Race and blood pressure status influences cardiovascular responses to challenge

Saab, Patrice G.; Tischenkel, Nancy J.; Spitzer, Susan B.; Gellman, Marc D.; Pasin, Rosemary DeCarlo; Schneiderman, Neil

doi:10.1097/00004872-199103000-00009

Cited by 22 publications

(12 citation statements)

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“…33 Thus, the synergistic effects of increased receptor bound ET-1 and reduced vasodilator responsiveness to classic vasodilators may explain the race differences in vasoconstrictive tone at rest or during acute physical or mental stress, particularly in studies involving healthy youths 10,11 and young adults. 8,9 Although the findings are provocative, they should be interpreted cautiously for several reasons. First, the sample consisted of youths with family histories of EH.…”

Section: Discussionmentioning

confidence: 95%

“…4 Although not entirely consistent, exaggerated blood pressure (BP) reactivity to brief laboratory stressors has been shown to be an independent predictor of future BP levels in youths and of EH in adults (see reviews [5][6][7]. Studies that involve normotensive adults 8,9 and youths 10,11 have found that blacks exhibit greater BP increases in response to acute stress than do whites and that these differences are frequently mediated by greater increases in total peripheral resistance (TPR).…”

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confidence: 99%

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Racial Differences in Endothelin-1 at Rest and in Response to Acute Stress in Adolescent Males

et al. 2000

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Abstract-Blacks exhibit greater vasoconstriction-mediated blood pressure (BP) increases in response to stress than do whites. Endothelin-1 (ET-1), a potent vasoconstrictive peptide, has been proposed as having a role in racial differences in stress reactivity. We evaluated the hemodynamic and plasma ET-1 levels of 41 (23 whites, 18 blacks, mean age 18.6 years) normotensive adolescent males at rest and in response to a video game challenge and forehead cold stimulation.Measurements were performed at catheter insertion and before and immediately after the 2 stressors, which were separated by 20-minute rest periods. Blacks exhibited higher absolute levels of diastolic blood pressure, total peripheral resistance index, or both in response to catheter insertion and to the video game challenge and during recovery from video game challenge and cold stimulation (PϽ0.05 for all). Blacks exhibited higher absolute levels of ET-1 at every evaluation point (PϽ0.05 for all) and greater increases in ET-1 in response to both stressors (psϽ0.05). These findings suggest that altered endothelial function may be involved in racial differences in hemodynamic reactivity to stress and possibly in the development of essential hypertension. Key Words: endothelin Ⅲ stress Ⅲ blood pressure Ⅲ race Ⅲ young adults Ⅲ blacks Ⅲ hypertension, essential B lacks experience a higher prevalence and earlier onset of essential hypertension (EH) and more frequent associated target-organ damage than do whites. 1 Although a few race-specific genetic factors have been identified, 2,3 raceshared physiological mechanisms that contribute to the development of EH (eg, increased sympathetic nervous system [SNS] arousal in response to stress) are believed to be differentially activated within different environmental contexts. It has been postulated that blacks experience greater chronic SNS arousal due to more frequent exposure to social and environmental stressors (eg, aversive social interactions related to socioeconomic status inequality, racism). 4 Although not entirely consistent, exaggerated blood pressure (BP) reactivity to brief laboratory stressors has been shown to be an independent predictor of future BP levels in youths and of EH in adults (see reviews 5-7 ). Studies that involve normotensive adults 8,9 and youths 10,11 have found that blacks exhibit greater BP increases in response to acute stress than do whites and that these differences are frequently mediated by greater increases in total peripheral resistance (TPR).The underlying physiological mechanisms responsible for enhanced vasoconstrictive responsivity (ie, increased TPR) to stress in blacks are unknown. Endothelial cell-derived vasoconstrictive and vasodilator substances are central to the regulation of vascular tone. Endothelin-1 (ET-1) is a 21-residue peptide with potent vasoconstrictive activity. 12 ET-1 is expressed by endothelial cells and is primarily released basolaterally to elicit smooth muscle cell contractions. 13 Therefore, circulating ET-1 may reflect only a minor portion o...

