Relationship of racial stressors to blood pressure responses and anger expression in black college students

The physiological effects of racism, as a stressor, were examined as they related to blood pressure (BP) and anger experiences in Black college students. Current research has failed to consider the stressful effects of racism as a factor contributing to the higher incidence of essential hypertension among Blacks. Twenty-seven Black college students viewed three excerpts showing racist situations involving Blacks; anger-provoking, nonracist situations; and neutral situations. After each scene, BP was taken, and a mood checklist was administered. The Framingham Anger Scale and the Anger Expression Scale were administered. Analyses revealed that BP significantly increased during the presentation of racist stimuli but not of anger-provoking or neutral stimuli. Self-reports of state anger, as measured by the mood checklist, were significant for both the anger-provoking and racist stimuli. BP scores were significantly correlated to the two trait anger measures. Exposure to racist stimuli was associated with BP increases among Blacks. Such cumulative exposure to racism may have important implications for the etiology of essential hypertension.     

Cardiovascular reactivity and central adiposity in older African Americans.

This study examined central adiposity, as measured by waist circumference (WC), in relation to mental-stress induced systolic (SBP) and diastolic blood pressure (DBP) and heart rate (HR) responses, body composition, the metabolic syndrome, and health practices in 22 older, African American men and women (ages 52-79 years). The high WC (> 100 cm) group showed significantly greater SBP, DBP, and HR reactivity, greater fasting insulin levels, lower high density lipoprotein cholesterol levels, greater fat mass in both truncal and peripheral regions, and greater body mass index as compared to the low WC (< 100 cm) group. Groups were comparable with respect to fat-free mass, peak oxygen consumption (VO2), leisure time activity, dietary intake, resting blood pressure, and other metabolic variables. The findings support a clustering of metabolic and mental stress risk factors that may predispose older African Americans to increased cardiovascular and metabolic disease.     

Patterns of cardiovascular responses to stress as a function of race and parental hypertension in men

This study investigated cardiovascular responses to two stressors known to elicit either beta-adrenergic (mental arithmetic) or alpha-adrenergic (forehead cold pressor) reactivity in Black and White men. Participants in each group were selected for presence or absence of parental hypertension. Based on previous research, Blacks were expected to show smaller cardiovascular responses to the beta-adrenergic mental arithmetic task and greater responses to the alpha-adrenergic cold pressor relative to the Whites. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate, forearm blood flow, and forearm vascular resistance were assessed during a resting baseline, a prestress period, and during and after each experimental procedure. Unlike previous findings, no significant racial differences in cardiovascular responses were found during either task. However, Black participants had significantly higher SBP and DBP levels throughout the cold pressor periods. Parental history did not significantly influence cardiovascular responses in either group. The results are discussed in relation to previous research on racial differences in stress reactivity and their implications for future research.     

Central adiposity is associated with cardiovascular reactivity to stress in adolescents.

The current study examined the association between central adiposity, measured by waist circumference, and cardiovascular reactivity to stress among 106 White and 105 Black adolescents, approximately 50% of whom were girls. Participants engaged in 4 laboratory tasks while cardiovascular reactivity measures were taken. Independent of body mass index, race, and gender, participants with a greater waist circumference exhibited greater systolic blood pressure reactivity and diastolic blood pressure reactivity (boys only). Race did not affect the results. Results from the present study suggest that central adiposity is associated with blood pressure reactivity early in life, especially in adolescent boys.     

Exploring Emotion-Regulation and Autonomic Physiology in Metastatic Breast Cancer Patients: Repression, Suppression, and Restraint of Hostility

We examined relationships between three emotion-regulation constructs and autonomic physiology in metastatic breast cancer patients (N = 31). Autonomic measures are not often studied in breast cancer patients and may provide evidence of an increase in allostatic load. Patients included participated as part of a larger clinical trial of supportive-expressive group therapy. Systolic and diastolic blood pressure and heart rate were assessed at a semi-annual follow-up. We averaged 3 resting assessments and used measures of Repression, Suppression, Restraint of Hostility, and Body Mass Index as predictors of autonomic response. We found that higher repression was significantly associated with higher diastolic blood pressure, while higher restraint of hostility was significantly associated with higher systolic blood pressure. A repressive emotion regulation style may be a risk factor for higher sympathetic activation possibly increasing allostatic load, while restraint of hostility may be a protective factor for women with metastatic breast cancer.     

