Browsing by Subject "Cardiovascular disease"
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Item Anti-inflammatory Properties of Citrus Limonoids and Their Isolation and Characterization(2012-02-14) Kim, Jin HeeThis dissertation investigates the role of limonoids in inflammation to reduce risk of breast cancer and cardiovascular disease. Radical scavenging activity and apoptotic effects of extracts from lemon seeds were investigated in human breast adenocarcinoma (MCF-7) cells and non-malignant breast (MCF-12F) cells. The MeOH:water (80:20) extract showed the highest (29.1%, P < 0.01) inhibition of MCF-7 cells without affecting the non-malignant breast cells. Further, the purified and modified limonoids were screened for their cytotoxicity on estrogen receptor (ER)-positive (MCF-7) or ER-negative (MDA-MB-231) human breast cancer cells. The MCF-7 cell was more susceptible to tested limonoids. Although most of limonoids induced anti-aromatase activity, the inhibition of proliferation was not related to the anti-aromatase activity. On the other hand, the anti-proliferative activity was significantly correlated with the level of caspase-7 activation by limonoids. The next study investigated the mechanism of anti-breast cancer and anti-aromatase activities of obacunone through inhibition of MCF-7 cell proliferation without affecting non-malignant breast cells. Treatment with obacunone resulted in an increased G1 cell cycle arrest and induction of apoptosis. Exposure of MCF-7 breast cancer cells to obacunone down-regulated expression of inflammatory molecules including nuclear factor-kappa B (NF--2 (COX-2). Furthermore, potential of obacunone on inhibition of COX-2 and NF-the p38 mitogen-activated protein (MAP) kinase was also investigated. In the final study, nomilin was the most potent natural inhibitor for p38 MAP kinase activity in human aortic smooth muscle cells indicating that a seven-membered A ring with acetoxy group, present in nomilin, seems to be essential for its inhibitory activity on p38 MAP kinase. The possible mechanism of nomilin for prevention of cardiovascular disease was determined. Pre-treatment with nomilin resulted in significant inhibition of TNF- induced HASMCs proliferation. The anti-proliferative activity of nomilin is due to apoptosis through mitochondrial dependent pathway.Item A closed-loop multi-scale model of the cardiovascular system for evaluation of ventricular assist devices(2007-05) Gohean, Jeffrey Robert; Moser, Robert deLanceyCardiovascular disease is the number one killer in America as well as most Westernized countries and is the primary cause of congestive heart failure. Over five million Americans are currently living with heart failure and over half a million more are diagnosed each year. Mechanical assist devices are used as a bridge to transplant and as destination therapy in people with severe heart failure. While these devices are highly engineered, their optimal implant configuration and settings have yet to be determined. A computational model has been developed in order to study the effect of these assist devices on the cardiovascular system. The model is multi-dimensional, making use of a quasi-one-dimensional arterial tree model for the systemic arteries coupled with lumped parameter models for the venous return and pulmonary circulation. In addition, a dynamic aortic valve model has been developed to account for the brief period of backflow at the onset of diastole and a complex impedance representation of the small arteries has been used as the outflow boundary condition to the arterial tree to account for phase-lag and wave reflection. The model produces physiologically consistent pressure and flow curves for both healthy and disease states, and preliminary validation has been performed against clinical data from patients under various levels of mechanical assist.Item The contribution of whole blood viscosity in assessment of vascular function(2011-05) Parkhurst, Kristin Louise; Tanaka, Hirofumi, Ph. D.; Farrar, RogerAlthough blood viscosity is an important component in determining vascular function, it is often assumed constant. Emerging evidence linking individual differences in viscosity to cardiovascular disease casts doubt on this assumption. The purpose of this study was to determine the contribution of whole blood viscosity to key measures of vascular function. To address this aim as comprehensively as possible, first, whole blood viscosity was compared with traditional