Background: Black women have among the highest rates of cardiovascular and cerebrovascular disease prevalence and mortality in part due to blunted vascular function. Psychosocial stress likely also contributes but its relationship to vascular function remains incompletely understood. Recent studies suggest that stress internalization and coping strategies are more important than stress exposure alone. We hypothesized that Black women would have blunted peripheral and cerebral vasodilation and that, among Black women, this would be inversely related with psychosocial stress internalization/coping but not stress exposures. Methods: Healthy Black (n=21; 20±2 years) and White (n=16; 25±7 years) women underwent testing for forearm reactive hyperemia, brachial artery flow-mediated dilation (FMD), and cerebrovascular reactivity. Psychosocial stress exposure (adverse childhood experiences; past week discrimination) and internalization/coping techniques (John Henryism Active Coping Scale, John Henryism Active Coping Scale; Giscombe Superwoman Schema Questionnaire) were assessed. Results: Reactive hyperemia and cerebrovascular reactivity were not different between groups ( P >0.05), whereas FMD was lower in Black women ( P =0.007). Neither adverse childhood experiences nor past week discrimination were associated with FMD in either group ( P >0.05 for all). John Henryism Active Coping Scale scores were negatively associated with FMD in Black women ( P =0.014) but positively associated with FMD in White women ( P =0.042). Superwoman Schema–Succeed was negatively associated ( P =0.044) and Superwoman Schema–Vulnerable tended to be negatively associated ( P =0.057) with FMD in Black women. Conclusions: These findings indicate that blunted FMD in Black women may be due more to stress internalization and maladaptive coping than stress exposure alone.

Non-Hispanic Black (BL) individuals are ~2-times more likely to suffer from conditions including cognitive dysfunction and Alzheimer’s disease and related dementias (ADRD) – conditions which are among the fastest growing causes of morbidity and mortality in the US. The prevalence of ADRD is expected to double by 2060 with a more rapid increase in the BL (and Hispanic) population. Importantly, reduced vascular function, particularly in the cerebral circulation, contributes to elevated risk for and prevalence of ADRD. While previous research has provided valuable insight into mechanisms of cerebral vascular dysfunction, this work has been primarily conducted in males and has largely not included socioeconomic/racial discrimination measurements, which are critical to understanding race/ethnicity-related disparities in cerebral vascular health. To our knowledge no studies have specifically examined cerebral vascular function in young, healthy BL females relative to WH females. Therefore, we tested the hypothesis that cerebral vascular function would be blunted in BL relative to WH females. METHODS: Eleven healthy WH (age: 26±7 yr; BMI: 26±3 kg/m2) and 17 healthy (age: 21±2 yr; BMI: 26±4 kg/m2) BL females participated. Beat-to-beat blood pressure, end-tidal carbon dioxide tension, and middle cerebral artery mean blood velocity (MCAVmean) were continuously collected. Transfer function analysis (i.e. gain, phase, and coherence) of blood pressure and MCAVmean were calculated in the very-low, low, and high-frequency ranges to assess cerebral autoregulation. Cerebral vascular function was also assessed as the % increase in MCA vascular conductance (CVCi = MCAVmean/mean arterial pressure) during administration of a hypercapnic gas (6% CO2 gas). Socioeconomic background and psychosocial stress exposures were assessed as: 1) parental education level; 2) adverse childhood experiences (ACEs); and 3) perceived ethnic discrimination (PEDQ). RESULTS: Transfer function analysis of gain, phase, and coherence was similar across all frequency ranges ( P>0.05 for all) and the % increase in CVCi ( P=0.71) during hypercapnia was similar between BL and WH females. Although perceived ethnic discrimination was greater in BL relative to WH females ( P<0.001), there were no group differences in parental education level nor ACEs ( P>0.05 for both). CONCLUSION: These preliminary data suggest that cerebral vascular function is not different between young, healthy BL and