High levels of chronic stress associated with hypertension in African Americans


African Americans reporting high levels of chronic stress tended to develop hypertension or hypertension, more often than those who reported low levels of stress, according to new research published in Diary of the American Heart Association, the open-access journal of the American Heart Association.

The researchers say that psychosocial stress is involved in the development of hypertension and note that African Americans experience greater exposure to specific chronic stress factors such as discrimination and low socioeconomic status. African Americans also report higher levels of overall stress than whites.

Given the disproportionately high burden of hypertension in African Americans, determining whether chronic stress increases the risk of hypertension in this population is an important question that could guide prevention strategies. "

Tanya Spruill, Ph.D., associate professor in the departments of health and population medicine at the NYU School of Medicine

Analyzing data from over 1,800 African Americans without hypertension who participated in the Jackson Heart Study, the researchers examined the potential association between chronic stress and hypertension. During the nearly 13-year study period, three study visits were conducted, each including home-based interviews and clinical examinations in which blood pressure was measured. Evaluations of perceived stress were collected during the annual follow-up telephone assessments and the researchers classified the participants into groups that reported low, moderate or high chronic stress.

They found that for about seven years, African Americans who reported high levels of stress over time had a 22% increased risk of developing high blood pressure compared to people who reported low and sustained stress levels. This association was independent of socio-demographic factors, traditional hypertension risk factors, health behaviors and underlying stress levels. This suggests that chronic stress can, over time, have a negative impact on cardiovascular health, especially hypertension.

"During the study follow-up period, almost half of the participants developed hypertension," said Spruill. "This highlights the need for new hypertension prevention strategies for African Americans. Lifestyle changes are effective, but can be difficult to achieve. Developing culturally sensitive stress management interventions can support primary prevention of hypertension and reduce the subsequent cardiovascular risk among African Americans. "

"Because this is an observational study, we interpret the results with caution. However, our results suggest that the assessment of chronic stress over time rather than on a single occasion may help to identify those at greatest risk. We believe that studies of intervention to determine whether reducing stress among African Americans can reduce the risk of developing hypertension. This could have a significant impact on cardiovascular health outcomes and inequalities. " Spruill said.



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