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怀孕非裔美国人的血管舒张功能受损:潜在的潜在前因和后果的初步证据。

Impaired vasodilation in pregnant African Americans: Preliminary evidence of potential antecedents and consequences.

机构信息

Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA.

The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA.

出版信息

Psychophysiology. 2021 Jan;58(1):e13699. doi: 10.1111/psyp.13699. Epub 2020 Oct 11.

Abstract

Significant health disparities exist between African Americans (AA) and European Americans (EA) in hypertension and hypertension-related disorders. Evidence suggests that this is due to impaired vasodilation in AAs. Pregnancy is a potent systemic vasodilatory state. However, differences in vasodilation between AAs and EAs have not been investigated in pregnancy. We sought to examine the effects of pregnancy on vasodilation in AA and EA women and how this might be related to discrimination and low birth weight in their offspring. Hemodynamics [blood pressure (MAP), cardiac output (CO), total peripheral resistance (TPR)] and heart rate variability (HF-HRV) were examined at baseline in 40 pregnant AAs (n = 20) and EAs (n = 20) and matched nonpregnant women (n = 40). The Experiences of Discrimination scale and birth weight were also measured in the offspring of the pregnant participants. Whereas pregnancy was associated with decreased MAP independent of race, AAs showed impaired vasodilation independent of pregnancy status as indicated by greater TPR despite greater HF-HRV. In AAs, but not EAs, reports of fewer incidences of discrimination were associated with greater TPR. Finally, the HF-HRV of EA mothers was inversely related to the birth weight of their offspring but was uncorrelated in AAs. We report novel evidence of impaired vasodilation to an endogenous vasodilatory stimulus in AAs. Higher TPR was related to discrimination in AAs and higher HF-HRV was related to low birth weight in EAs. These findings have implications for understanding the intergenerational transmission of impaired vasodilation in AAs.

摘要

非裔美国人和欧洲裔美国人(EA)在高血压和与高血压相关的疾病方面存在显著的健康差距。有证据表明,这是由于非裔美国人的血管舒张功能受损。怀孕是一种强大的全身血管舒张状态。然而,尚未在怀孕期间研究非裔美国人和 EA 之间的血管舒张差异。我们试图研究怀孕对非裔美国人和 EA 女性血管舒张的影响,以及这如何与她们子女的歧视和低出生体重有关。在 40 名怀孕的非裔美国女性(n=20)和 EA(n=20)和匹配的未怀孕女性(n=40)中,基线时检查了血液动力学[血压(MAP)、心输出量(CO)、总外周阻力(TPR)]和心率变异性(HF-HRV)。还测量了怀孕参与者子女的歧视经历量表和出生体重。尽管 HF-HRV 更大,但怀孕与 MAP 降低有关,而与种族无关,而非裔美国人的血管舒张功能受损,与怀孕状态无关,这表明 TPR 更高。在非裔美国人中,但在 EA 中并非如此,报告的歧视发生率较低与 TPR 较高有关。最后,EA 母亲的 HF-HRV 与其子女的出生体重呈负相关,但在非裔美国人中则无关。我们报告了非裔美国人对内源性血管舒张刺激血管舒张受损的新证据。在非裔美国人中,较高的 TPR 与歧视有关,而在 EA 中,较高的 HF-HRV 与低出生体重有关。这些发现对理解非裔美国人血管舒张受损的代际传递具有重要意义。

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