Race/Ethnicity, Cumulative Midlife Loss and Carotid Atherosclerosis in Middle-Aged Women.

2020 
African-American women have elevated rates of cardiovascular disease compared to women of other race/ethnicities, and race/ethnicity-related stressors may play a role. We examined the association between an understudied race/ethnicity-related stressor, midlife loss (e.g. deaths of friends/family members) and a marker of cardiovascular risk, carotid intima media thickness (IMT) in 1,410 African-American, White, Chinese and Hispanic women from the Study of Women's Health Across the Nation. Participants were queried about losses annually over 12 years (1996-2013), with IMT assessed Year 12-13 via ultrasound. Linear regression models examined associations between cumulative upsetting losses and IMT, adjusting for covariates. In minimally-adjusted models in the full cohort, ≥3 upsetting losses (versus none) were associated with IMT (β = .03, 95% confidence interval (CI):.01, .05, p=.0003). Results were more robust among African-American (β=.042, 95% CI:.01, .07, p<.009), than White (β=.014, 95% CI:-.01, .03, p=.21), Chinese (β=.036, 95% CI:-.03, .10, p=.25), or Hispanic women (β=.036, 95% CI:-.07, .14, p=.51), although associations among racial/ethnic minority women overall were of similar magnitude. Results persisted in fully-adjusted models (p for interaction with race/ethnicity=.04). Findings suggest that midlife loss may be one pathway through which race/ethnicity impacts cardiovascular risk for African-American women, and potentially Chinese and Hispanic women as well.
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