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Section: Discussionmentioning

confidence: 95%

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confidence: 99%

Racial Differences in Endothelin-1 at Rest and in Response to Acute Stress in Adolescent Males

et al. 2000

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“…16 Nevertheless the sympathetic nervous system is likely to play a role in the aetiology of raised blood pressure, at least in a proportion of patients 17 and the possibility of an enhanced role among black patients is suggested by the greater variation in BP found among blacks than whites in response to exogenous noradrenaline and to acute mental and physical stresses. 18,19 The interrelationships between the sympathetic nervous system, central obesity, and insulin resistance to produce elevated BP levels have been previously described. 20 However, overall BPs were highest in older black men and women, groups which are not particularly prone to central obesity or insulin resistance.…”

Section: Discussionmentioning

confidence: 98%

Blood pressure levels and hypertension status among ethnic groups in England

Primatesta

Bost

2000

J Hum Hypertens

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The prevalence of cardiovascular disease and hypertension show wide variability among different ethnic groups in the UK. We combined data collected annually between 1991-1996 in the Health Surveys for Englandnationwide surveys that provide information on the health status in a representative sample of the population living in England, to compare blood pressure (BP) levels, hypertension rates (systolic BP у160 mm Hg or diastolic BP у95 mm Hg, or those on antihypertensive medication), hypertension treatment and control rates in people of white, black (combining black-Caribbean, black-African and black-other), and South Asian origin (combining Indians, Pakistanis and Bangladeshis). Analyses were stratified into two age groups, 16-39 (younger) and у40 years (older), but were focused on older adults (30 619 whites, 295 blacks and 529 South Asians).Age-adjusted mean BP levels and hypertension rates

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“…The second additional external stressor is the inclusion of the digital game stressor in a battery of tasks, that is, a set of tasks or stressors presented to the participant in a series, in contrast to the presentation of one stressor. This procedure is found in several studies, mostly utilizing additional tasks such as reaction time or speech tasks (e.g., Ironson et al, ; Saab et al, ; Sita & Miller, ). This inclusion may alter the obtained baseline of the digital game stressor in cases where the other stressors are presented before obtaining the baseline, or change unmeasured internal endocrine or other physiological levels, which, in turn, potentially alter the stress response through carryover effects.…”

Section: Methodsmentioning

confidence: 99%

“…Digital games have been widely used as psychological stressors in the past decades and have been found to induce both physiological and psychological stress responses, such as altered heart rate and blood pressures increased cortisol level, altered aggressiveness, and prosocial behavior (see, among others, Barlett, Anderson, & Swing, ; Barlett, Harris, & Baldassaro, ; Dickerson & Kemeny, ; Miller & Ditto, ; Saab et al, ). They act as a psychological stressor by virtue of the challenges imposed on individuals: digital games present complex tasks that require intensive mental processing, are able to produce aversive stimuli, or create frustration from the inability to reach a desired goal in the game.…”

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confidence: 99%

Meta‐analysis of digital game and study characteristics eliciting physiological stress responses

et al. 2015

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Digital games have been used as stressors in a range of disciplines for decades. Nonetheless, the underlying characteristics of these stressors and the study in which the stressor was applied are generally not recognized for their moderating effect on the measured physiological stress responses. We have therefore conducted a meta-analysis that analyzes the effects of characteristics of digital game stressors and study design on heart rate, systolic and diastolic blood pressure, in studies carried out from 1976 to 2012. In order to assess the differing quality between study designs, a new scale is developed and presented, coined reliability of effect size. The results show specific and consistent moderating functions of both game and study characteristics, on average accounting for around 43%, and in certain cases up to 57% of the variance found in physiological stress responses. Possible cognitive and physiological processes underlying these moderating functions are discussed, and a new model integrating these processes with the moderating functions is presented. These findings indicate that a digital game stressor does not act as a stressor by virtue of being a game, but rather derives its stressor function from its characteristics and the methodology in which it is used. This finding, together with the size of the associated moderations, indicates the need for a standardization of digital game stressors.

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Race and blood pressure status influences cardiovascular responses to challenge

Cited by 22 publications

References 0 publications

Racial Differences in Endothelin-1 at Rest and in Response to Acute Stress in Adolescent Males

Racial Differences in Endothelin-1 at Rest and in Response to Acute Stress in Adolescent Males

Blood pressure levels and hypertension status among ethnic groups in England

Meta‐analysis of digital game and study characteristics eliciting physiological stress responses

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