EVALUATING NOVEL RISK FACTOR ASSOCIATIONS FOR SUBCLINICAL CARDIOVASCULAR DISEASE

Globally, cardiovascular disease (CVD) is the leading cause of death. Increased risk for CVD can be attributed to smoking, high blood pressure, poor lipid profiles, obesity and psychosocial factors. Markers of subclinical CVD are non-invasive measures that detect early atherosclerotic changes. The purpose of this dissertation was to evaluate novel risk factor associations for subclinical CVD in three distinct populations. The protective effect of HDL-c for subclinical CVD was diminished in a population of postmenopausal women compared to premenopausal women. Furthermore, the concentration of small HDL particles was higher among postmenopausal women. Lipid profile changes with the menopausal transition may in part explain the increased risk of CVD seen after menopause.The protective effect of education for subclinical CVD was evident only among females from an Afro-Caribbean population. Educational differences in SBP and lipids varied for males and females providing insight into potential mechanisms for the education-subclinical CVD relationship observed on the island of Tobago.Tonic cardiac sympathetic activity and parasympathetic reactivity were independent predictors of subclinical CVD in a population of overweight and obese young adults. The effect of C-reactive protein (CRP) on subclinical CVD is potentially explained by the autonomic anti-inflammatory mechanisms linking heart rate variability and CRP. Identifying novel risk factor associations for subclinical CVD in various populations supports the important public health objective of reducing the global burden of CVD morbidity and mortality through early detection of atherosclerosis