risk factors for cardiovascular disease. Then flow-mediated dilation (FMD), carotid-femoral pulse wave velocity (cfPWV), and carotid artery compliance were calculated either with or without blood viscosity taken into account. Lastly, we tested whether the removal of blood viscosity could influence well-established associations between age and vascular function. Blood viscosity and vascular function were measured in 97 adults ranging in age from 18-63 years. No significant differences were observed between whole blood viscosity and traditional risk factors for cardiovascular disease. Whole blood viscosity was not significantly correlated with FMD, cfPWV, and carotid compliance. As expected, age was positively correlated with cfPWV (r=0.65, p<0.001) and negatively correlated with FMD (r=-0.21, p<0.05) and carotid compliance (r=-0.45, p<0.01). Even after controlling for viscosity, these relationships remained statistically significant (cfPWV r=0.65, p<0.001; FMD r=-0.24, p<0.05; carotid compliance r=-0.44, p<0.05). These results indicate that whole blood viscosity does not appear to significantly impact measures of vascular function and that the rationale for including whole blood viscosity in the calculation of vascular function remains weak.Item Development and application of optical imaging techniques in diagnosing cardiovascular disease(2012-05) Wang, Tianyi, 1982-; Milner, Thomas E.; Feldman, Marc; Johnston, Keith; Dunn, Andrew; Tunnell, JamesAtherosclerosis and specifically rupture of vulnerable plaques account for 23% of all deaths worldwide, far surpassing both infectious diseases and cancer. Plaque-based macrophages, often associated with lipid deposits, contribute to atherogenesis from initiation through progression, plaque rupture and ultimately, thrombosis. Therefore, the macrophage is an important early cellular marker related to vulnerability of atherosclerotic plaques. The objective of my research is to assess the ability of multiple optical imaging modalities to detect, and further characterize the distribution of macrophages (having taken up plasmonic gold nanoparticles as a contrast agent) and lipid deposits in atherosclerotic plaques. Tissue phantoms and macrophage cell cultures were used to investigate the capability of nanorose as an imaging contrast agent to target macrophages. Ex vivo aorta segments from a rabbit model of atherosclerosis after intravenous nanorose injection were imaged by optical coherence tomography (OCT), photothermal imaging (PTW) and two-photon luminescence microscopy (TPLM), respectively. OCT images depicted detailed surface structure of atherosclerotic plaques. PTW images identified nanorose-loaded macrophages (confirmed by co-registration of a TPLM image and corresponding RAM-11 stain on a histological section) associated with lipid deposits at multiple depths. TPLM images showed three-dimensional distribution of nanorose-loaded macrophages with a high spatial resolution. Imaging results suggest that superficial nanorose-loaded macrophages are distributed at shoulders on the upstream side of atherosclerotic plaques at the edges of lipid deposits. Combination of OCT with PTW or TPLM can simultaneously reveal plaque structure and composition, permitting assessment of plaque vulnerability during cardiovascular interventions.Item Development of a bioreactor imaging system for characterizing embryonic stem cell-derived cardiomyocytes(2010-05) Abilez, Oscar John; Suggs, Laura J.; Roy, KrishnenduCardiovascular disease (CVD) affects more than 70 million Americans and is the number one cause of mortality in the United States. Because the regenerative capacity of adult tissues such as the heart is limited, human embryonic stem cells (hESC) have emerged as a source for potential cardiac therapies. However, despite the use of a variety of biochemical differentiation protocols, current yields of hESC-derived cardiomyocytes (CM) have been low. In the case of hESC-CM, which are inherently electromechanically active, additional forms of inducing a mature cardiac fate have not been fully explored. In order to non-invasively visualize and quantify biochemical, electrical, and mechanical stimulation on hESC-CM differentiation in future studies, a bioreactor imaging system has been developed and is described in this report.Item The effects of acute muscle damage and autoimmune disease on vascular function : the potential role of inflammation(2009-08) Barnes, Jill Nicole; Tanaka, Hirofumi, Ph. D.Inflammation