Martin Zachary T, Al-Daas Iman O, Cardenas Natalia, Kolade John O, Merlau Emily R, Vu Joshua K, Brown Kyrah K, Brothers R Matthew
medRxiv. 2023 Mar 17:2023.03.16.23287388. doi: 10.1101/2023.03.16.23287388.
Black women have the highest rates of cardiovascular and cerebrovascular disease prevalence and mortality in part due to blunted vascular function. Psychosocial stress likely also contributes but its relationship to vascular function remains incompletely understood. Recent studies suggest that internalization and coping strategies are more important than stress exposure alone. We hypothesized that Black women have blunted peripheral and cerebral vascular function and that, among Black women, this would be inversely related with psychosocial stress internalization/coping but not stress exposures. Healthy Black ( = 21; 20 ± 2 yr) and White ( = 16; 25 ± 7 yr) women underwent testing for forearm reactive hyperemia (RH), brachial artery flow-mediated dilation (FMD), and cerebrovascular reactivity (CVR). Psychosocial stress exposure (adverse childhood experiences, ACEs; past week discrimination, PWD) and internalization/coping techniques (John Henryism Active Coping Scale, JHAC12; Giscombe Superwoman Schema Questionnaire, G-SWS-Q) were assessed. RH and CVR ( > 0.05) were not different between groups whereas FMD was lower in Black women ( = 0.007). Neither ACEs nor PWD were associated with FMD in either group ( > 0.05 for all). JHAC12 scores were negatively associated with FMD in Black women ( = 0.014) but positively associated with FMD in White women ( = 0.042). SWS-Succeed was negatively associated ( = 0.044) and SWS-Vulnerable tended to be negatively associated ( = 0.057) with FMD in Black women. These findings indicate that blunted FMD in Black women may be due more to internalization and maladaptive coping than stress exposure alone.
黑人女性的心血管和脑血管疾病患病率及死亡率最高,部分原因是血管功能受损。心理社会压力可能也有影响,但其与血管功能的关系仍未完全明了。近期研究表明,内化和应对策略比单纯的压力暴露更为重要。我们假设黑人女性的外周和脑血管功能受损,而且在黑人女性中,这与心理社会压力内化/应对呈负相关,而与压力暴露无关。健康的黑人女性(n = 21;20±2岁)和白人女性(n = 16;25±7岁)接受了前臂反应性充血(RH)、肱动脉血流介导的舒张(FMD)和脑血管反应性(CVR)测试。评估了心理社会压力暴露(不良童年经历,ACEs;过去一周的歧视,PWD)以及内化/应对技巧(约翰·亨利主义积极应对量表,JHAC12;吉斯科姆女超人模式问卷,G-SWS-Q)。两组之间的RH和CVR无差异(P>0.05),而黑人女性的FMD较低(P = 0.007)。两组中,ACEs和PWD均与FMD无关(所有P>0.05)。在黑人女性中,JHAC12评分与FMD呈负相关(P = 0.014),而在白人女性中与FMD呈正相关(P = 0.042)。在黑人女性中,SWS-成功与FMD呈负相关(P = 0.044),SWS-易受伤害与FMD呈负相关趋势(P = 0.057)。这些发现表明,黑人女性FMD受损可能更多是由于内化和适应不良的应对,而非单纯的压力暴露。