Psychological Predictors of Blood Pressure in African Americans

Howard University, Washington DC

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Abstract

The sequelae of hypertension rank among the chief causes of death in the African American community. Interrupting the chain of events that contribute to hypertension would improve substantially the health status of this group. Borderline hypertensives are more likely to develop established hypertension over time. However, predictive models are in need of improvement. Behavioral approaches seek to identify modifiable elements of the environment or of persons that predispose one to cardiovascular disease. The present study tests the utility of three psychological and two psychophysiological predictors of arterial monitored for a period of four years. Resting blood pressure, depressive affect, and psychological stress levels will be assessed twice each year. Participants will complete indices of hostility and cultural orientation during the first and third years of the study. Regression models will determine if hostility, stress, depression, and cultural orientation predict existing blood pressure levels or increases in pressure over time. Cardiovascular reactivity to handgrip and psychomotor tasks will be expressed in terms of systemic overperfusion (additional cardiac output) and the ratio of shared versus simple contributions of cardiac and vascular determinants of blood pressure. These indices will be employed as predictors of both causal blood pressure levels and changes in blood pressure across the four-year measurement period. The study is designed to identify a set of predictors of blood pressure status that are subject to modification prior to the onset of the target organ damage associated with hypertension.