Chronic Stress-Related Neural Activity Associates With Subclinical Cardiovascular Disease in a Community-Based Cohort: Data From the Washington, D.C. Cardiovascular Health and Needs Assessment

Abstract

Background: Psychosocial stress correlates with cardiovascular (CV) events; however, associations between physiologic measures of stressors and CVD remain incompletely understood, especially in racial/ethnic minority populations in resource-limited neighborhoods. We examined associations between chronic stress-related neural activity, measured by amygdalar 18Fluorodeoxyglucose (18FDG) uptake, and aortic vascular FDG uptake (arterial inflammation measure) in a community-based cohort.Methods: Forty participants from the Washington, DC CV Health and Needs Assessment (DC-CHNA), a study of a predominantly African-American population in resource-limited urban areas and 25 healthy volunteers underwent detailed phenotyping, including 18FDG PET/CT for assessing amygdalar activity (AmygA), vascular FDG uptake, and hematopoietic (leukopoietic) tissue activity. Mediation analysis was used to test whether the link between AmygA and vascular FDG uptake was mediated by hematopoietic activity.Results: AmygA (1.11 ± 0.09 vs. 1.05 ± 0.09, p = 0.004) and vascular FDG uptake (1.63 ± 0.22 vs. 1.55 ± 0.17, p = 0.05) were greater in the DC-CHNA cohort compared to volunteers. Within the DC-CHNA cohort, AmygA associated with vascular FDG uptake after adjustment for Framingham score and body mass index (β = 0.41, p = 0.015). The AmygA and aortic vascular FDG uptake relationship was in part mediated by splenic (20.2%) and bone marrow (11.8%) activity.Conclusions: AmygA, or chronic stress-related neural activity, associates with subclinical CVD risk in a community-based cohort. This may in part be mediated by the hematopoietic system. Our findings of this hypothesis-generating study are suggestive of a potential relationship between chronic stress-related neural activity and subclinical CVD in an African American community-based population. Taken together, these findings suggest a potential mechanism by which chronic psychosocial stress, such as stressors that can be experienced in adverse social conditions, promotes greater cardiovascular risk amongst resource-limited, community-based populations most impacted by cardiovascular health disparities. However, larger prospective studies examining these findings in other racially and ethnically diverse populations are necessary to confirm and extend these findings.

Retinal Microvasculature in Schizophrenia

“…This is a complex issue because schizophrenia is not independent of social disadvantage, and there is evidence that the latter set of factors can contribute to the development of schizophrenia, [53][54][55] but also to cardiovascular disease. 56 Nevertheless, it will be important to better match groups on race in future studies to begin to determine the relative extents to which social (eg, discrimination) and medical factors that can affect retinal health (eg, diabetes, which is over-represented in schizophrenia and in non-white samples), and a diagnosis of schizophrenia itself are driving the microvasculature effects. In this study, it was notable that our post-hoc analyses did not reveal a pattern of white versus non-white differences on any of the OCTA variables.…”

Neighborhood Environment Associates with Trimethylamine-N-Oxide (TMAO) as a Cardiovascular Risk Marker

“…Another limitation to consider is our use of the 2010 US census tract data for NDI calculation. Although chosen to be consistent with prior studies [69] and our data collection period, future studies would utilize more recent census-tract level data.…”

Neural‐hematopoietic‐inflammatory axis in nonsmokers, electronic cigarette users, and tobacco smokers

“…As an initiator of sympathetic nerve activity, the amygdala embeds itself in discussions of the splenocardiac axis; prior research has illuminated this connection (Macefield et al, 2013 ). Heightened amygdala activity, due to psychosocial stress, has been shown to predispose individuals to development of atherosclerosis (Powell‐Wiley et al, 2021 ). Amygdala activity has also independently predicted cardiovascular disease events, as mediated by increased bone marrow activity and arterial inflammation (Tawakol et al, 2017 ).…”

“…This activity, as elucidated by the splenocardiac model, may put these individuals at greater risk for the downstream development of atherosclerosis compared to nonsmokers. As previously mentioned, there is burgeoning literature associating amygdala activation with inflammation in the target tissues of the splenocardiac axis (Boas et al, 2017 ; Powell‐Wiley et al, 2021 ; Tawakol et al, 2017 ). With this, we hypothesized that FDG‐PET/CT scans would demonstrate positively correlated metabolic activity in the amygdala, bone marrow, spleen, and aorta, elucidating activation of the splenocardiac axis in otherwise healthy young people who use tobacco products compared to nonusers.…”