Thayer Julian F, Carnevali Luca, Sgiofo Andrea, Williams DeWayne P
Department of Psychological Science, University of California, Irvine, CA, USA.
Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Italy.
Ann Behav Med. 2020 Dec 1;54(12):924-931. doi: 10.1093/abm/kaaa094.
African Americans have the highest rates of hypertension-related disease of any ethnic group in the USA. Importantly, racism and discrimination have been linked to these higher rates of morbidity and mortality. Discrimination is deleterious not only to those that are the recipients of this unfair treatment but also to the partners and family members of those affected as well to those that perpetrate this bias.
In this paper, we identify a unique pattern of physiological response to unfair treatment, we have called the "cardiovascular conundrum." This pattern is characterized by greater heart rate variability and greater total peripheral resistance in African Americans compared to their European American counterparts.
We review the evidence supporting the existence of this pattern and propose several physiological and psychological factors that might underpin it. We also propose a number of factors that might help to mitigate the deleterious effects associated with it.
Whereas the context of the current review is on Black/White disparities the framework we propose may be relevant to others exposed to unfair treatment. Ultimately, the systemic factors that perpetuate these inequalities will require that we first acknowledge and then face the challenges they present if we are to address the wealth and health disparities in our country.
在美国，非裔美国人患高血压相关疾病的比例高于其他任何种族群体。重要的是，种族主义和歧视与这些较高的发病率和死亡率有关。歧视不仅对遭受这种不公平待遇的人有害，而且对受影响者的伴侣和家庭成员以及实施这种偏见的人也有害。
在本文中，我们确定了一种对不公平待遇的独特生理反应模式，我们称之为“心血管难题”。与美国白人相比，非裔美国人的这种模式表现为心率变异性更大和总外周阻力更大。
我们回顾了支持这种模式存在的证据，并提出了一些可能是其基础的生理和心理因素。我们还提出了一些可能有助于减轻与之相关的有害影响的因素。
尽管当前综述的背景是黑/白差异，但我们提出的框架可能与其他遭受不公平待遇的人相关。最终，如果我们要解决我国的财富和健康差距问题，使这些不平等长期存在的系统性因素将要求我们首先承认，然后面对它们带来的挑战。
