Tené T Lewis

Tené T Lewis
Emory University | EU · Department of Epidemiology

Doctor of Philosophy

About

187
Publications
21,246
Reads
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17,905
Citations
Additional affiliations
July 2012 - present
Emory University
Position
  • Professor (Associate)
July 2011 - July 2012
Yale University
Position
  • Professor (Associate)
July 2006 - June 2011
Yale University
Position
  • Professor (Assistant)

Publications

Publications (187)
Article
Background: Psychological stress disorders are twice as prevalent in women with ischemic heart disease compared to men. The disproportionate psychological health experience of these women is not well understood. The objective of this study was to examine whether neighborhood social factors are associated with disparities in psychological health by...
Article
Full-text available
Objective Depression is common in individuals with chronic cutaneous lupus erythematosus (CCLE). However, how CCLE may impact patients’ psychological well-being is poorly understood, particularly among disproportionally affected populations. We examined the relationships between depression and psychosocial factors in a cohort of predominantly Black...
Article
Rationale Much of the research linking racism-related stressors to poor health has focused on fairly non-violent forms of racism that directly impact individuals under study. Exposure to particularly extreme and/or violent racist events are increasingly visible via smartphone recordings and social media, with consistent anecdotal reports of the eff...
Article
Background: An established link exists between acute mental stress and the development of transient endothelial dysfunction (TED) as assessed by brachial artery flow-mediated vasodilation (FMD). Black individuals have a high burden of cardiovascular (CV) risk factors and social disadvantages, which may result in adverse vascular responses to stress...
Article
Introduction: Young and middle-aged women with ischemic heart disease are a high-risk group for morbidity and mortality particularly after a myocardial infarction (MI). This group exhibits higher concentrations of the inflammatory cytokine interleukin-6 (IL-6) at baseline and in response to mental stress compared to men. The reasons for these diffe...
Article
OBJECTIVE: To examine whether net worth is associated with increased ambulatory blood pressure (ABP), a marker of cardiovascular disease (CVD) risk, independent of educational level and income, in young to middle-aged African American women. DESIGN,SETTING,AND PARTICIPANTS A cross-sectional, community-based study conducted in the southeastern US w...
Article
Immune responses differ between men and women, with women at higher risk of developing chronic autoimmune diseases and having more robust immune responses to many viruses, including HIV and hepatitis C virus. Although immune dysregulation plays a prominent role in chronic systemic inflammation, a key driver in the development of atherosclerotic car...
Article
Background Early life trauma has been associated with increased cardiovascular risk, but the arrhythmic implications are unclear. We hypothesized that in patients with coronary artery disease, early life trauma predicts increased arrhythmic risk during mental stress, measured by elevated microvolt T‐wave alternans (TWA), a measure of repolarization...
Article
Background: The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glu...
Article
Early life stress (ELS) has been associated with an increased risk of cardiovascular disease. We examined whether ELS was associated with autonomic function and stress reactivity among individuals with coronary heart disease (CHD). We included patients with stable CHD from two parallel studies, the Mental Stress Ischemia Prognosis Study (MIPS) and...
Article
Full-text available
Significance How structural racism contributes to the disproportionate burden of cardiovascular disease risk on minoritized groups in the United States is understudied. This study examined the impact of historical redlining, a government-sanctioned and racially discriminatory policy, and present-day cardiovascular health (CVH). Results suggested th...
Article
Introduction: Black Americans suffer from disparate levels of CVD and CVD risk factors, but metabolic pathways that underlie cardiometabolic risk in Blacks remain largely unknown. Objective: We defined metabolomic profiles and associated metabolic pathways underlying CVH in a Black community that is richly diverse in ethnic origin and socioeconomic...
Article
Importance Mental stress–induced myocardial ischemia is a recognized phenomenon in patients with coronary heart disease (CHD), but its clinical significance in the contemporary clinical era has not been investigated. Objective To compare the association of mental stress–induced or conventional stress–induced ischemia with adverse cardiovascular ev...
Article
Full-text available
Arterial stiffness is a precursor for the development of hypertension and premature cardiovascular disease (CVD). Physical activity has been associated with lower arterial stiffness among largely White populations, but the types of activity required and whether these findings apply to Black adults remain unknown. We examined whether physical activi...
Article
Background Black patients tend to develop coronary artery disease at a younger age than other groups. Previous data on racial disparities in outcomes of myocardial infarction (MI) have been inconsistent and limited to older populations. Our objective was to investigate racial differences in the outcome of MI among young and middle‐aged patients and...
Article
Background Early trauma (general, emotional, physical, and sexual abuse before age 18 years) has been associated with both cardiovascular disease risk and lifestyle-related risk factors for cardiovascular disease, including smoking, obesity, and physical inactivity. Despite higher prevalence, the association between early trauma and cardiovascular...
