Browsing by Subject "Coronary artery disease"
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Item Assessing the psychosocial risk factors for coronary artery disease: an investigation of predictive validity for the psychosocial inventory for cardiovascular illness(2009-08) Baker, Maria Kathryn; McCarthy, Christopher J.This dissertation investigated the psychometric properties and clinical applications of the Psychosocial Inventory for Cardiovascular Illness (PICI). The PICI is an inventory developed to measure the psychosocial risk factors for heart disease including anxiety, depression, stress, social isolation, and anger. The inventory was developed to measure the ways that each psychosocial risk factor contributes to the coronary artery disease process through the lifestyle behaviors and pathophysiological mechanisms with which they are associated. The primary purpose of the study was to examine predictive validity for the PICI. With support for predictive validity, the inventory may aid in early identification of individuals at increased risk for coronary artery disease (CAD) so that behavioral, psychosocial, and medical interventions can be implemented. Both healthy and cardiac samples were used in the inventory development and validation process. The PICI was administered in conjunction with similar inventories and physiological markers of CAD were collected including percent of coronary artery blockage and history of heart attacks. Item analysis and factor analysis were used to yield a 20-item PICI comprised of three subscales to include Negative Affect, Social Isolation, and Anger. It was hypothesized that the PICI subscales would predict group membership; whether or not a participant carried a diagnosis of CAD, and would be have a strong relationship to the physiological markers of CAD that were measured. Analysis revealed that the PICI was unable to predict diagnostic status and did not have a strong relationship with the physiological markers of CAD. Results suggest that the PICI has acceptable reliability and construct validity as demonstrated in the current sample, yet further investigation must be conducted to gain support for the instrument’s predictive abilities.Item Depressive symptoms, behavioral health risk factors, and physical illness among older Mexican Americans(2010-12) Talavera-Garza, Liza; Holahan, Charles J.; Bigler, Rebecca S.; Iscoe, Ira; Ramirez, Manuel; Warner, David C.This study utilized data from the Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE) at two different time points, seven years apart, to examine the relationship between physical illness and depressive symptoms in elderly Mexican Americans. The two physical illnesses studied are coronary artery disease and type II diabetes due to their high prevalence among Mexican Americans. The relationship between physical illness and depressive symptoms is examined longitudinally and prospectively, in both directions. In addition, the relationship between depressive symptoms and three behavioral health risk factors: alcohol use, cigarette smoking, and physical inactivity, at baseline is examined. The roles of gender, acculturation, nativity, and locus of control are examined as moderators of the key relationships studied. Additionally, self-rated health at baseline is examined as a predictor of physical illness and mortality at follow-up.Item Low flow-mediated constriction : prevalence, impact and physiological determinants(2010-08) Harrison, Michelle Lorraine; Tanaka, Hirofumi, Ph. D.; Farrar, RogerFlow-mediated dilation (FMD) is used as a surrogate marker for endothelial function, a subclinical indicator of coronary artery disease (CAD) and for that reason; FMD is commonly used to compare endothelial function across groups differing in age and number and/or type of CAD risk factors. The traditional calculation of FMD involves arterial diameter prior to cuff inflation and then peak arterial diameter following cuff release. Generally, arterial response during cuff inflation is not taken into consideration. The aims of the present study were to determine 1) if there were differences in brachial artery response, more specifically vasoconstriction, during cuff inflation in a diverse population of subjects, 2) if variability existed, the resulting impact on the calculation of traditional FMD, and 3) if arterial stiffness was a physiological determinant in this process. A total of 84 subjects, varying in age (18-62 years) and CAD risk factor profiles were studied. Low flow-mediated constriction (L-FMC), during cuff inflation, traditional FMD, and modified FMD, which accounts for L-FMC, were calculated to investigate brachial artery response during all three stages of the FMD measurement. Subjects ≥ 50 years old had lower FMD response compared with those ≤ 35 years old but only the modified FMD was statistically significant. The same effect was seen when comparing healthy subjects to those with multiple risk factors for CAD; there was an attenuated FMD response that only reached statistical significance with modified FMD. L-FMC was modestly but significantly associated with FMD. L-FMC was weakly but positively correlated with brachial pulse wave velocity (PWV). Our results indicate that modified FMD, which takes into consideration brachial response to cuff inflation, may be a more sensitive indicator of endothelial dysfunction and that arterial stiffening may be a physiological determinant in this process.