Biomedical subjects

Sharon B Wyatt

Publications and source records attributed to Sharon B Wyatt.

15 recordsLinked to original sources

PubMed2006

Cumulative socioeconomic status across the life course and subclinical atherosclerosis.

PURPOSE: The purpose of this study is to investigate the relationship between individual-level and neighborhood-level socioeconomic status (SES) across the life course and subclinical atherosclerosis. METHODS: Participants from the Atherosclerosis Risk in Communities Study (n=12,332) were queried about individual-level SES and residential addresses across the life course. Individual-level measures were scored and summed to obtain a summary score (I-CumSES), whereas residential addresses were geocoded and linked to census data to obtain a summary neighborhood z score (N-CumSES) to evaluate the association of SES with intima-media thickness (IMT) and peripheral arterial disease (PAD). RESULTS: A 1-SD lower I-CumSES was associated with greater mean IMT in each race-sex group and greater odds of PAD in white men (odds ratio [OR], 1.28; 95% confidence interval [CI], 0.99-1.64), white women (OR, 1.18; 95% CI, 1.02-1.36), and black women (OR, 1.33; 95% CI, 1.00-1.76). Compared with the highest tertile of N-CumSES, the lowest tertile was associated with greater mean IMT among whites, but was not associated with PAD for whites or blacks. When I-CumSES and N-CumSES were considered simultaneously, associations remained for only I-CumSES and were attenuated after adjustment for cardiovascular disease (CVD) risk factors. CONCLUSIONS: Lower cumulative individual-level SES across the life course was associated with a greater burden of subclinical atherosclerosis, and this association was mediated in part by CVD risk factors.

Atherosclerosis↗

PubMed2006

Blood pressure usually considered normal is associated with an elevated risk of cardiovascular disease.

PURPOSE: Research on the risk of cardiovascular disease among individuals with prehypertension (blood pressure 120/80 to 139/89 mm Hg) is incomplete. Additional information among individuals with a high risk of cardiovascular disease complications may help to focus current and future efforts. SUBJECTS AND METHODS: We performed a prospective cohort analysis among 8960 middle-aged adults in the Atherosclerosis Risk in Communities (ARIC) study. The exposure variables were blood pressure levels: high normal blood pressure, systolic blood pressure 130-139 mm Hg or diastolic blood pressure 85-89 mm Hg; and normal blood pressure, systolic blood pressure 120-129 mm Hg or diastolic blood pressure 80-84 mm Hg. The outcome was incident cardiovascular disease defined as fatal/nonfatal coronary heart disease, cardiac procedure, silent myocardial infarction, or ischemic stroke. Subgroup analysis was performed among blacks, diabetics, individuals aged 55-64 years, individuals with renal insufficiency, and among individuals with varying levels of low-density lipoprotein (LDL) cholesterol and body mass index (BMI). RESULTS: Compared with optimal blood pressure (systolic blood pressure <120 mm Hg and diastolic blood pressure <80 mm Hg), the relative risk (RR) of cardiovascular disease for high normal blood pressure was 2.33 (95% confidence interval [CI], 1.85-2.92), and RR for normal blood pressure was 1.81 (1.47-2.22); among blacks: RR for high normal blood pressure was 3.29 (95% CI, 1.68-6.45); among diabetics: RR for high normal blood pressure 4.10 (95% CI, 2.26-7.46); age 55-64 years: RR for high normal blood pressure 2.41 (95% CI, 1.75-3.30) among individuals with renal insufficiency: RR for high normal blood pressure was 1.90 (95% CI, 1.34-2.70); among individuals with BMI >30 kg/m2: RR for high normal blood pressure was 3.56 (95% CI, 1.99-6.35); and among individuals with LDL >160 mg/dL, RR for high normal blood pressure was 1.85 (95% CI, 1.26-2.72). CONCLUSIONS: Individuals with prehypertensive levels of blood pressure have an increased risk of developing cardiovascular disease relative to those with optimal levels. The association is pronounced among blacks, among individuals with diabetes mellitus, and among those with high BMI.

Blood Pressure↗

PubMed2006

Overweight and obesity: prevalence, consequences, and causes of a growing public health problem.