Associations of blood pressure with self-report measures of anger and hostility among black and white men and women

This study examined associations between blood pressure (BP) and dispositional variables pertaining to anger and hostility. Black and White 25- to 44-year old male and female normotensives and unmedicated mild to moderate hypertensives completed four reliable self-report scales--the Cook-Medley Hostility (Ho) Scale, the Trait Anger subscale of the State-Trait Anger Scale (STAS-T), and the Cognitive Anger and Somatic Anger subscales of the Cognitive-Somatic Anger Scale--plus the Framingham Anger Scale and the Harburg Anger Scale. They also engaged in three laboratory tasks--Type A Structured Interview (SI), a video game, and a cold pressor task--that elicit cardiovascular reactivity. Ambulatory BP readings at home and at work were also obtained from most subjects. Blacks had significantly higher Ho and lower STAS-T scores than did Whites. Women reported higher levels of somatic anger than did men. White women showed significant positive correlations between STAS-T and systolic BP (SBP) and diastolic BP (DBP) both at rest in the laboratory and during the SI. Black women revealed significant positive relationships between STAS-T and SBP and DBP at rest in the laboratory and at work as well as with DBP during the cold pressor test. For Black men, cognitive anger and DBP at rest were positively related. In contrast, White men revealed significant negative correlations between Ho scores and SBP at rest and during the video game; these men also showed significant negative relationships between somatic anger and SBP and DBP reactivity during the cold pressor test. Women, but not men, showed significant positive relationships between all four anger measures and ambulatory BP at work. Whereas main effects relating anger and cardiovascular measures were not apparent as a function of race, Blacks demonstrated significantly greater SBP and DBP reactivity than Whites during the cold pressor test, with the converse occurring during the SI. Men demonstrated significantly greater DBP reactivity than women during the video game. The present findings indicate that self-reports on anger/hostility measures and cardiovascular responses to behavioral tasks differ as a function of race but that relationships between anger and BP regulation need to take into account possible race-sex interactions and selection of anger/hostility measures.     

Discrimination and unfair treatment: relationship to cardiovascular reactivity among African American and European American women.

This study examined the relationship of cardiovascular reactivity to both interpersonal mistreatment and discrimination in a community-based sample of African American and European American women (N=363) in midlife. Subtle mistreatment related positively to diastolic blood pressure (DBP) reactivity for African American participants but not their European American counterparts. Moreover, among the African American participants, those who attributed mistreatment to racial discrimination exhibited greater average DBP reactivity. In particular, these women demonstrated greater DBP reactivity to the speech task, which bore similarities to an encounter with racial prejudice but not to a nonsocial mirror tracing task. These findings are consistent with the hypothesis that racial discrimination is a chronic stressor that can negatively impact the cardiovascular health of African Americans through pathogenic processes associated with physiologic reactivity.     

Mortal Kombat (tm): The Effects of Violent Videogame Play on Males' Hostility and Cardiovascular Responding1

We examined cardiovascular (CV) reactivity and hostility among 30 male undergraduates after either nonviolent (billiards) or 1 of 2 levels of violent videogame play. Violence varied among 2 versions of the game Mortal Kombat (MK1 = less violent, MK2 = more violent)—all other factors (graphics, sound) were held equal. As expected, increased game violence elicited greater CV reactivity and higher scores on hostility measures. Subjects who played MK1 or MK2 had higher heart rate reactivity than those who played billiards. Subjects who played MK2 showed greater systolic blood pressure reactivity than those who played MK1 or billiards. Finally, subjects who played MK2 scored higher on the hostility measures than those who played MK1, who in turn scored higher than those who played billiards. These results indicate that the level of videogame violence, not just violence per se, should be of concern to consumers.     

