Differential Impact of Stress Reduction Programs upon Ambulatory Blood Pressure among African American Adolescents: Influences of Endothelin-1 Gene and Chronic Stress Exposure

Abstract

Stress-activated gene × environment interactions may contribute to individual variability in blood pressure reductions from behavioral interventions. We investigated effects of endothelin-1 (ET-1) LYS198ASN SNP and discriminatory stress exposure upon impact of 12-week behavioral interventions upon ambulatory BP (ABP) among 162 prehypertensive African American adolescents. Following genotyping, completion of questionnaire battery, and 24-hour ABP monitoring, participants were randomized to health education control (HEC), life skills training (LST), or breathing awareness meditation (BAM). Postintervention ABP was obtained. Significant three-way interactions on ABP changes indicated that among ET-1 SNP carriers, the only group to show reductions was BAM from low chronic stress environments. Among ET-1 SNP noncarriers, under low chronic stress exposure, all approaches worked, especially BAM. Among high stress exposure noncarriers, only BAM resulted in reductions. If these preliminary findings are replicated via ancillary analyses of archival databases and then via efficacy trials, selection of behavioral prescriptions for prehypertensives will be edging closer to being guided by individual's underlying genetic and environmental factors incorporating the healthcare model of personalized preventive medicine.

Formative evaluation on cultural tailoring breathing awareness meditation smartphone apps to reduce stress and blood pressure

“…We have observed promising results from two 3-month smartphone delivered TT trials (37,41,42), where TT was found to be highly acceptable and intuitive in its use. In addition, clinically meaningful reductions in resting BP, ambulatory BP and reductions in SNS activation (i.e., reduced morning awakening curve of salivary alpha amylase) have been observed in preEH White and African American adults outlining a biological mechanistic pathway for BAM and resultant stress reduction (15,41,42).…”

“…Stress exposure also increases unhealthy coping behaviors such as comfort eating, smoking, excessive alcohol intake, pharmaceutical abuse and increased sedentary activity. These behaviors exacerbate psychological and physiological stress-related symptoms and increase risk for disease (9)(10)(11)(12)(13)(14)(15). There is reason to believe health disparities also contribute to stress resulting in differences in trust and engagement in the health care system (16).…”

Tension Tamer: Delivering Meditation With Objective Heart Rate Acquisition for Adherence Monitoring Using a Smart Phone Platform

“…In previous work, we have examined and demonstrated that stress-related gene · environment contributions can modulate the benefit of a meditation intervention in terms of ambulatory blood pressure reduction. 5 Another potential modulator that we have not fully examined is adherence.…”

Dysregulated aldosterone secretion in persons of African descent with endothelin-1 gene variants

“…Its widespread potential effects include modification of risk for HTN in the overweight/obese population (41-43), BP reactivity to stressors (44)(45)(46), idiopathic pulmonary arterial Figure 4. Comparison in European descent subjects and African descent subjects of aldosterone/renin ratio was obtained on a restricted salt diet.…”

“…Several other factors may, in part, explain the differences between the AD and ED. First, some studies have reported a relationship between the level of stress and the relationship between BP and EDN1 polymorphism and between AD and BP (45,46,55,56). Stress profiles are not present in the HyperPATH data set, and salt sensitivity of BP, ALDO, ARR, or SASSI-II were not performed in these previous studies.…”