This paper provides an overview of the evidence on the current epidemic of obesity in the United States. The prevalence of overweight and obesity now exceeds 60% among US adults, and the rate is rapidly increasing among children and adolescents. Dismal medical, social, and economic consequences are already apparent and likely to worsen without multipronged intervention. Increased rates of hypertension, diabetes, and dyslipidemia, among other medical conditions, threaten to shorten the longevity of the American populace by as much as 5 years. The incidence of depression is increasing and experts suggest this is linked with the increased prevalence of obesity. The cost of obesity-related medical care has increased astronomically since 1987, in addition to lost productivity and income. Novel multidisciplinary, preventive, and therapeutic approaches, and social changes are needed that address the complex interplay of biologic, genetic, and social factors that have created the current obesity epidemic.

Cardiovascular Diseases↗

PubMed2006

Psychometric examination of the Daily Spiritual experiences Scale.

Despite the burgeoning research literature addressing spirituality and its measurements, few instruments have undergone rigorous reliability and validity testing. This study contributed to determining the reliability and validity of the 16- and 6-item Daily Spiritual Experiences Scale (DSES) in a convenience sample of African Americans ages 34-85. Data were collected via self-administered questionnaire including the DSES and sociodemographic variables thought to influence spiritual experiences. Data were analyzed using paired t-tests, ANOVA, inter-class correlation coefficients, Pearson's correlation, and Cronbach's alpha. Both versions were stable over time, internally consistent, and the forms were equivalent and valid in an all-African American sample.

Adult↗

PubMed2005

Recruiting African-American research participation in the Jackson Heart Study: methods, response rates, and sample description.

OBJECTIVE: The sampling and recruitment methods, response rate, and cohort description for the all-African-American Jackson Heart Study (JHS) are detailed. METHODS: Four subsamples of participants residing in the Jackson, Mississippi metropolitan statistical area (MSA) were included: random, volunteer, ARIC (continuing from Atherosclerosis Risk in Communities study), and family. A community-driven recruitment model was developed, and community representatives guided recruitment. RESULTS: 96% (n=5,302) of target enrollment was achieved with diversity in sex, education, and income. The JHS cohort provides a sample of African-American adults for longitudinal investigation. DISCUSSION: Cohort recruitment was challenging. The JHS experiences provide useful lessons for observational epidemiological studies recruiting African-American research participation. Co-participation of researchers and researched in study design and realistic evidence of community benefit were crucial to recruitment success.

Adult↗

PubMed2005

Study design for genetic analysis in the Jackson Heart Study.

OBJECTIVE: This paper describes the preparation of genetic materials and the recruitment and initial characterization of a nested Family Study within the Jackson Heart Study (JHS) METHODS: Genomic DNA was prepared from all consenting JHS participants. In addition, family members of a subset of JHS participants were recruited to the JHS Family Study to allow heritability and linkage analyses and family-based association studies. Family Study participants completed the same questionnaires, measures, and procedures as all other JHS participants and provided blood samples for lymphocyte cryopreservation and transformation. RESULTS: DNA samples were obtained from 4726 JHS participants, including 1499 members of 291 families. In the family cohort, estimated heritabilities of body mass index, selected lipid levels, and blood pressure are highly significant, supporting the validity of the sample. DISCUSSION: The JHS data and genetic materials (DNA and cryopreserved cells) offer valuable opportunities to identify susceptibility alleles for common complex diseases by positional and candidate gene approaches.

Adult↗

PubMed2005

Sociocultural methods in the Jackson Heart Study: conceptual and descriptive overview.

The Jackson Heart Study (JHS) is a prospective, population-based cohort study designed to investigate risk factors for cardiovascular disease (CVD) in African-American men and women. An aim of the JHS is the elucidation of the role that sociocultural factors play in the excess CVD risk and mortality in African Americans. Considerable evidence is available to document the influence of social, cultural, psychological, and other lifestyle risk factors on cardiovascular outcomes. Far less is known about how these factors affect health outcomes for African Americans. The JHS provides a unique opportunity to evaluate the presence and impact of these factors in this ethnoracial group. This paper describes the rationale and overall approach for sociocultural assessment in the JHS, both generally and for each content area.

Adult↗

PubMed2005

Dietary assessment in African Americans: methods used in the Jackson Heart Study.

