School of Public Health
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The collections in this community comprise faculty research works, as well as graduate theses and dissertations.
Note: Prior to July 1, 2007, the School of Public Health was named the College of Health & Human Performance.
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Item SIMILAR VASCULAR RESPONSES TO A HIGH-FAT MEAL, REGARDLESS OF RACE AND SOCIAL DETERMINANTS OF HEALTH(2022) Weiner, Cynthia Marie; Ranadive, Sushant M; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Black individuals are at a higher risk for developing cardiovascular disease (CVD), including hypertension, compared to white individuals. Chronic low-grade inflammation contributes to hypertension by causing vascular dysfunction, including increased vascular resistance. Young, healthy, normotensive black individuals exhibit heightened inflammatory biomarkers at rest, a possible factor in the higher prevalence of hypertension seen within this population. Vascular function decreases transiently as a result of an acute inflammatory stimulus, such as with consumption of a high-fat meal (HFM). However, there is limited evidence regarding the racial differences in inflammatory and vascular responses to a HFM in young, healthy black and white individuals. Furthermore, there are limited data regarding the association between social determinants of health (SDH) factors and the physiological components of inflammation and vascular responses. Therefore, the goal of the present study was twofold: to evaluate the racial differences in inflammatory and vascular responses to a HFM and to evaluate the potential impact of SDH factors on these relationships. Five black individuals (5 males, 21.2 ± 1.5 yrs) and 14 white individuals (7 males/7 females, 25 ± 4.1 yrs) completed the study. White individuals were significantly older than black individuals, but were similar in fitness status (VO2peak; 43.4 ± 10.8 ml/kg/min vs. 40.5 ± 5.9 ml/kg/min) and BMI (22.6 ± 2.9 kg/m2 vs. 23.5 ± 3.3 kg/m2). Black and white individuals exhibited similar vascular function, arterial stiffness, wave reflection, and hemodynamic variables (BP, HR) at baseline and following the HFM. Black individuals had a significantly lower total SDH score compared to white individuals, indicating lower SDH across seven domains assessed in the SDH questionnaire. However, SDH was not associated with any of the vascular measurements at baseline or following the HFM. Inflammation was not detected at baseline and following the HFM, as measured by a multiplex immunoassay. Therefore young, healthy black and white individuals maintain vascular function following a HFM, regardless of SDH status.Item The Health Implications of Stress among Asian Americans in the US and Chinese In China: the Effects of Perceived Stress and Caregiving Stress on Cardiovascular Risk Factors(2018) Lu, Xiaoxiao; Lee, Sunmin; Epidemiology and Biostatistics; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Prior research suggests that stress plays a role in the etiology and progression of cardiovascular disease (CVD). To lend a more accurate depiction of the associations between stress and CVD risk factors, this dissertation used a comprehensive approach to conceptualizing stress by assessing two dimensions of stress: perceived stress and caregiving stress. The objective of this dissertation was to investigate the associations between multiple dimensions of stress and the risk factors of CVD. This dissertation also explored the potential mechanisms that underlie the relationships between stress and CVD risk factors. In Paper 1 (Chapter 3), we assessed the associations between perceived stress and hypertension across varying levels of social support and social network among 530 Chinese, Korean and Vietnamese Americans. Results indicated that individuals with high perceived stress were 61% more likely to have hypertension compared to those with low levels of perceived stress (Odds Ratio (OR): 1.61, 95% Confidence interval (CI): 1.15, 2.46). Social support had a direct beneficial effect on hypertension, irrespective of whether individuals were under stress. In Paper 2 (Chapter 4), we used five waves of longitudinal data from the China Health and Nutrition Survey to examine the association between parental caregiving and blood pressure among 2,586 Chinese women. We found that parental caregivers were associated with higher systolic (β-coefficient (β) = 1.16; p ≤ 0.01) and diastolic blood pressure (β = 0.75; p ≤ 0.01) compared with non-caregivers across multiple waves. In Paper 3 (Chapter 5), we investigated the relationship between caregiving trajectory and Metabolic Syndrome (MetS) among 1,636 Chinese women. Three caregiving trajectories were identified by using group-based trajectory analysis. Results showed that ‘rising to high-intense’ caregivers (OR = 1.90; 95% CI: 0.90, 4.00) and ‘stable low-intense’ caregivers (OR = 1.56; 95% CI: 1.06, 2.29) were associated with higher risk of MetS compared with non-caregivers. This dissertation is innovative in its examining the associations of multiple dimensions of stress with CVD risk factors among Asian subgroups. Findings from the proposed study will be used to develop future stress management interventions, and incorporating culturally and linguistically appropriate strategies into community outreach and education to decrease cardiovascular disease risk within the Asian population.Item ASSOCIATION OF SERUM VITAMIN D AND KEY CO-NUTRIENTS IN RELATION TO HYPERTENSION: A CROSS-SECTIONAL STUDY BASED ON NHANES DATA(2016) Barainca, Pamela; Carter-Pokras, Olivia; Epidemiology and Biostatistics; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Observational studies demonstrate strong associations between deficient serum vitamin D (25(OH)D) levels and cardiovascular disease. To further examine the association between vitamin D and hypertension (HTN), data from the 2003-2006 National Health and Nutrition Examination Survey were analyzed to assess whether the association between vitamin D and HTN varies by sufficiency of key co-nutrients necessary for metabolic vitamin D reactions to occur. Logistic regression results demonstrate independent effect modification by calcium, magnesium, and vitamin A on the association between vitamin D and HTN. Among non-pregnant adults with adequate renal function, those with low levels of calcium, magnesium, and vitamin D levels had 1.75 times the odds of HTN compared to those with sufficient vitamin D levels (p = <0.0001). Additionally, participants with low levels of calcium, magnesium, vitamin A, and vitamin D had 5.43 times the odds of HTN compared to those with vitamin D sufficiency (p = 0.0103).