Hostile affect and casual blood pressure

Abstract

The present study investigated the relation between hostile affect and casual blood pressure in men and women. Data were collected from two independent samples: (1) 204 university students, and (2) 175 adults from the community. Findings on blood pressure-hostile affect linkage are reported with age and body-mass index corrected values. Data were analyzed for subgroups split at the median for hostility and also for tercile subgroups. Median splits revealed no relationship between hostility and blood pressure. Systolic blood pressure tended to be highest in the medium and high hostility terciles. The diastolic pressure-hostility link in men represented a “V”-shaped curve. In women, there was no relationship. Heart rate levels were consistently unrelated to hostile affect. The importance of testing for linear as well as curvilinear relationships in future studies is highlighted.     

Race differences in stress-induced reactivity in young adults

The cardiovascular response to the stress of mental arithmetic was studied in young Black and White adults. Stress-induced reactivity was studied before and following 14 days of oral sodium loading (10 gm NaCl per day). Marginal hypertensives, both Black and White, had greater systolic blood pressure (SBP) levels (p less than 0.001) and greater diastolic blood pressure (DBP) levels (p less than 0.01) in response to stress. Whites had a greater SBP level during mental stress than Blacks (p = 0.008) and greater reactivity (change from baseline; p less than 0.001). The prevalence of sodium sensitivity was greater in Blacks (37.3%) than in Whites (18.4%). Sodium loading did not augment the BP reactivity to the mental stress in any of the racial or BP groups. These data demonstrate racial variation in the cardiovascular response to centrally mediated adrenergic stimuli. The results also suggest that mild BP elevation in Blacks may be regulated through changes in vascular resistance.     

Mindful attention predicts greater recovery from negative emotions,but not reduced reactivity

This study investigated the role of dispositional mindful attention in immediate reactivity to, and subsequent recovery from, laboratory-induced negative emotion. One hundred and fourteen undergraduates viewed blocks of negative pictures followed by neutral pictures. Participants’ emotional responses to negative pictures and subsequent neutral pictures were assessed via self-reported ratings. Participants’ emotional response to negative pictures was used to index level of emotional reactivity to unpleasant stimuli; emotional response to neutral pictures presented immediately after the negative pictures was used to index level of emotional recovery from pre-induced negative emotion (residual negativity). Results indicated that mindful attention was not associated with the emotional response to negative pictures, but it was associated with reduced negative emotion in response to the neutral pictures presented immediately after the negative pictures, suggesting better recovery as opposed to reduced reactivity. This effect was especially pronounced in later experimental blocks when the accumulation of negative stimuli produced greater negative emotion from which participants had to recover. The current study extends previous findings on the relationship between dispositional mindfulness and reduced negative emotion by demonstrating that mindful attention may facilitate better recovery from negative emotion, possibly through more effective disengagement from previous stimuli.     

Gender Differences in Biobehavioral Aftereffects of Stress on Eating,Frustration, and Cardiovascular Responses1

Eating, persistence, and cardiovascular responses were evaluated after exposure to a 25‐min noise stressor with or without perceived control. Participants were healthy men (n = 29) and women (n = 34), aged 21 to 45 years. There were no group differences in cognitive task performance or blood pressure during the stressor. However, perceived control resulted in lower mean blood pressure and heart rate after cessation of the stressor for men and women. Women without perceived control displayed greater frustration levels following the stressor, and frustrated women ate more bland food than did nonfrustrated women. Perceived control and frustration did not affect food consumption among men following the stressor. These findings indicate that there are health‐relevant gender differences in biobehavioral responses that occur in the aftermath of stressor exposure. In addition, perceived control was especially important for women to attenuate the behavioral and biological effects of stressor exposure.     

Blood lead (Pb) levels: a potential environmental mechanism explaining the relation between socioeconomic status and cardiovascular reactivity in children.

