Defensive coping and subclinical vascular disease risk – Associations with autonomic exhaustion in Africans and Caucasians: The SABPA study

Defensive coping and renovascular disease risk — Adrenal fatigue in a cohort of Africans and Caucasians: The SABPA study

“…Nonetheless, the Africans also revealed probable alcohol abuse and this might further enhance dysregulation of the HPAA [29][30]. Subsequently, the damaging effects of increased cortisol, in prolonged unmanageable stress (when defensive coping "fails" or dissociate) [11], as well as the probable cortisol sensitivity of the Africans, may affect end-organ function [2,24,[31][32]. Indeed, we were able to demonstrate more prominent increased renovascular disease risk in the defensive coping Africans within the low and high cortisol categories.…”

“…These responses are closely associated with the defensive coping response, in which an individual will actively seek ways to solve the problem at hand, with hard work, determination, as well as intense control over the situation and/or by asking others for help [5][6]. The effects of norepinephrine in defensive coping Africans have been explained previously, showing that decreased norepinephrine metabolites are associated with an enhanced risk of subclinical vascular disease in these Africans [2]. This may be due to autonomic exhaustion subsequent to prolonged sympathetic hyperactivity.…”

“…Values above the mean of 26 on the defensive coping scale, as well as 19 on emotional avoidance, and 23 on seeking social support, were documented as high preference for the specific coping response [5]. We focussed on defensive coping as this is associated more with cardiovascular risk in Africans [2,13].…”

“…The Coping Strategy Indicator (CSI) questionnaire developed by Amirkhan, determined the preferred coping strategy of each self-reporting participant, whilst thinking of a specific stressful situation in the last six months [5]. The following three strategies were included in the CSI; problem solving (formerly described as defensive coping), seeking social support, and emotional avoidance [2,5]. A Cronbach's alpha reliability coefficient of between 0.81 and 0.87 was determined for defensive coping, 0.61-0.85 for emotional avoidance, and 0.83-0.90 for seeking social support.…”

“…Chronic exposure to these hormones can cause permanent autonomic changes and increases in cardiovascular disease risk [1][2][3][4]. Norepinephrine and cortisol are released when the stress response is activated by the sympathoadrenal-medullary (SAM) and hypothalamic-pituitary-adrenal axis (HPAA) neural systems.…”