Article
Full-text available
Objective: To simultaneously examine multiple individual-level neighbourhood perceptions and psychosocial characteristics and their relationships with cardiovascular health (CVH) among blacks. Design: Cross-sectional study. Setting: Subjects were recruited between 2016 and 2018 via convenience sampling. Participants: 385 Black men and women,...
Article
Full-text available
Background: The COVID-19 pandemic adversely affected the socially vulnerable and minority communities in the USA initially, but the temporal trends during the year-long pandemic remain unknown. Objective: We examined the temporal association of county-level Social Vulnerability Index (SVI), a percentile-based measure of social vulnerability to d...
Article
Background: We aimed to examine if neighborhood social cohesion moderated longitudinal associations between baseline reports of discrimination and 10-year changes in Leukocyte Telomere Length (LTL). Methods: Data are from the Multi-Ethnic Study of Atherosclerosis (MESA; N=1,064; age range 45-84 years). Baseline discrimination was measured using...
Article
Study objectives: African-Americans have a high burden of poor sleep, yet, psychosocial determinants (e.g., discrimination) are understudied. We investigated longitudinal associations between everyday discrimination and sleep quality and duration among African-Americans (N=3404) in the Jackson Heart Study. Methods: At Exam 1 (2000-2004) and Exam...
Preprint
Full-text available
Background The COVID-19 pandemic adversely affected the socially vulnerable and minority communities in the U.S. initially, but the temporal trends during the year-long pandemic remain unknown. Objective We examined the temporal association between the county-level Social Vulnerability Index (SVI), a percentile-based measure of social vulnerability...
Article
Objective: Mental stress-induced myocardial ischemia (MSIMI), a transient myocardial ischemic response to mental stress, is associated with poorer outcomes among patients with coronary heart disease and is more likely to occur among women. However, predictors of MSIMI are not well explored. The current study investigated the association between ex...
Article
Objective African Americans progress from early to late-stage chronic kidney disease (CKD) at a rate that is three times that of Whites. Given research that implicates social stress in poor kidney outcomes, there is a need to examine whether race-related stress contributes to these disparities. Through experimental manipulation, this study sought t...
Article
Introduction: Psychological stress disorders are twice as prevalent in women with ischemic heart disease compared to their male counterparts. The disproportionate psychological health experience of these women is not well understood. Neighborhood social factors may help to explain disparities in psychological risk by sex. Hypothesis: We hypothesize...
Article
Introduction: Mental stress-induced myocardial ischemia (MSI) is a risk marker for adverse outcomes among coronary artery disease (CAD) that is more prevalent among patients with posttraumatic stress disorder (PTSD). Hypothesis: CAD patients with PTSD who develop MSI experience a higher risk of adverse cardiovascular events compared with those who...
Article
Title: Net Worth, Debt Stress, and Ambulatory Blood Pressure in African American Women Author Names: Telisa Spikes, RN, PHD, Raphiel Murden, MS, Izraelle McKinnon, MPH, Miriam Van Dyke, PhD, Samantha Bromfield, PhD, Renee Moore, PhD, Bianca Booker, MA, Frederic Rahbari-Oskoui MD, Arshed Quyyumi, MD, Viola Vaccarino, MD, PhD, Tené T. Lewis, PhD Back...
Article
Introduction: Poor quality neighborhoods are independent risk factors for cardiovascular disease (CVD) but are understudied in Blacks, who face large CVD health disparities. Arterial stiffness (AS) precedes development of hypertension and adverse CVD events but the effect of neighborhood on AS among Blacks remain unknown. Objective: We compared the...
Article
Studies documenting self-reported experiences of discrimination over the life-course have been limited. Such information could be important for informing longitudinal epidemiologic studies of discrimination and health. We described trends in self-reports of racial, socioeconomic status, and gender discrimination over time measured using the Experie...
Article
Introduction: Perceived and actual access to healthy foods may differ in urban areas, particularly among Black people. We assessed the effect of objective and perceived neighborhood food access on self-reported cardiovascular disease (CVD) among Black people living in areas of high risk and low risk for the disease in Atlanta, Georgia. We hypothes...
Article
Background Black Americans have a higher risk of hypertension compared with White Americans. Perceived discrimination is a plausible explanation for these health disparities. Few studies have examined the impact of perceived discrimination on the incidence of hypertension among a racially diverse sample. Our study examined associations of everyday...
Article
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and gluco...
Article
Background Neighborhood environment is increasingly recognized as an important determinant of CVH among Black adults. Most research to date has focused on negative aspects of the neighborhood environment, with little attention being paid to the specific positive features, in particular the social environment, that promote cardiovascular resilience...
