Race and cardiovascular reactivity. A neglected relationship.

Abstract

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-

Central adiposity and hemodynamic functioning at rest and during stress in adolescents

“…20,21 Brie¯y, for the postural change stressor, the subject stood and placed the right arm at a 90 angle across the trunk and hemodynamic responses were recorded at 1 min intervals for 3 min. The 5 min video game challenge was based upon the protocol of Murphy et al 26 The subject remained supine with a 68.5 cm color television positioned at an appropriate height and angle for viewing the video game`Breakout' (Atari, Inc.). Three sets of hemodynamic readings were obtained during 1st, 3rd and 5th minute of the video game challenge, in which monetary incentive was used to increase involvement.…”

Hypertension in Black Patients

“…Consistent with this hypothesis, a number of studies have demonstrated that black Americans display greater cardiovascular reactivity to a number of physical and mental stressors. For example, Murphy et al 15 reported that black children and adolescents exhibit significantly higher blood pressure increase during a video game challenge. Similarly, Dysart et al 16 and Treiber et al 17 demonstrated that black children with a family history of essential hypertension manifest greater increases in total peripheral resistance, leading to greater increases in blood pressure in response to cold pressor test and the mental stress of playing a video game.…”

Exercise training favourably affects autonomic and blood pressure responses during mental and physical stressors in African-American men

“…[1][2][3][4] To date, stress-response studies have demonstrated that African-American (AA) men and individuals with a positive family history of hypertension have a greater propensity towards augmented BP reactivity compared with non-AA men. 4,5 These augmented BP responses appear to be mediated predominantly through changes in autonomic modulation. [5][6][7] Favourable modifications in autonomic modulation and BP have been documented following endurance training in animals and humans.…”

“…4,5 These augmented BP responses appear to be mediated predominantly through changes in autonomic modulation. [5][6][7] Favourable modifications in autonomic modulation and BP have been documented following endurance training in animals and humans. [8][9][10][11][12] Our prior study has demonstrated an augmentation in parasympathetic or vagal modulation and enhanced baroreflex sensitivity (BRS) and arterial compliance (AC) following aerobic training.…”