has been implicated in the development of cardiovascular disease and a potential underlying mechanism in the pathogenesis of impaired vascular function. Two different but complementary approaches were utilized to determine the role of inflammation on vascular function. First, to evaluate the effect of acute inflammation, we induced muscle damage to both small and large muscle mass and measured vascular function every 24 hours for up to 5 days of recovery. Eccentric exercise-induced muscle damage, in both small and large muscle mass, resulted in a transient increase in central arterial stiffness. Next, patients with systemic lupus erythematosus (SLE) were studied as a model of chronic inflammation. Measurements of vascular function were compared in habitually-exercising and sedentary SLE patients, and age-matched healthy controls. Individuals with SLE demonstrated lower vascular function than healthy controls. When SLE patients were grouped by exercise status, habitually-exercising SLE patients exhibited similar vascular function to healthy controls, and lower overall disease activity compared with sedentary SLE patients, supporting the beneficial effect of regular exercise in this population. Inflammatory biomarkers were associated with measures of macro- and microvascular function. In conclusion, acute muscle damage and chronic disease-related inflammation have a potent effect on measures of vascular function, suggesting that inflammation plays a role in the pathogenesis of vascular dysfunction and is an important biomarker for cardiovascular risk.Item Health disparities between blacks and whites with HIV/AIDS : an analysis of U.S. national health care surveys from 1996-2008(2011-05) Oramasionwu, Christine Uzonna, 1982-; Frei, Christopher R.Blacks are more affected by Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) than any other race or ethnicity in the United States. The purpose of this dissertation was to investigate potential race-based differences in cardiovascular disease (CVD)-related hospitalizations and use of opportunistic infection (OI) prophylaxis between Blacks and Whites with HIV/AIDS. This dissertation includes two systematic literature reviews that identified knowledge gaps in the areas of CVD diagnosis and OI prophylaxis use between Blacks and Whites with HIV/AIDS, as well as two independent studies that addressed some of the gaps identified in the literature. The first study evaluated the association between race and CVD-related hospitalization in Blacks and Whites with HIV/AIDS. Data were retrieved from the 1996-2008 National Hospital Discharge Surveys (NHDS). Approximately 1.5 million hospital discharges were identified. After controlling for confounders, the odds of CVD-related hospitalization were 45% higher for Blacks than Whites (OR=1.45, 95% CI, 1.39-1.51). There was a statistically significant difference in the proportions of CVD-related hospitalization type and race (x2=479.77; df=3; p<0.001). Compared to Whites with HIV/AIDS, Blacks with HIV/AIDS had greater proportions of heart failure and hypertension, but lower proportions of stroke and coronary heart disease. These results suggest that there is an influence of race on both the occurrence and type of CVD-related hospitalizations in patients with HIV/AIDS. The second study assessed if race was associated with the use of OI prophylaxis (Pneumocystis jiroveci pneumonia [PCP] and Mycobacterium avium complex [MAC]). Data for this study were retrieved from the 1996-2008 National Hospital Ambulatory Medical Care Surveys (NHAMCS). Approximately 9.1 million hospital ambulatory visits were identified. After controlling for confounders, the odds of PCP prophylaxis use were 16% higher for Blacks than for Whites (OR=1.16, 95% CI, 1.15-1.17). In a separate regression analysis, the odds of MAC prophylaxis use were 12% higher for Blacks than for Whites (OR=1.12, 95% CI, 1.10-1.13). These findings suggest that Blacks with HIV/AIDS may have increased odds for OI prophylaxis. Based on this work, there is a need for further research to confirm these findings and to identify the causes of these race-based disparities.Item High-Oleic Ground Beef, Exercise, and Risk Factors for Cardiovascular Disease in Men and Postmenopausal Women(2012-02-14) Gilmore, Linda AnneSixty-six percent of the ground beef consumed in the U.S. contains 16-30 percent fat by weight, and at the retail level, ground beef fat varies widely with regards to saturated, monounsaturated and