# Social Vulnerability, Sleep, and Early Hypertension Risk in Younger Adults

> **NIH NIH K23** · YALE UNIVERSITY · 2023 · $172,453

## Abstract

PROJECT SUMMARY/ABSTRACT
This K23 Career Development Award will support Dr. Allison Gaffey’s development into an independent
patient-oriented investigator with a focus on women’s risk for hypertension (HTN) and cardiovascular disease
(CVD), the contributions of social vulnerability (SV; e.g., stress from adverse childhood and adult exposures,
and from social determinants of health) and insufficient sleep (e.g., short sleep duration) to this risk, and the
identification of early opportunities to mitigate this risk. By age 35, women begin to show a steeper annual
increase in blood pressure (BP) than men and over 1 in 3 premenopausal women exhibit an early stage HTN
phenotype (i.e., elevated BP or Stage 1 HTN). SV and short sleep duration - each amenable to behavioral and
public health interventions - are especially impactful for women, and may contribute to this observed, yet
underappreciated BP increase prior to menopause. The K23 Award will ensure that Dr. Gaffey develops the
knowledge and skills to investigate the social and behavioral determinants of early risk for HTN, to improve
related behavioral CV prevention for women. In the resource rich environment of the Yale School of Medicine,
Dr. Gaffey has assembled a multidisciplinary mentoring and advisory team to facilitate her transition to
independence via training in: (1) the pathophysiology of BP, HTN, and CVD, including associations unique to
women; (2) physiological and behavioral mechanisms of sleep, state-of-the-art sleep measurement, and sleep
health disparities, including those specific to women; (3) social determinants of health in CV epidemiology,
including associations unique to women; and (4) statistical modeling of longitudinal and repeated sampling
data. Dr. Gaffey’s training will be complemented by a novel plan of research: (AIM 1) With longitudinal data
from the Coronary Artery Risk Development in Young Adults Study (CARDIA), test associations of SV and self-
reported sleep duration to: a) the onset of early stage HTN phenotypes, and b) the rate of BP change from
early- to mid-adulthood. Analyses will be stratified by sex. (AIM 2) Limitations of CARDIA will be addressed by
conducting a mixed methods, pilot study with a community sample of premenopausal women and same-aged
men to, a) test short-term associations of home BP to SV-related stress exposures and ecologically, objectively
assessed sleep duration; and b) qualitatively assess personal experiences of SV-related stress, barriers to
sleep, and study feasibility/acceptability. Outcomes will include within-person variability in stress, sleep, and
BP associations over time, contextual themes to inform future assessment of SV, stress, and sleep, and rates
of recruitment, adherence, retention, and satisfaction. This K23 builds logically on Dr. Gaffey’s prior research
and clinical background and provides her with the requisite expertise and evidence base to prepare a later R01
application to collect more comprehensive, objective...

## Key facts

- **NIH application ID:** 10643145
- **Project number:** 1K23HL168233-01
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** Allison Gaffey
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $172,453
- **Award type:** 1
- **Project period:** 2023-06-01 → 2028-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10643145

## Citation

> US National Institutes of Health, RePORTER application 10643145, Social Vulnerability, Sleep, and Early Hypertension Risk in Younger Adults (1K23HL168233-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10643145. Licensed CC0.

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