Rationale and Design of the Contribution of Chronic Stress and Resilience on Aging in Young and Early Middle Age Black Women Study

Cardiovascular disease (CVD) is the leading cause of death among women in the United States, with Black women disproportionately affected by hypertension. These disparities are not fully explained by traditional risk factors but are attributed to chronic social and environmental stressors. Chronic psychosocial stress may accelerate biological and vascular aging, increasing CVD susceptibility. Although psychological resilience may mitigate adverse effects of chronic stress, its protective effects may vary across social and environmental contexts. The Contribution of Chronic Stress and Resilience on Aging in Young and Early Midlife Black Women Study is a sequential mixed-methods study examining whether accelerated biological aging represents a pathway linking chronic stress to subclinical vascular dysfunction. Eighty-five Black women aged 30-44 years from metropolitan Atlanta completed psychosocial assessments and underwent clinical biomarker evaluation, DNA methylation-based epigenetic aging analyses, inflammatory biomarker assessment, and subclinical vascular function measures. Following quantitative data collection, semi-structured qualitative interviews explored perceptions of stress, resilience, and health. This study integrates clinical, epigenetic, vascular, and qualitative data to characterize how chronic psychosocial stress and resilience relate to biological aging and vascular function, a marker of CVD risk during early midlife. Findings will inform strategies to reduce CVD disparities among Black women.