Hemodynamics and Vascular Hypertrophy in African Americans and Caucasians With High Blood Pressure

Hill, LaBarron K.; Blumenthal, James A.; Hinderliter, Alan L.

doi:10.1093/ajh/hpw080

Cited by 8 publications

(5 citation statements)

References 40 publications

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“…Therefore, the prominent vascular HP described here in healthy normotensive AAs may be among the earliest precursors to the development of hypertension in this ethnic group. Recent studies have suggested that the greater prevalence of hypertension observed in AAs may reflect a larger underlying pattern of vascular remodelling, by demonstrating (i) that total peripheral resistance was positively associated with minimal forearm vascular resistance, an index of vascular hypertrophy, among AAs, but not Whites, with elevated blood pressure (Hill, Sherwood, Blumenthal, & Hinderliter, 2016), and (ii) that in a sample of individuals with undiagnosed, untreated hypertension, AAs exhibited a blunted night-time BP dipping which was accompanied by an attenuated fall in total peripheral resistance compared with Whites (Sherwood, Hill, Blumenthal, & Hinderliter, 2018). The present findings in healthy normotensive young adults indicate statistically reliable higher values of resting diastolic BP in AAs, while no statistically reliable ethnic differences are observed in resting measures of MAP, systolic BP, cardiac output and total peripheral resistance although they were in the expected direction.…”

Section: Discussionmentioning

confidence: 99%

Hemodynamic profile and compensation deficit in African and European Americans during physical and mental stress

Carnevali

Ottaviani

Williams

et al. 2019

Biological Psychology

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Increased vascular reactivity to stress has been suggested to contribute to the greater risk for developing hypertension in African Americans. Here, we examined the way (hemodynamic profile) and the extent to which (compensation deficit) cardiac output and total peripheral resistance compensate for each other in determining blood pressure responses to a physical (orthostasis) and a mental (anger recall) stress task, in normotensive African American (AA, n = 30) and European American (EA, n = 48) college students. Blood pressure stress reactivity did not differ as a function of race. However, AAs showed a prominent vascular hemodynamic profile and a significant compensation deficit in response to both tasks, while EAs showed no hemodynamic response to orthostasis and a mixed profile in response to anger recall. The present findings demonstrate a more prominent vascular hemodynamic reactivity to stress in AAs, which could contribute to the pathogenesis of hypertension in this ethnic group.

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Section: Discussionmentioning

confidence: 99%

Hemodynamic profile and compensation deficit in African and European Americans during physical and mental stress

Carnevali

Ottaviani

Williams

et al. 2019

Biological Psychology

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“…SNS-mediated vascular dysfunction has been proposed as the predominant mechanism underpinning the higher burden of hypertension among African Americans [10][11][12]. Indeed, several lines of evidence provide converging support for this view including observations that African Americans tend to exhibit elevated SVR in early-stage hypertension, as well as greater levels of SVR at similar levels of BP, relative to European Americans [13][14][15]. SVR also has been shown to play a stronger role in diurnal BP regulation among African Americans relative to European Americans [16].…”

Section: Taking a Closer Look At Autonomic (Im) Balancementioning

confidence: 99%

The Autonomic Nervous System and Hypertension: Ethnic Differences and Psychosocial Factors

Hill

Thayer

2019

Curr Cardiol Rep

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Purpose of the Review-In the present paper, we overview emerging research examining the autonomic nervous system (ANS), especially the parasympathetic nervous system as indexed by heart rate variability (HRV), and the impact of psychosocial factors on hypertension-related disease in African Americans. Recent Findings-A growing corpus of studies has shown that (1) usual patterns of compensatory sympathetic-parasympathetic regulation differ between African Americans and European Americans; (2) despite their enhanced cardiovascular disease risk profile, African Americans tend to exhibit higher HRV relative to European Americans; and (3) racial discrimination and other forms of psychosocial stress are associated with diminished HRV among African Americans. Summary-Significant disparities in hypertension-related disease exist such that African Americans have greater risk. The underlying factors associated with this increased risk are, to date, not fully understood. The present review provides evidence for a unique pattern of ANS regulation in African Americans and shows that psychosocial factors such as racial discrimination may contribute to this paradoxical situation.

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“…Reflex and autonomic BP control is impaired in Blacks/African-Americans relative to Whites, as indicated by blunted carotid baroreflex responsiveness to hypertensive stimuli [105], upregulated alpha-adrenergic receptor sensitivity [106,107] coupled with depressed beta-adrenergic receptor responsiveness [107,108], enhanced sympathetic vascular transduction [109], and reduced nocturnal decline in epinephrine and norepinephrine excretion [76,110]. Functional and structural vascular deterioration in Blacks/African-Americans is further expressed as impaired endothelial responsiveness in the micro-and macro-circulation [111,112], heightened systemic and minimum forearm vascular resistance [113], and greater arterial stiffness [112,114]. Aberrant renin-angiotensin system and imbalanced electrolyte homeostasis, with elevated prevalence of salt sensitivity, are more common substrates of hypertension in African-Americans [115,116].…”

Section: Candidate Mechanismsmentioning

confidence: 99%

Disparities in Hypertension Among African-Americans: Implications of Insufficient Sleep

et al. 2018

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The prevalence of insufficient sleep is high and rising and has been recognized as an important cardiovascular risk factor. Presumably due to a constellation of environmental, psychosocial, and individual determinants, these risks appear exacerbated in Blacks/African-Americans, who are more likely to experience short sleep than other ethnic/racial groups. Population-based data suggest that the risk of hypertension associated with sleep deficiency is greater in those of African ancestry. However, there is a paucity of experimental evidence linking short sleep duration to blood pressure levels in African-Americans. Blacks/African-Americans may be more vulnerable to sleep deficiency and to its hypertensive effects. Future research is needed to unequivocally establish causality and determine the mechanism underlying the postulated racial inequalities in sleep adequacy and consequent cardiovascular risk.

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Hemodynamics and Vascular Hypertrophy in African Americans and Caucasians With High Blood Pressure

Abstract: Hypertrophy of the systemic microvasculature may contribute to the elevated SVR that is characteristic of the early stages of hypertension in African American compared with Caucasians.

Cited by 8 publications

References 40 publications

Hemodynamic profile and compensation deficit in African and European Americans during physical and mental stress

Hemodynamic profile and compensation deficit in African and European Americans during physical and mental stress

The Autonomic Nervous System and Hypertension: Ethnic Differences and Psychosocial Factors

Disparities in Hypertension Among African-Americans: Implications of Insufficient Sleep

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