BIOBEHAVIORAL MECHANISMS OF BLOOD PRESSURE REGULATION

高血压在黑人中比白色男性更普遍， 男性比女性更普遍。此外，即使控制血液， 压力，向心性左心室肥厚，早期结构性 适应性高血压，在黑人中比白色男性更普遍， 男性比女性更普遍。向心性左心室肥大 是心血管疾病最强的预测因子，而不是年龄。 与高血压有关的发病率。拟议的研究将 研究生物行为因素在发病机制中的作用 向心性左心室肥厚 200例正常血压和临界高血压患者的血压样本 年龄在25-39岁的男性和女性将接受测试。向心性左 心室肥大和向心性重塑将通过以下方式进行评估： 超声心动图测量左心室质量和相对室壁 厚实验室程序将用于：（i）评估血流动力学 和神经体液的反应， 身体和心理压力，以及;（ii）评估α和β 肾上腺素能受体反应性、压力感受器反射增益和最小 前臂血管阻力因为在一个典型的工作日里， 是左心室肥大的既定预测指标， 进行评估。 将测试一种新的生物行为模型， 发病机制中的行为诱发升压反应模式 向心性左心室肥厚该模型的一个预测是， 在治疗过程中， 压力（黑人的特点）将有利于发展 向心性肥大因此，全身血管阻力反应， 在实验室评估，假设独立预测 左心室质量和相对壁厚，即使在控制 确定的风险因素，包括工作日血压。 将检查交感神经系统功能，以测试假设 血液动力学中种族和性别差异的机制 血压调节模式。这些研究的结果应该 强调种族和性别在处方药物时的重要性 和/或高血压性心脏病的行为治疗。

Hypertension is more prevalent in black than white men, and is more prevalent in men than women. Furthermore, even controlling for blood pressure, concentric left ventricular hypertrophy, an early structural adaptation of hypertension, is more prevalent in black than white men, and more prevalent in men than women. Concentric left ventricular hypertrophy is the strongest predictor, other than age, of the cardiovascular morbidity associated with high blood pressure. The proposed research will investigate the role of biobehavioral factors in the pathogenesis of concentric left ventricular hypertrophy. A biracial sample of two hundred normotensive and borderline hypertensive men and women aged 25-39 years, will be tested. Concentric left ventricular hypertrophy and concentric remodelling will be assessed by echocardiographic measures of left ventricular mass and relative wall thickness. Laboratory procedures will be used to: (i) assess hemodynamic and neurohumoral responses during exposure to a diverse battery of physical and psychological stressors, and; (ii) evaluate alpha and beta adrenergic receptor responsiveness, baroreceptor reflex gain and minimal forearm vascular resistance. Since blood pressure during a typical workday is an established predictor of left ventricular hypertrophy, it will also be assessed. A new biobehavioral model will be tested that implicates the hemodynamic pattern of behaviorally-evoked pressor responses in the pathogenesis of concentric left ventricular hypertrophy. One prediction of this model is that a predisposition to exhibit increased vascular resistance during stress (characteristic of black men) will favor the development of concentric hypertrophy. Thus, systemic vascular resistance responses, evaluated in the laboratory, are hypothesized to independently predict left ventricular mass and relative wall thickness, even after controlling for established risk factors, including workday blood pressure. Sympathetic nervous system function will be examined to test hypothesized mechanisms responsible for race and gender differences in the hemodynamic patterns of blood pressure regulation. The results of these studies should emphasize the impOrtance of race and gender in prescribing pharmacological and/or behavioral treatment for hypertensive heart disease.