Cardiovascular Health & Early Stress
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Stress
- Sponsor
- Virginia Commonwealth University
- Enrollment
- 120
- Locations
- 1
- Primary Endpoint
- Cardiac Function
- Status
- Recruiting
- Last Updated
- 8 months ago
Overview
Brief Summary
Childhood adversity is highly prevalent, with 59% of the U.S. population reporting at least one adverse childhood experience (ACE). Substantial evidence links childhood adversity to cardiometabolic disease later in the life course, including heart disease, diabetes, and stroke, which are 3 of the top 10 causes of mortality in the United States.
ACEs encompass many possible traumatic and distressing experiences, including abuse, neglect, or severe household dysfunctions. It is not surprising that the experience of those extreme events during the first decade of life has tremendous implications for the individual's psychological and physical health.
Detailed Description
Current knowledge supports that ACEs trigger emotional stress, anxiety, fear, and discomfort in the individual. Acute and intense mental stress leads to structural changes in the amygdala, prolonged activation of the hypothalamic-pituitary-adrenal axis, and hyperactivation of the sympathetic nervous system. Then, the body secretes hormones to activate the cardiovascular system to cope with stress with a rapid increase in arterial pressure and heart rate. If the trauma is severe and/or repeated, the resting state for heart rate and blood pressure are readjusted, resulting in these children living in a heightened physiological state of arousal, including higher heart and respiration rates. This status leads to endothelial dysfunction and atherothrombotic activation that can contribute to premature cardiovascular dysfunctions. Notably, there is evidence of a cumulative effect, or dose-response relationship, between the number of reported ACEs and the prevalence of health risk behaviors and chronic diseases. Thus, despite the prevalence of ACEs and the impact on health and society, the mechanisms underlying these dysfunctions are still poorly understood. The present study aims to understand the impact of different types of ACEs on cardiovascular health.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Men and pre-menopausal women
- •18-30 years old
- •males and females
- •9-17 years old
Exclusion Criteria
- •Evidence of cardiovascular, pulmonary, renal, hepatic or cerebral diseases
- •Evidence of pregnancy or currently nursing.
- •Having a history of chronic pain
- •Having a history of rheumatoid arthritis
- •Evidence of cardiovascular, pulmonary, renal, hepatic or cerebral diseases
- •Evidence of pregnancy or currently nursing.
- •Having a history of chronic pain
- •Having a history of rheumatoid arthritis
Outcomes
Primary Outcomes
Cardiac Function
Time Frame: Baseline
An evaluation of cardiac response will be monitored non-invasively. We will use ultrasound to visualize the heart and the blood vessels.
Cardiac MRI (CMR)
Time Frame: Baseline
Cardiac MRI will be completed to monitor early signs of poor functionality.
Vascular function
Time Frame: Baseline
This test examines how the blood vessels respond to different challenges and expand. It is used to characterize the cardiovascular health of the subject's blood vessels. Different events and substances will be used (under an IND) to test how the blood vessels react. The test is completed using Laser Doppler Speckle Contrast. We will measure how much the blood vessels dilate. Greater dilation, better vascular function.
Secondary Outcomes
- Lung Diffusing Capacity(Baseline)
- HbA1c(Baseline)
- Questionnaires(Baseline)
- Spirometry(Baseline)
- Arterial Stiffness(Baseline)
- C-Reactive protein(Baseline)
- Complete blood count(Baseline)