trans-fatty acid content. Through two independent studies the effect of fatty acid composition of ground beef on selected cardiovascular disease risk indicators was evaluated. In the first study, 27 free-living normocholesterolemic men completed a three-way crossover dietary intervention. Subjects consumed five, 114-g ground beef patties per week for 5 wk with intervening 4-wk washout periods. Patties contained 24 percent total fat with monounsaturated fatty acid:saturated fatty acid (MUFA:SFA) of either 0.71 (low-MUFA, pasture-fed), 0.83 (mid-MUFA, short-term corn-fed), or 1.10 (high-MUFA, long-term corn-fed). Blood was collected from each subject before and at the end of each diet period. Overall, the ground beef interventions decreased plasma insulin, HDL2, and HDL3 particle diameter and ?-linolenic acid (18:2 (n-3)), and increased plasma arachidonic (20:4(n-6)). The greatest increase in HDL cholesterol from baseline (0.07 mmol/L) was after the high-MUFA ground beef intervention. An increase from baseline in LDL particle diameter (0.5 nm) occurred after the mid- and high-MUFA interventions.We concluded that low-MUFA ground beef from pasture/hay-fed cattle was no more ?heart healthy? than high-MUFA ground beef from corn-fed cattle as judged by common clinical criteria. In the second study, 19 of 29 post menopausal women completed a two-way crossover design. Subjects consumed five, 114-g ground beef patties per week for 6 wk periods separated by a 4 wk washout period. The low-MUFA patties contained 19.4 percent fat with MUFA:SFA of 0.9. The high-MUFA patties contained 22.5 percent fat with a MUFA:SFA ratio of 1.3. In addition to patty consumption, the subjects completed a bout of exercise during the last week of each phase. Blood was taken before, each diet phase (24 hr before exercise) and 24 hr post exercise. Total cholesterol was increased by the high-MUFA patties with the most significant increase seen in HDL cholesterol, mainly HDL2b subfraction. Lipid-rich lipoprotein fractions were increased with the low-MUFA diet, but not by the high-MUFA diet. Very long chain fatty acids were depressed by low MUFA patty consumption. When unadjusted for plasma volume shifts (raw), exercise decreased triglycerides in all three phases. Raw VLDL cholesterol was reduced after exercise during the intervention phases. Raw RLP and IDL cholesterol were reduced after exercise during the high-MUFA intervention. HDL2b was reduced after exercise during the high-MUFA phase. LDL mean size increased and LDL mean density decreased after exercise during the low-MUFA intervention. HDL mean density increased after exercise during both ground beef interventions. The data indicate that high-oleic ground beef can reduce some cardiovascular disease risk factors and can be a part of a healthful diet. Exercise can have a beneficial impact on cardiovascular disease risk factors independent and in conjunction with ground beef consumption.Item The impact of Medicare Part D coverage on medication adherence and health outcomes in end-stage renal disease (ESRD) patients(2013-05) Park, Haesuk; Rascati, Karen L.The purpose of this study was to investigate the impact of Medicare Part D coverage on medication adherence and health outcomes in dialysis patients. A retrospective analysis (2006-2010) using the United States Renal Data System was conducted for Medicare-eligible dialysis patients. Cardiovascular disease morbidity, healthcare utilization and expenditures, medication adherence, and mortality rates were compared, categorized based on patients’ Part D coverage in 2007 for those who: 1) did not reach the coverage gap (cohort 1); 2) reached the coverage gap but not catastrophic coverage (cohort 2); 3) reached catastrophic coverage (cohort 3); and 4) did not reach the coverage gap but received a low-income subsidy (cohort 4). Cox proportional hazards models, Kaplan-Meier methods, logistic regressions, generalized linear models, and generalized estimating equations were used. A total of 11,732 patients were included as meeting inclusion criteria: 1) cohort 1: 3,678 patients had out-of-pocket drug costs <$799; 2) cohort 2: 4,349 patients had out-of-pocket drug costs between $799 and $3,850; 3) cohort 3: 1,310 patients had out-of-pocket drug costs > $3,850; and 4) cohort 4: the remaining 2,395 patients had out-of-pocket drug costs <$799 but received a low-income subsidy. After adjusting for demographic and clinical factors, patients in cohort 2 and cohort 3 had 42 percent