Blood Pressure Control--Racial and Psychosocial Influences

May 12, 2016 updated by: National Heart, Lung, and Blood Institute (NHLBI)
To examine racial and psychosocial influences on blood pressure control.

Study Overview

Status

Completed

Conditions

Detailed Description

BACKGROUND:

Environmental and psychosocial factors relating to hypertension and cardiovascular disease are incompletely understood, particularly for women and African Americans. Recent research has suggested that job strain is more strongly linked to elevated work blood pressure in men than women. In contrast, the combination of having a high status job plus the trait of high effort coping style (John Henryism) was related to higher work blood pressure in women and African American men, but not Caucasian men.

The grant has been ongoing since September 1983. The original study had as its purpose to ascertain similarities and differences in the etiology of hypertension for Blacks and whites and to identify those biobehavioral factors contributing to the excess risk for hypertension among Blacks. Myocardial, blood pressure, and renal responses (sodium and potassium handling) to laboratory and naturalistic stressors were evaluated in young adult normotensive or marginally hypertensive Black and white men. Behavioral stressors included competitive, reaction time tasks (active coping) as well as more passive coping conditions. Data were collected on family history of hypertension, family social class background, Type A behavior, propensity for anger and hostility, and coping style. The role of the sympathetic nervous system in mediating these effects was assessed by the use of beta-adrenergic antagonists.

When the grant was renewed in 1991, the goal of the research was to evaluate the interactive effects of environmental stressors and sodium chloride (NACl) and potassium (K) intake as they related to hypertension development in a biracial population.

DESIGN NARRATIVE:

There were two studies in the current grant. Study 1 reexamined hypothesized relationships of high effort coping and job strain to elevated ambulatory blood pressure (BP) at work and at home in a sample of 288 Black and white men and women stratified by job status. Also, assessments were made of the relationships of these traits to increased epinephrine and norepinephrine responses, other measures of sympathetic activation, adverse lipid profiles, and cardiac and vascular structural changes. Job strain and high effort coping were also related to hypertension prevalence in 576 black and white men and women stratified by job status. The influence of additional psychosocial variables (social support, hostility, anger-in, depressed mood, anxiety) was also examined.

Study 2 built on prior research on gender differences in total peripheral resistance during stressors which enhance alpha-adrenergic activity, and on a recent observation that among young adults, slow sodium excretion during stress is seen in five times as many men as women. It also built on recent work suggesting that estrogen may attenuate total peripheral resistance responses to stress by reducing vasoconstrictive effects of alpha-adrenergic activity. The study was designed to examine cardiovascular, lipid, epinephrine, norepinephrine, and sodium excretion responses to stressors in 120 subjects maintained for a week on a controlled high salt diet. Thirty subjects were tested in each of these groups: 1) premenopausal women, 2) postmenopausal women not using hormone replacement therapy, 3) postmenopausal women using hormone replacement, 4) men. Each group included 15 Black and 15 white subjects, and each subject was tested twice, once after receiving placebo and once after receiving either an alpha- or a beta-receptor antagonist.

The study completion date listed in this record was obtained from the "End Date" entered in the Protocol Registration and Results System (PRS) record.

Study Type

Observational

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

No older than 100 years (Child, Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

Male

Description

No eligibility criteria

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Collaborators and Investigators

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Sponsor

National Heart, Lung, and Blood Institute (NHLBI)

Investigators

  • Kathleen Light, University of North Carolina

Publications and helpful links

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General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

September 1, 1983

Study Completion (Actual)

July 1, 2002

Study Registration Dates

First Submitted

May 25, 2000

First Submitted That Met QC Criteria

May 25, 2000

First Posted (Estimate)

May 26, 2000

Study Record Updates

Last Update Posted (Estimate)

May 13, 2016

Last Update Submitted That Met QC Criteria

May 12, 2016

Last Verified

January 1, 2006

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 4131
  • R01HL031533 (U.S. NIH Grant/Contract)

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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