OBJECTIVE: A number of studies have shown an association between socioeconomic status (SES) and cardiovascular reactivity to acute stress. In addition, the authors recently reported that higher early childhood blood lead (Pb) levels are associated with significantly greater total peripheral (vascular) resistance (TPR) responses to acute stress. It is not known whether the SES-TPR association is mediated by underlying differences in blood lead levels. DESIGN: Participants were 9.5-year-old children (N=122) with established early childhood blood lead levels. MAIN OUTCOME MEASURES: Family SES was measured using the Hollingshead Index, blood lead levels were abstracted from pediatrician and state records, and children's cardiovascular responses to acute stressors were measured in the laboratory with impedance cardiography and an automated blood pressure monitor. RESULTS: Lower family SES was shown to be associated with significantly higher blood lead levels as well as significantly heightened systolic blood pressure, diastolic blood pressure, and TPR responses to acute stress tasks. A mediational analysis confirmed that Pb was a significant mediator of the SES-TPR reactivity association; some evidence also suggested moderation. CONCLUSION: These results suggest the importance of considering the chemical environment as well as social and psychological environment when evaluating cardiovascular effects of low SES.     

Discrimination, dispositions, and cardiovascular responses to stress.

OBJECTIVE: Recent research suggests that past exposure to discrimination may influence perceptions of, and physiological responses to, new challenges. The authors examined how race and trait levels of hostility and optimism interact with past exposure to discrimination to predict physiological reactivity and recovery during an anger recall task. DESIGN: A community sample of 165 normotensive Black and White adults participated in an anger recall task while having their cardiovascular function monitored. MAIN OUTCOME MEASURES: Blood pressure and heart rate indicators of physiological reactivity and recovery. RESULTS AND CONCLUSION: Participants had higher reactivity and slower recovery to the anger recall task when they had high past discrimination, low cynicism, or high optimism. The pattern of effects was similar for both racial groups, but Blacks had more acute reactivity and slower recovery than Whites. These results are consistent with the perspective of discrimination as a chronic stressor that is related to acute stress responses, particularly for Blacks.     

Effects of experienced disgust on habituation during repeated exposure to threat-relevant stimuli in blood-injection-injury phobia

Despite growing evidence implicating disgust in the etiology of blood-injection-injury (BII) phobia, the relevance of disgust for exposure-based treatment of BII phobia remains largely unknown. Individuals with BII phobia were randomly assigned to a disgust (view vomit videos) or neutral activation (view waterfall videos) condition. They were then exposed to 14 videotaped blood draws, during which fear and disgust levels were repeatedly assessed. Participants then engaged in a behavioral avoidance test (BAT) consisting of exposure to threat-relevant stimuli. Examination of outcome comparing the identical first and last blood-draw clips revealed that fear and disgust toward blood draws was significantly reduced in both groups. Disgust levels were also found to be more intense for the video stimuli relative to fear levels whereas the opposite was true for BAT stimuli. Contrary to predictions, the disgust induction did not enhance reductions in negative responses to the target video or reduce behavioral avoidance. Growth curve analyses did show that individuals with BII phobia exposed to the disgust induction showed greater initial fear levels during repeated exposure than those in the neutral condition. However, this effect was not consistently observed across different analytic approaches. Changes in fear during exposure were also found to be independent of changes in disgust but not vice versa, and greater initial fear levels during repeated exposure to threat was associated with fear and disgust levels during the BAT. The implications of these findings for conceptualizing the role of disgust in etiology and treatment of BII phobia are discussed.     

Psychosocial predictors of natural killer cell mobilization during marital conflict.

This study examined how specific emotions relate to autonomic nervous and immune system parameters and whether cynical hostility moderates this relationship. Forty-one married couples participated in a 15-min discussion about a marital problem. Observers recorded spouses' emotional expressions during the discussion, and cardiovascular, neuroendocrine, and immunologic parameters were assessed throughout the laboratory session. Among men high in cynical hostility, anger displayed during the conflict was associated with greater elevations in systolic and diastolic blood pressure, cortisol, and increases in natural killer cell numbers and cytotoxicity. Among men low in cynical hostility, anger was associated with smaller increases in heart rate and natural killer cell cytotoxicity. These findings suggest that models describing the impact of stress on physiology should be refined to reflect the joint contribution of situational and dispositional variables.     