and 36 percent increased risk of cardiovascular disease (odds ratio (OR)=1.42, 95% confidence interval (CI):1.20-1.67; OR=1.38, 95% CI:1.10-1.72); and had 36 percent and 37 percent higher death rates compared to those in cohort 4, respectively (hazard ratio (HR)=1.36, 95% CI:1.27-1.44; HR=1.37, 95% CI:1.27-1.48). Patients in cohort 2 were more likely to be nonadherent to medications for diabetes (OR=1.72, 95% CI:1.48-1.99), hypertension (OR=1.69, 95% CI:1.54-1.85), hyperlipidemia (OR=2.01, 95% CI:1.76-2.29), hyperphosphatemia (OR=1.74, 95% CI:1.55-1.95), and hyperparathyroidism (OR=2.08, 95% CI:1.66-2.60) after reaching the coverage gap. These patients had total health care costs that were $2,644 higher due to increased rates of hospitalization and outpatient visits, despite $2,419 lower pharmacy costs compared to patients in cohort 4 after controlling for covariates (p<0.0001). Reaching the Part D coverage gap was associated with decreased medication adherence and unfavorable clinical and economic outcomes in dialysis patients.Item Interaction of exercise and simvastatin on myocardial ischemia-reperfusion (I/R) injury and post-ischemic cardiac function(2006-05) Meissner, Maxi; Starnes, Joseph W.Simvastatin is one of the statins, which are a class of drugs originally developed to fight cardiovascular disease by lowering cholesterol. However, it is now clear that they have effects independent of cholesterol. For example, statin therapy, like exercise, induces adaptations within the heart that protect it against I/R injury. Patients are frequently advised to undergo a combination treatment of statins and chronic exercise, although little is known about how this combination treatment affects cardioprotective adaptations. Both treatments appear to exert their cardioprotective effects through different mechanisms, therefore it appears plausible that combining the two treatments would provide added cardioprotection than either treatment alone. Purpose: To investigate the effects of a combination treatment of statins and exercise upon parameters of post-ischemic myocardial function and damage. Methods: Female Sprague-Dawley rats (6 months of age) were separated into 4 groups for a period of 4 weeks: Sedentary (S, n=10), sedentary plus 10 mg simvastatin (Zocor®)/kg body wt/ day (SD, n=9), exercise (R, n=9), and exercise plus simvastatin (RD, n=9). R and RD were exercised identically on a treadmill for 5 days/week at an intensity of about 70% VO2max and for a duration that was gradually increased to 60 min/day. Twenty-four hrs following the last exercise bout, isolated perfused working hearts were subjected to 30 min of global ischemia followed by 30 min of normoxic reperfusion. Coronary effluents were used to determine lactate dehydrogenase (LDH) leakage and prostaglandin generation. Results: Cardiac function was similar in all groups prior to ischemia. Post I/R recovery of cardiac function in S was 17.6 [greater than or equal to]6.6% of pre-ischemic cardiac output times systolic pressure. Recovery was significantly higher in SD (37.7[greater than or equal to]7.7%) and R (40.1[greater than or equal to]7.8%) and tended to be highest in RD (49.7[greater than or equal to]7.1%). SD had significantly higher pre-ischemic coronary flow per g heart weight (CF/g) than all other groups. At 10 min post-ischemia, simvastatin treatment significantly increased CF/g compared to S (p<0.05). Exercise had an effect on increasing post-ischemic myocardial efficiency and RD had significantly higher post-ischemic myocardial efficiency vs. S (p<0.05). Compared to S, LDH leakage during reperfusion was dramatically decreased in SD, R and RD by approximately similar amounts. Simvastatin treatment doubled the basal production of protective prostaglandins, whereas exercise did not significantly alter their production and combining both treatments yielded a lower prostaglandin release than simvastatin treatment. SD had s significantly higher basal prostaglandin release than R (p<0.05). Conclusion: Although the combination treatment of simvastatin and exercise did not result in a statistically significant addition in cardioprotection compared to either treatment alone, there was a trend for improved parameters of post-ischemic cardiac function and damage upon combining both treatments compared to each treatment alone. Specifically, the prostaglandin, CF/g and efficiency data suggest that exercise and statininduced cardioprotection against I/R injury appears to occur