OBJECTIVES: The dietary assessment methods used in the Jackson Heart Study (JHS) with the entire cohort and a subset of the cohort who participated in a diet and physical activity substudy (DPASS) are reported. These methods were employed to validate culturally explicit data collection instruments developed by Delta Nutrition Intervention Research Initiative (NIRI) for assessing dietary intake in an all African-American cohort. DESIGN: A validation/calibration design was employed. A short food frequency questionnaire (FFQ) was used with all JHS participants (N=5302). A long FFQ and four 24-hour diet recalls were used for the subset of DPASS participants (n=449). OUTCOME MEASURES: Completion rates and preliminary macronutrient intakes are reported for the cohort and DPASS methods. RESULTS: Participants (5302) in the JHS full cohort completed the short FFQ. Of these, 572 were enrolled in the DPASS. A total of 506 participants completed four 24-hour dietary recalls, and 499 completed all six measures, including the long FFQ. Validation of dietary instruments in African Americans will help assure that valid conclusions can be drawn regarding the effects of diet on cardiovascular disease in this population.

Adult↗

PubMed2005

Physical activity assessment methods in the Jackson Heart Study.

OBJECTIVES: Physical activity measures used in exam 1 of the Jackson Heart Study (JHS), including the diet and physical activity substudy (DPASS), are described. DESIGN: The JHS physical activity (PAC) survey instrument was administered by interview. Accelerometer data, pedometer step counts, and additional questionnaire data were collected from volunteer subsamples of the cohort, including the DPASS. OUTCOME MEASURES: The PAC assessed four different domains of physical activity (active living, work, home and garden, and sport and exercise indexes). The 24-hour accelerometer and pedometer monitoring provided objective measures for validation of cohort survey responses. The DPASS past week activity (PWA) questionnaire assessed time spent in moderate and vigorous activity during the previous seven days. Pedometer step counts for three days before three DPASS visits provided additional data for the DPASS. RESULTS: 5296 respondents completed the PAC, 423 completed 24-hour accelerometer monitoring, and 499 completed the DPASS measures; 85 completed both 24-hour monitoring and DPASS measures. Initial analyses of leisure and sports activity items showed similar distributions for men and women and for the cohort and DPASS participants, in a bimodal distribution, with similar proportions reporting infrequent and frequent activity. The physical activity measures from the JHS can provide unique information about the association between physical activity, other risk factors, and cardiovascular disease in African Americans.

Activities of Daily Living↗

PubMed2005

Cardiovascular disease event classification in the Jackson Heart Study: methods and procedures.

OBJECTIVE: The process of identifying, abstracting, and classifying cardiovascular disease (CVD) endpoints in the Jackson Heart Study (JHS) is described. METHOD: Trained interviewers conduct telephone annual followup interviews on or near the JHS exam 1 anniversary to ascertain any significant health events since the last JHS contact, including diagnostic tests, hospitalizations, or death. Information on cohort hospitalizations and deaths is transmitted to the medical record abstraction (MRA) unit who review death certificates and hospital records to identify CVD events in the cohort. Interviews with the next of kin and completed questionnaires by physicians and medical examiners or coroners are used to obtain information on deaths in the cohort. A computer-generated diagnosis with follow-up review and adjudication by trained medical personnel completes final, disease-specific event classification of hospitalized and fatal coronary heart disease (CHD), stroke, and congestive heart failure (CHF) events. DISCUSSION: Surveillance of this well-characterized group of African Americans for CVD events as well as sub- and preclinical manifestations of disease is a central aspect of the JHS. Particular focus is placed on the leading causes of CVD illness and death, including fatal and nonfatal CHD, stroke, and CHF.

Adult↗

PubMed2005

Toward resolution of cardiovascular health disparities in African Americans: design and methods of the Jackson Heart Study.

OBJECTIVE: The design, overall methods, and major phenotypes for the all-African-American Jackson Heart Study (JHS) are detailed. METHODS: Participants were enrolled from the three counties that make up the Jackson, Mississippi metropolitan area. Relatives of selected participants were recruited to develop a large, nested family cohort. Participants provided extensive medical and social history, had an array of physical and biochemical measurements and diagnostic procedures, and provided genomic DNA. RESULTS: Data and biologic materials have been collected from 5302 adult African Americans, including 1499 members of 291 families. Participants have a high prevalence of diabetes, hypertension, obesity, and related disorders. DISCUSSION: The JHS dataset and biologic materials (serum, DNA, and cryopreserved cells) offer a valuable resource for the study of diseases that are of particular importance to African Americans.

Adult↗

PubMed2004

Women's employment status and mortality: the atherosclerosis risk in communities study.