Article
Introduction: Arterial stiffness is a precursor for development of hypertension and premature cardiovascular disease (CVD). Physical activity has been associated with lower arterial stiffness among largely White populations, but the types of activity required and whether these findings apply to Blacks remain unknown. We examined whether physical ac...
Article
Importance Compared with older patients, young adults with a history of myocardial infarction (MI) tend to have a higher burden of psychosocial adversity. Exposure to early-life stressors may contribute to the risk of adverse outcomes in this patient population, potentially through inflammatory pathways. Objective To investigate the association of...
Article
Full-text available
African-American women have elevated rates of cardiovascular disease compared to women of other race/ethnicities, and race/ethnicity-related stressors may play a role. We examined the association between an understudied race/ethnicity-related stressor, midlife loss (e.g. deaths of friends/family members) and a marker of cardiovascular risk, carotid...
Article
Stress may contribute to progression of coronary heart disease (CHD) through inflammation, especially among women. Thus, we sought to examine whether increased inflammatory response to stress among patients with CHD is associated with a greater risk of cardiovascular events and whether this risk is higher in women. We examined inflammatory biomarke...
Article
Objective To investigate differences in sleep quality by race in participants with and without a prior myocardial infarction (MI). Design Case-control study. Setting Emory-affiliated hospitals in Atlanta, Georgia. Participants Two hundred and seventy-three individuals (190 Black) ≤60 years of age with a verified MI in the previous 8 months, and...
Article
African Americans have a higher risk of hypertension compared with other racial or ethnic groups in the United States. One possible explanation for this disparity is discrimination. Few studies have examined the association between discrimination and incidence of hypertension. We examined whether everyday discrimination, lifetime discrimination, an...
Article
Full-text available
Background Cardiovascular disease incidence, prevalence, morbidity, and mortality have declined in the past several decades; however, disparities persist among subsets of the population. Notably, blacks have not experienced the same improvements on the whole as whites. Furthermore, frequent reports of relatively poorer health statistics among the b...
Article
Full-text available
Importance Posttraumatic stress disorder (PTSD) is prevalent among patients who survived an acute coronary syndrome and is associated with adverse outcomes, but the mechanisms underlying these associations are unclear. Objective To evaluate the association of PTSD with mental stress–induced myocardial ischemia among individuals who survived a myoc...
Preprint
Full-text available
Importance: Prior pandemics have disparately affected socially vulnerable communities. Whether regional variations in social vulnerability to disasters influence COVID-19 outcomes and incidence in the U.S. is unknown. Objective: To examine the association of Social Vulnerability Index (SVI), a percentile-based measure of county-level social vulnera...
Article
Background: Poor adherence to hypertensive medication has been suggested to be a major contributor to uncontrolled hypertension (HTN) in African Americans. The impact that social determinants have on the various patient-level factors, including HTN beliefs, mental well-being, and social support, may provide insight into the development and tailori...
Article
Full-text available
Background: Despite well-documented cardiovascular disparities between racial groups, within-race determinants of cardiovascular health among Black adults remain understudied. Factors promoting cardiovascular resilience among Black adults in particular warrant further investigation. Our objective was to examine whether individual psychosocial resi...
Article
Background Self-reported experiences of discrimination have been linked to indices of cardiovascular disease. However, most studies have focused on healthy populations. Thus, we examined the association between experiences of everyday discrimination and arterial stiffness among patients with a history of myocardial infarction (MI). Purpose We hypo...
Article
Objectives: Mental stress-induced myocardial ischemia (MSIMI) is a transient myocardial ischemic response to mental stress. Women are about two times more likely to develop MSIMI compared to men, which could potentially explain their worse morbidity and mortality after myocardial infarction (MI). We sought to examine the associations between experi...
Article
Introduction: Early trauma (e.g. general, emotional, physical, and sexual abuse before age 18) has been associated with both cardiovascular disease (CVD) risk and lifestyle-related risk factors for CVD including smoking, obesity, and physical inactivity. However, previous studies have primarily focused on White participants, despite the fact that e...
Article
Introduction: Sleep is hypothesized to be a contributing factor towards disparities in cardiovascular disease (CVD). It has been demonstrated that Black Americans have worse sleep quality compared to other ethnic groups, but within group differences have not been studied. Whether overall sleep quality and patterns affect cardiovascular health (CVH)...
Article
Background: Early-life traumatic experiences have been associated with increased cardiovascular disease risk. Little is known about how early-life traumatic experiences may affect changes in autonomic function during mental stress among young subjects post-MI. Objective: We hypothesized that those with high exposure to early-life trauma, compared t...