by different mechanisms and combining the two treatments may provide greater protection than either alone.Item Investigating mesenchymal stem cell therapy for ischemic repair(2014-08) Ricles, Laura Michelle; Suggs, Laura J.; Emelianov, Stanislav Y.; Baker, Aaron B; Farrar, Roger P; Zoldan, JanetaCardiovascular diseases are the leading cause of death globally and continue to be a growing health concern. The currently available therapies are not suitable or effective for all patients, which has prompted investigation into stem cell-based therapies for vascular regeneration and ischemic repair. Clinical trials using stem cell therapy have shown promising outcomes for patients with cardiovascular diseases. However, the mechanisms of repair, and the contribution of stem cells to wound healing, are poorly understood. The objective of this dissertation is to evaluate the use of bone marrow-derived mesenchymal stem cells (MSCs) delivered within a PEGylated fibrin gel for revascularization therapies. Demonstrated in this dissertation is the design of nanoparticle contrast agents which are capable of labeling and tracking stem cells and infiltrating macrophages in vivo. In addition, the effect of hypoxia on MSC function and the resulting interaction with macrophages was studied. Hypoxia was shown to modulate MSCs to have pro-regenerative and angiogenic-promoting properties, which subsequently affected the interaction with macrophages. Lastly, functional recovery and vascular regeneration in an in vivo ischemia model were shown to be enhanced in response to MSCs delivered within PEGylated fibrin gels. The results of this work provide insights into the mechanisms of stem cell therapy in combination with PEGylated fibrin matrices and can contribute to the advancement of the field of regenerative medicine.Item Mechanisms of cutaneous microvascular endothelial dysfunction in young black Americans(2016-12) Kim, Kiyoung, active 2013; Tanaka, Hirofumi, Ph. D.; Farrar, Roger P.; Castelli, Darla M.; Brothers, Robert Matthew; Davis, Scott L.Black Americans have an increased risk for developing a variety of cardiovascular disease (CVD) when compared to white Americans and other populations in the United States. It has also been demonstrated that the underlying impairments in black Americans manifest during early adulthood prior to any overt signs of risk, which leads to higher rates of CVD related morbidity and mortality in black Americans than other populations. Study 1 was designed to investigate the potential mechanisms of cutaneous microvascular dysfunction in young college-age black Americans. This was assessed by measuring the skin blood flow response to local heating while various vasoactive substances were delivered into the cutaneous interstitial space by intradermal microdialysis. We demonstrated that an attenuated nitric oxide (NO) mediated vasodilation due in part to a relative deficit of L-arginine in the endothelial cells is one mechanism by which microvascular dysfunction occurs in young black Americans. Study 2 conducted to investigate the effects of acute cocoa flavanol intake on cutaneous microvascular function in young black Americans. This was assessed by measuring the skin blood flow response to local heating and delivery of vasoactive substances (as described above) before and after consumption of a beverage high in flavanol content. Study 2 demonstrated that acute flavanol intake improved cutaneous microvascular function in response to local heating in young black Americans relative to young white Americans. Study 3 was designed to investigate the effects of acute flavonal intake on endothelium-dependent microvascular dilation in response to exogenous administration of methacholine (MCh) in young black Americans. This was assessed by skin blood flow responses to incremental dose of MCh, which was delivered by intradermal microdialysis, before and after consumption of a beverage high in polyphenol content. Study 3 identified that acute flavanol intake did not alter the dose-response curve of MCh-induced cutaneous vasodilation in either racial groups. Overall, the series of studies in this dissertation may provide evidence that young black Americans have attenuated microvascular function relative to young white Americans, and that a potential mechanism of decreased microvascular function is a decrease in NO bioavailability and/or NO mediated vasodilation, which is related to a deficit of L-arginine in the endothelial cells in young