Impact of Perceived Discrimination on Cardiovascular Blunting among African Americans in Rural and Urban Settings

African Americans (AAs) suffer disproportionately from premature mortality and cardiovascular disease (CVD) compared to their European American counterparts. Hypertension and related complications account for the largest proportion of CVD-related deaths among African Americans (Wong, Shapiro, Boscardin & Ettner, 2002). Stressors such as perception of exposure to racial discrimination have been identified as important unique predictors of morbidity and mortality related to CVD and hypertension. Further, evidence demonstrates that individual difference person factors such as racial identity may moderate the negative impact of racial discrimination on elevated blood pressure (Harrell, Burford, Cage, Nelson, and Shearon, 2011;) Neblett & Roberts, 2013). Traditionally, the cardiovascular reactivity model has been used to understand the association between psychosocial stress and autonomic dysregulation and hypertension. Specifically, the model proposes that exaggerated compared to blunted cardiovascular reactions to acute psychological stress is related to increased risk for hypertension and premature elevations in blood pressure. However, more recently, emerging evidence suggests that blunting cardiovascular stress reaction (blunted peripheral physiological stress reactivity) is an alternative mechanism through which psychosocial stressors confers poor cardiovascular health (Carroll, Ginty, Whittake, Lovallo, and de Rooji, 2017; Ginty, Gianaros, Derbyshire, Phillips, and Carroll, 2013). For example, blunted cardiovascular and cortisol reactions to acute stress have been associated with obesity, depression, self-reported health and smoking (Ginty, Gianaros, Derbyshire, Phillips, and Carroll, 2013). While cardiovascular blunting has been documented in European samples and more recently in indigenous individuals (rural Maori), to our knowledge, there are no studies that have examined the relationship between blunted cardiovascular reactivity among African Americans. Given the potential role of blunted peripheral physiological stress reactivity in adverse cardiovascular health, and the absence of data on African Americans, the purpose of this study was to address this gap in the literature.