Article
Introduction: While cardiovascular disease (CVD) morbidity and mortality is particularly pronounced among Black Americans, there is a great deal of intra-racial heterogeneity within the population. Our objective was to identify novel circulating biomarkers (extracellular miRNA and metabolites) that predict cardiovascular health (CVH) within Blacks,...
Article
Introduction: Stressful life events (SLE) have been associated with poor cardiovascular health but most studies have focused on stressors that directly impact the individuals under study, or personal stressors. Research suggests that women, particularly African-American women, may actually be more vulnerable to network stressors (e.g. SLE that impa...
Article
Da Costa originally described Soldier's Heart in the 19th Century as a syndrome that occurred on the battlefield in soldiers of the American Civil War. Soldier's Heart involved symptoms similar to modern day posttraumatic stress disorder (PTSD) as well as exaggerated cardiovascular reactivity felt to be related to an abnormality of the heart. Inter...
Article
Full-text available
Background The extent to which cardiovascular disease ( CVD ) risk factors across the menopause explain racial/ethnic differences in subclinical vascular disease in late midlife women is not well documented and was explored in a multi‐ethnic cohort. Methods and Results Participants (n=1357; mean age 60 years) free of clinical CVD from the Study of...
Article
Objective: To examine associations among race, the accumulation of multiple forms of discriminatory experiences (i.e., "pervasive discrimination") and allostatic load (AL) in African-Americans and Whites in mid-life. Methods: Using data collected in 2004-2006 from 226 African-American and 978 White adults (57% female; mean age=54.7 years (SD=0.1...
Article
Full-text available
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports on the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and gl...
Article
Background We examined the relationships of anger, vital exhaustion, anti-depressant use, and poor social ties with incident atrial fibrillation in a biracial cohort of middle and older-aged adults. Methods This analysis included 11,445 Atherosclerosis Risk in Communities Study participants who were free of atrial fibrillation at baseline in 1990–...
Article
Purpose: We sought to assess the association of reports of discrimination with leukocyte telomere length (LTL) and effect measure modification by social support. Methods: This study used data from the Multi-Ethnic Study of Atherosclerosis Stress Ancillary Study (n = 1153). Discrimination was measured using the everyday discrimination and the maj...
Chapter
This chapter focuses on how discrimination can impact sleep health, with an emphasis on stress as a mediator in the relationship. Given that the vast majority of sleep research on discrimination focuses on racial discrimination, this type of discrimination is the focus of the chapter. Measurement of discrimination is a strong focus of the chapter a...
Article
Full-text available
Background Educational attainment is an indicator of socioeconomic status and is inversely associated with coronary artery disease risk. Whether educational attainment level ( EAL ) among patients with coronary artery disease influences outcomes remains understudied. Methods and Results Patients undergoing cardiac catheterization had their highest...
Article
Hypertension, a modifiable risk factor of cardiovascular disease, is largely responsible for the disproportionate morbidity and mortality in black women. Black women 20 years of age and older have a higher prevalence of HTN compared to white women (44% vs 28%). Poor adherence and non‐adherence to hypertensive medications have been strongly indicate...
Article
Leukocyte telomere length (LTL) may be sensitive to psychosocial stressors such as discrimination. An inclusive examination of experiences of discrimination on LTL across racial/ethnic and sex groups is currently lacking. Baseline data were obtained from 369 White and African American patients with coronary artery disease (CAD) in the Mental Stress...
Article
Objectives: Research suggests that following a myocardial infarction (MI), women under the age of 60 have more elevated depressive symptoms and adverse outcomes than similarly aged men. Identifying risk factors that contribute to gender differences in depressive symptoms among this group may be critical to the development of psychosocial intervent...
Article
Full-text available
Background Factors promoting cardiovascular health in the face of high risk, ie, resilience, are unknown and may identify novel areas of intervention for reducing racial health disparities. We examined neighborhood perceptions and psychological attributes of blacks living in high and low cardiovascular–risk neighborhoods, as potential characteristi...
Article
Full-text available
Introduction: Despite the growing interest in place as a determinant of health, areas that promote rather than reduce cardiovascular disease (CVD) in blacks are understudied. We performed an ecologic analysis to identify areas with high levels of CVD resilience and risk among blacks from a large southern, US metropolitan area. Methods: We obtain...
Article
Full-text available
Background Higher symptom levels of a variety of measures of emotional distress have been associated with cardiovascular disease (CVD), especially among women. Here, our goal was to investigate the association between a composite measure of psychological distress and incident cardiovascular events. Methods and Results In a prospective cohort study...
Article
Full-text available
Objective: Mental stress-induced myocardial ischemia is a frequent phenomenon in patients with coronary artery disease (CAD). The link between an integrated measure of chronic psychosocial distress and mental stress-induced myocardial ischemia, and whether it differs by sex, has not been examined before. Methods: We used latent class analysis to...