The relevance of allostatic load in explaining health inequalities in cardiovascular disease

• Applicants: Privatdozent Dr. Timo-Kolja Pförtner; Professor Dr. Börge Schmidt
• Subject Area: Public Health, Healthcare Research, Social and Occupational Medicine ; Epidemiology and Medical Biometry/Statistics
• Term: since 2024
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 536978486

Worldwide, cardiovascular diseases (CVDs) are the leading cause of death and pose major challenges to healthcare systems due to intensive care needs. As causes of HKE, psychosocial stressors and genetic factors have increasingly attracted attention, in addition to behavioral and environmental factors. The socioeconomic gradient in overall and age-related HKE prevalence is also striking. A robust predictor of CVD that combines behavioral, environmental, and psychosocial factors is allostatic load (AL). Allostasis is an organism-initiated stress response that occurs at levels of the cardiovascular, metabolic, immune, and nervous systems. AL is the consequence of chronic allostasis, which can lead to the manifestation of pathophysiological processes and, consequently, to chronic diseases. Research Objective 1: The socioeconomic gradient of CVD will be investigated for its causative factors from a life-course perspective. The focus will be on investigating the causal relationship between life-course socioeconomic status (SES) and AL. Modifications by psychosocial and behavioral factors will be differentiated. Research Objective 2: Another well-studied cause of HKE is the presence of HKE-associated genetic risk alleles. However, the presence of possible interaction between these alleles and AL on the genesis of CVD is largely unexplored. Moreover, in view of the socioeconomic gradient of CVD, gene-SES interactions are plausible. Research Objective 3: To examine the relative contribution of SES, AL, and genetic factors on CVD incidence in an overall causal model. To test whether the association between SES and CVD can be fully explained by differences in AL and gene-AL and gene-SES interactions. The German Heinz Nixdorf Recall Study, which collected information on a total of 4814 individuals from the Rhine-Ruhr region at three measurement time points, will serve as the data basis. In addition to information from questionnaires at the measurement time points and the recording of incident HKE, biological data (blood and urine samples) are available that can provide information on genetic information and AL over time. Examining the socioeconomic gradient of CVD for differences in AL from a life-course perspective and the presence of gene interactions provides insight into the utility of parameter-specific and target-group-specific interventions to prevent CVD. For example, the benefit of an intervention on AL to reduce CVD risk in individuals with low SES could be quantified and specified according to the presence of CVD-associated risk alleles.

• DFG Programme: Research Grants