, participants with short sleep duration (n=252), had average 0.87 m/s (95% CI: -1.47, -.27) lower PWV and 0.23 mmHg -1 (95% CI: .01, .45) higher DAD, compared with those with normal sleep duration (n=552). No significant difference in PWV or DAD was found between those with normal and long sleep duration. No associations were noted between sleep duration and AAD. Sleep duration had no significant interactions with age, gender or race. Conclusion: This study shows that short sleep duration, as assessed by actigraphy, is significantly associated with low aortic stiffness measured by MRI in a large community-based cohort. Future studies on the association between sleep duration and aortic stiffness are warranted to confirm these findings and elucidate potential underlying mechanisms

Actigraphy-based sleep characteristics and aortic stiffness: the Multi-Ethnic Study of Atherosclerosis

The study aimed to examine the association between objective estimates of sleep duration and quality and aortic stiffness while accounting for the potential confounding effect of sleep-disordered breathing. Participants were part of the Multi-Ethnic Study of Atherosclerosis Sleep study. Sleep duration and quality were assessed by 7-day wrist actigraphy, sleep-disordered breathing by home polysomnography, and aortic stiffness by magnetic resonance imaging-based aortic pulse wave velocity (aPWV), ascending and descending aorta distensibility. Aortic stiffness of participants with "normal" sleep duration (6-8 hours) were compared with those of "short" (8 hours) adjusting for common cardiovascular risk factors and apnea-hypopnea index. The sample consisted of 908 participants (mean age 68.4 ± 9.1 years, 55.3% female). There was a significant linear trend of increased aPWV across short (n = 252), normal (n = 552), and long sleep durations (n = 104) (P for trend = .008). Multivariable analysis showed that people with short sleep duration had 0.94 m/s lower aPWV (95% CI: -1.54, -0.35), compared with those with normal sleep duration. In this ethnically diverse community cohort, habitual short sleep duration as estimated by actigraphy was associated with lower aortic stiffness

Multi-ancestry epigenome-wide analyses identify methylated sites associated with aortic augmentation index in TOPMed MESA.

Despite the prognostic value of arterial stiffness (AS) and pulsatile hemodynamics (PH) for cardiovascular morbidity and mortality, epigenetic modifications that contribute to AS/PH remain unknown. To gain a better understanding of the link between epigenetics (DNA methylation) and AS/PH, we examined the relationship of eight measures of AS/PH with CpG sites and co-methylated regions using multi-ancestry participants from Trans-Omics for Precision Medicine (TOPMed) Multi-Ethnic Study of Atherosclerosis (MESA) with sample sizes ranging from 438 to 874. Epigenome-wide association analysis identified one genome-wide significant CpG (cg20711926-CYP1B1) associated with aortic augmentation index (AIx). Follow-up analyses, including gene set enrichment analysis, expression quantitative trait methylation analysis, and functional enrichment analysis on differentially methylated positions and regions, further prioritized three CpGs and their annotated genes (cg23800023-ETS1, cg08426368-TGFB3, and cg17350632-HLA-DPB1) for AIx. Among these, ETS1 and TGFB3 have been previously prioritized as candidate genes. Furthermore, both ETS1 and HLA-DPB1 have significant tissue correlations between Whole Blood and Aorta in GTEx, which suggests ETS1 and HLA-DPB1 could be potential biomarkers in understanding pathophysiology of AS/PH. Overall, our findings support the possible role of epigenetic regulation via DNA methylation of specific genes associated with AIx as well as identifying potential targets for regulation of AS/PH