black Americans. Furthermore, our findings may provide evidence that the consumption of cocoa flavanols is an effective therapeutic strategy to prevent and/or delay the development of CVD at least in young black Americans.Item The perception and knowledge of cardiovascular risk factors among Chinese Americans(2006-08) Yu, Teng-Yuan; Clark, Angela P.The purpose of this study was to evaluate Chinese Americans’ perceptions and knowledge about cardiovascular disease (CVD) risk factors and to determine if acculturation has systematic effects on perception of illness. Perception about the cause, seriousness, curability, and controllability of CVD were investigated. Relationships between the demographic characteristics of the participants and cardiovascular knowledge and perception were examined. The conceptual framework for this study was based on Leventhal’s (1970, 1984) Common Sense Model of Illness Representation. The influence of Kleinman’s Explanatory Model about the cultural and social consideration of illness representation was incorporated. A cross-sectional design was selected for this descriptive study with a convenience sampling technique. The target population was community-based Chinese Americans who live in the United States. Data collection was conducted using the Internet to access a population. The sample of the study was comprised of 124 adults with 68% being female. The majority of participants retained a high Asian identity. Participants identified Chinese over English for speaking, reading, writing preferences. Instruments included the Illness Perception Questionnaire-Revised (IPQ-R), Suinn-Lew Asian Self-Identity Acculturation Scale (SL-ASIA) and the Healthy Heart IQ. Findings included the following: the IPQ-R subscales were intercorrelated in a logical manner. Illness perceptions correlated positively with each other but were negatively correlated with optimistic perceptions like personal and treatment control. No difference was observed in the IPQ-R based on age, gender or educational level. Knowledge of CVD among Chinese Americans was lower than the general population. The level of acculturation had an impact on the illness perception. Acculturation level was significantly related to all seven illness perception dimensions of illness representation on the IPQ-R. There were significant relationships between acculturation level and knowledge of CVD. However, due to the low acculturation level presented by majority of participants, caution must be exercised in the interpretation of the study findings. The findings of this study have important implications for nursing practice, education, and theory. These results also provide directions for future research. Suggestions for health care professionals who care for patients with ethnic cultural backgrounds were given.Item The association between socioeconomic status and cardiovascular disease risk factors in a rural-dwelling aging cohort of west Texas(2011-05) Chen, Wenping; Rahnama, Masha; Ende, Terry V.; Miller, Peggy G.Socioeconomic status (SES) refers to an individual’s social and economic position relative to other members in a society. Due to the fact that American society is aging and few studies on the association between socioeconomic status and risk factors for cardiovascular disease were conducted in rural residents of U.S., it is urgent that more related studies focus on rural aging people. Data on 509 rural-dwelling aging people from West Texas were analyzed using binary Logistic regression. Data analysis showed that people in rural areas have relative lower socioeconomic status and higher prevalence of risk factors for cardiovascular disease. Logistic regression results demonstrated that both of SES and demographic indicators have significant effects on cardiovascular disease (CVD) risk. Age was linked to most of the CVD risk factors; males and Hispanic have a higher risk for developing diabetes; people without house tenure tend to have alcohol use problem; household income is the strongest estimator to diabetes and an effective estimator to hypertension and depression in a rural setting; higher occupational level was positively associated with the decrease of diabetes and obesity risk; both household income and occupation directly affect CVD risk; in contrast, education indirectly influence health outcome; the underlying pathway through which education benefit health outcomes is the financial and occupational improvement that associated with education.