BACKGROUND: As women's labor force participation in the United States has increased over the past decades, there has been an interest in the potential health effects of employment. To date, however, research findings have been contradictory. METHODS: Thus, the aim of this study was to investigate the association between employment status and mortality among 7361 middle-aged African American and white women who participated in the Atherosclerosis Risk in Communities (ARIC) Study. Women were classified as employed or homemakers at the baseline examination (1987-1989) and were followed for approximately 11 years. Proportional hazards regression was used to estimate unadjusted and adjusted hazard ratios. RESULTS: After adjusting for sociodemographic factors and selected risk factors for mortality, employed women had a lower risk of mortality than homemakers (hazard ratio [HR] = 0.65, 95% confidence interval [CI] = 0.49, 0.86). This decreased risk of mortality persisted in additional analyses that excluded those who died within the first 2 years of follow-up or, alternatively, those with a history of coronary heart disease (CHD), stroke, cancer, hypertension, diabetes, or a perception of fair or poor health at baseline. In cause of death-specific analyses, the mortality advantage among employed women persisted for circulatory system-related deaths; however, the association for cancer-related deaths was weaker, and the CI included one. CONCLUSIONS: As the association between employment status and mortality was not explained by known risk factors for mortality, additional research is needed to identify other potential factors that may help to explain this relationship.

Black or African American↗

PubMed2003

Racism and cardiovascular disease in African Americans.

This article provides an overview of the evidence on the ways racism can affect the disproportionate rates of cardiovascular disease (CVD) in African Americans. It describes the significant health disparities in CVD for blacks and whites and suggests that racial disparities should be understood within the context of persistent inequities in societal institutions and relations. Evidence and potential pathways for exploring effects of 3 levels of racism on cardiovascular health risk factors and outcomes are reviewed. First, institutional racism can lead to limited opportunities for socioeconomic mobility, differential access to goods and resources, and poor living conditions that can adversely affect cardiovascular health. Second, perceived/personally mediated racism acts as a stressor and can induce psychophysiological reactions that negatively affect cardiovascular health. Third, in race-conscious societies, such as the United States, the negative self-evaluations of accepting negative cultural stereotypes as true (internalized racism) can have deleterious effects on cardiovascular health. Few population-based studies have examined the relationship between racism and CVD. The findings, though suggestive of a positive association, are neither consistent nor clear. The research agenda of the Jackson Heart Study in addressing the role of racism in CVD is presented.

Black or African American↗

PubMed2003

A community-driven model of research participation: the Jackson Heart Study Participant Recruitment and Retention Study.

Recruiting African Americans for research participation is a recognized challenge. The aim of the Jackson Heart Study (JHS) is to recruit and retain 6,500 African-American participants to examine the risk factors and causes of heart disease in this ethnic group. A multi-method Participant Recruitment and Retention Study was conducted prior to initiating the JHS as a basis for designing a culture-specific plan for recruitment, retention, and adherence of participants. Probability and purposive sampling were used to select African-American adults aged 35-84 from the Jackson area. Data were collected using a structured survey (N=125) and in-depth interviews (N=31 individual; 10 group). Data were analyzed and interpreted using inferential statistics and interpretive phenomenology to identify participatory barriers and facilitators, and to uncover the meaning of taking part in research. Findings generated an emerging Community-Driven Model, which has potential to enlighten researchers about effective strategies for recruiting and retaining African Americans for research participation.

Adolescent↗

PubMed2002

Ethnicity and unprovoked hypokalemia in the Atherosclerosis Risk in Communities Study.

BACKGROUND: Hypertension is more prevalent in the African American population when compared with the European American population in the United States. Unprovoked hypokalemia may lead to hypertension and is associated with several forms of recognized secondary hypertension. METHODS: We investigated the association of ethnicity with unprovoked hypokalemia in the second Atherosclerosis Risk in Communities (ARIC) study examination. Hypokalemia was defined as serum potassium <3.5 mmol/L. RESULTS: A statistically significant association was detected between ethnicity and unprovoked hypokalemia (odds ratio = 5.3; 95% confidence interval = 3.6, 7.7) with unprovoked hypokalemia more prevalent in African Americans both before and after adjustment for important covariates. The unadjusted prevalence for unprovoked hypokalemia was 2.6% for African Americans and 0.5% for European Americans. CONCLUSIONS: We found that the prevalence of unprovoked hypokalemia for African Americans in the ARIC cohort was more than five times that for European Americans. These data suggest that an increased awareness of hypokalemia and its etiology may be indicated for African Americans.

Arteriosclerosis↗