SUMMARY The magnitude of the cardiovascular response to stress has been implicated in the pathogenesis of cardiovascular disease. Psychological stress procedures have received increased usage as an alternative to expensive physical (exercise) stress procedures. In the present investigation, 213 healthy, black or white, male or female children between the ages of 6 and 18 years were exposed to the psychological stress of a video game. The video game challenge was administered by a black or a white experimenter and was played under three levels of increasing stress, 1) personal challenge, 2) experimenter's challenge, and 3) experimenter's challenge accompanied by a financial incentive, while blood pressure and heart rate were monitored. Results indicated that the video games provoked significant and incremental cardiovascular reactivity across the games. Black children demonstrated significantly greater reactivity than white children; the racial difference was more reliably observed for systolic and diastolic blood pressure than for heart rate. Furthermore, the race of the experimenter exerted a significant effect and often interacted with the race of the child, such that greater reactivity occurred in same-race pairings than in mixed-race pairings. These results suggest that reactivity is affected by an individual's race and social milieu and that reactivity may be one mechanism responsible for the greater prevalence of hypertension among blacks. (Hypertension 8: 1075(Hypertension 8: -1083(Hypertension 8: , 1986 hypertension, ""^ but this association has not been consistent. 23 ' 2 * Unfortunately, the effects of race were not evaluated in these previous studies.In our previous studies 25 ' M with healthy children and adolescents, we found racial differences in the hemodynamic responses to the physical stress of maximal voluntary exercise on a cycle ergometer. Black children of both genders demonstrated significantly greater systolic BP (SBP) reactivity (maximal minus resting BP values) than did white children. These racial differences were obtained despite the demonstration that blacks and whites in the same gender groups showed no differences in either resting SBP or maximal heart rate (HR) during exercise. Because maximal exercise testing is a time-consuming and expensive procedure, we sought to evaluate the efficacy of a less involved procedure, the psychological challenge of playing a television video game, in provoking CV reactivity in a similar biracial sample of healthy children. Given the significance of the child's race during our physical stress studies, we also questioned whether the race of the experimenter would affect reactivity. As with the effects of the child's race, the effect of the experimenter's race on CV reactivity has received scant atten-
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