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INDIVIDUAL AND SOCIOECONOMIC VARIABLES AFFECTING BLOOD PRESSURE RESPONSES TO PSYCHOLOGICAL STRESS

Exaggerated blood pressure (BP) responses to stress may be a mechanism or marker for the development of hypertension. In a sample of 211 healthy children between the ages of 6-18 years, we administered a psychological stressor (3 video games) while monitoring BP. If a child's BP (systolic and diastolic) values for each video game were above the median, the child was classified as hyperreactive. We found that 34, or 16%, were classified as hyperreactive. Variables investigated for possible association with hyperreactivity included gender, race, income (as a measure of socio-economic status [SES]), physical activity level, Quetelet index, age, and family history of cardiovascular disease. Only two variables were significantly associated classification as hyperreactive: race and SES. Black children were 3.5 times more likely to demonstrate hyperreactivity than white children. Likewise, children of low SES were 3.2 times more likely to demonstrate hyperreactivity than high SES children. Thus, in normotensive healthy children, low SES black children were at the highest risk of being classified as hyperreactive to a psychologic stressor, i.e., 4.7 times more likely than high SES white children. These data may have critical impact upon research investigating the pathogenesis of hypertension in black Americans. Intervention studies in high risk populations, such as low SES blacks, which attempt to reduce physiologic response to environmental stress, seem to be justified.