Cynical hostility and vulnerability to disease: social support, life stress, and physiological response to conflict

Previous research has indicated that high scores on the Cook and Medley Hostility (Ho) scale are associated with increased risk of coronary heart disease and other illness. Our study attempts to clarify this relationship by providing additional evidence concerning the construct assessed by the Ho scale, examining the level of physiological reactivity during interpersonal conflict in high- and low-Ho groups, and assessing the psychosocial profile associated with this characteristic. Extremely high and low Ho groups were selected from a pool of male undergraduates. Consistent with previous findings, high-Ho participants reported greater anger proneness and a more cynical, disparaging view of others than did low-Ho participants. The high-Ho group also tended to be more hostile and less friendly during role-played interactions involving high and low levels of interpersonal conflict, respectively. High-Ho persons also displayed greater diastolic blood pressure reactivity during interpersonal conflict. Finally, the high-Ho group reported less social support and more negative life events and daily irritants then did the low-Ho group. These results support the interpretation of the Ho scale as a measure of cynical hostility and are consistent with the hypothesis that it is related to disease by way of excessive physiological reactivity and a generally stressful, unsupportive social network.     

Timing is everything: Anticipatory stress dynamics among cortisol and blood pressure reactivity and recovery in healthy adults

Psychological states of anticipation modulate biological stress responsivity. While researchers generally investigate how subjective distress corresponds to the magnitude of stress reactivity, physiological recovery after acute stressors must also be considered when investigating disease vulnerabilities. This study assessed whether anticipatory stress would correspond to stress reactivity and recovery of salivary cortisol and blood pressure levels in response to a well-validated psychosocial stressor. Thirty participants (63% female; mean?±?SEM age 45.4?±?2.12 years) were exposed to the Trier Social Stress Test (TSST) consisting of a public speech and mental arithmetic. Ten salivary cortisol samples and systolic and diastolic blood pressure recordings were collected at time points spanning 50?min before and up to 50?min after stress exposure. These data were transformed into parameters representing stress reactivity (area under the curve) and stress recovery (percent change). The Primary Appraisal Secondary Appraisal scale assessed anticipatory stress before exposure to the TSST. Our results revealed that increased anticipatory stress predicted increased stress reactivity for cortisol (p?=?0.009) but not blood pressure. For stress recovery, increased anticipatory stress predicted greater decrements of cortisol concentration (p?=?0.015) and blood pressure (p?=?0.039), even when controlling for total systemic "output" by incorporating baseline activity. This efficient shutdown of stress responses would have otherwise been ignored by solely investigating reactive increases. These findings underscore the importance of measuring multiple dynamic parameters such as recovery when investigating physiological stress response patterns as a function of psychosocial factors.     

Loneliness accentuates age differences in cardiovascular responses to social evaluative threat

The effects of aging and loneliness on cardiovascular stress responses were examined in 91 young (18-30 years) and 91 older (65-80 years) normotensive adults. Participants completed the revised UCLA Loneliness Scale and a modified version of the Trier Social Stress Test. Piece-wise linear growth-curve analysis was used to model group differences in resting, reactivity, and recovery levels of systolic blood pressure (SBP) and diastolic blood pressure (DBP). Replicating and extending prior research, analyses revealed age-related increases in resting SBP and DBP. Adjusting for demographics and health covariates, interactions were found for SBP in which age differences in stress reactivity and recovery were greater among lonely than nonlonely participants. Findings provide further evidence that loneliness interacts with age to augment cardiovascular risk to social evaluative threat.     

Age-related differences in ambulatory blood pressure during daily stress: evidence for greater blood pressure reactivity with age

Prior research on age and emotions has found that older adults may show better physiological regulation to stressful stimuli than do younger adults. However, the stress reactivity literature has shown that age is associated with higher cardiovascular reactivity to laboratory stress (J. R. Jennings et al., 1997). The authors investigated these conflicting findings further by examining daily ambulatory blood pressure in 428 middle-aged to older adults. Consistent with the age and reactivity literature, relatively old individuals showed significantly greater increases in ambulatory diastolic blood pressure compared with younger individuals when dealing with daily stressors. However, results also revealed that relatively old individuals reported less of an increase in negative affect during daily stress compared with their younger counterparts. The results of this study are consistent with the age-related increase in cardiovascular risk but highlight the complex links between stress and different facets of the aging process.