WH females of similar socioeconomic background. Future studies should continue to examine these relationships but expand inclusion to a wider age group with a greater diversity in socioeconomic background. Funding: NIH R15 (HL156128, RMB) & AHA Predoctoral Fellowship (915133, ZTM) This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Black women have the highest rates of cardiovascular and cerebrovascular disease prevalence and mortality in part due to blunted vascular function. Psychosocial stress likely also contributes but its relationship to vascular function, remains incompletely understood. Recent studies suggest that internalization and coping strategies are more important than stress exposure alone. We hypothesized that Black women have blunted peripheral and cerebral vascular function and that among Black women, this would be inversely related more with psychosocial stress internalization/coping relative to stress exposures alone. Healthy Black (n= 21; 20 2 yr) and White (n= 16; 25 7 yr) women underwent testing for forearm reactive hyperemia (RH), brachial artery flow-mediated dilation (FMD), and cerebrovascular reactivity (CVR). Psychosocial stress exposure (adverse childhood experiences, ACEs; past week discrimination, PWD) and internalization/coping techniques (John Henryism Active Coping Scale, JHAC12; Giscombe Superwoman Schema Questionnaire, G-SWS-Q) were assessed. RH and CVR (p> 0.05) was similar whereas FMD was lower in Black women (p= 0.007). Neither ACEs nor PWD were associated with FMD in either group (p> 0.05 for all). JHAC12 scores were negatively associated with FMD in Black (p= 0.014) but positively associated with FMD in White (p= 0.042) women. SWS-Motivation to Succeed was negatively associated (p= 0.044) and SWS-Resistance to Being Vulnerable tended to be negatively associated (p= 0.057) with FMD in Black women. These findings indicate that blunted FMD in Black women may be due more to internalization and maladaptive coping than stress exposure alone.

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Introduction: Among females in the United States, Black females suffer from the highest rates of hypertension, coronary artery disease, and total cardiovascular disease (CVD) mortality. Vascular endothelial dysfunction precedes overt CVD and predicts CVD risk and has been reported in this population, but this is not always a consistent finding. Although psychosocial stress from numerous sources likely contributes to this disparity, the precise pathways and mechanisms remain incompletely understood. A growing literature suggests that internalization and coping may be more important than exposure to stressors alone. Therefore, we examined the relationship between endothelial function (brachial artery flow-mediated dilation, FMD) and psychosocial stress exposure (adverse childhood experiences, ACEs; past week discrimination, PWD) versus internalization/coping (John Henryism Active Coping Scale, JHAC12; Giscombe Superwoman Schema Questionnaire, G-SWS-Q). We hypothesized that 1) FMD would be blunted in Black relative to White females and 2) among Black females, internalization and maladaptive coping would exhibit a stronger negative relationship with FMD than exposure to stressful experiences alone. Methods: Twelve Black (21 ± 3 yr) and 8 White (25 ± 6 yr) healthy females underwent standard FMD testing. Black participants completed the ACEs, PWD, JHAC12, and G-SWS-Q inventories. Higher scores indicated greater stressor exposure or endorsement of the internalization/coping constructs. Results: Brachial artery FMD was lower in Black relative to White females (4.93 ± 3.10 vs 8.58 ± 1.62%; p < .01). Neither ACEs ( r = -.10, p = .75) nor PWD ( r = -.24, p = .45) were associated with FMD. JHAC12 scores were ( r = -.61, p = .02) and SWS scores tended to be ( r = -.39, p = .11) negatively associated with FMD. Among the SWS subscales, SWS-Resistance to Being Vulnerable ( r = -.51, p = .04) and SWS-Intense Motivation to Succeed ( r = -.54, p = .04) were negatively associated with FMD. Conclusion: These preliminary data indicate that 1) brachial artery endothelial function is blunted in young Black females and 2) reduced vascular function in Black females may be due more to internalization and maladaptive coping than exposure to stressful experiences alone.