Racism, Coping and Ambulatory Blood Pressure

健康状况的种族差异，特别是黑人高血压(HT)的超标率， 得到了广泛的认可。调查人员假设，社会应激源，包括暴露于种族主义或 种族歧视可能会增加患高血压和心血管疾病(CVD)的风险。这个 这项拟议的研究的具体目的是测试一个模型，该模型描述了种族歧视、应对、 和动态血压(ABP)。该模型提出，感受到的种族歧视风险 B#是否与ABP的平均水平以及急性发作的严重程度和持续时间呈正相关？ 血压和心率对当前负面人际互动的反应。应对方式和 用于管理种族歧视的战略有望调解种族关系 对总部基地的歧视。社会经济地位(SES)预计将缓和种族主义与 应对方式、民族歧视与应对方式的关系。 为了检验该模型的泛化能力，假设将在720个多点样本中进行检验 美国出生的黑人和拉丁裔男性和女性来自城市初级保健医疗实践。这些 诊所位于文化多元化的社区，为来自社会经济领域的患者提供服务。 背景。参与者将佩戴24小时动态血压监测仪。 可用来评估过去遭受族裔/种族歧视的情况。在每次完成时完成的日记 动态血压读数将被用来识别检测当天的阴性和潜在的 歧视性的相互作用。独具特色的应对方式和特定事件的应对策略 与种族歧视有关的问题被审查。可能影响认知的人口统计和个性变量 将检查和控制种族歧视的可能性。将使用结构方程模型来 评估感受到的种族歧视与应对方式和ABP之间的关系。其他分析将 考察性别、社会地位和种族/民族与使用不同风格和策略的关系 应对民族歧视，以及这些特征对应对关系的影响 总部基地。这项研究对有关心理社会压力与高血压风险关系的理论有一定的指导意义 并制定干预措施，以减少健康状况方面的种族差异。

Racial disparities in health status, and in particular the excess rates of hypertension (HT) among Blacks, are widely recognized. Investigators have hypothesized that social stressors, including exposure to racism or ethnic discrimination, may contribute to increased risk for HT and cardiovascular disease (CVD). The specific aim of the proposed study is to test a model of the relationships among ethnic discrimination, coping, and ambulatory blood pressure (ABP). The model proposes that perceived exposure to ethnic discrimination will b# positively associated with the average level of ABP and with the magnitude and duration of acute blood pressure and heart rate responses to current negative interpersonal interactions. Coping styles and strategies used to manage ethnic discrimination are expected to mediate the relationship of ethnic discrimination to ABP. Socioeconomic status (SES) is expected to moderate the relationship of racism to coping and the relationships of ethnic discrimination and coping to ABP. To test the generaWzability of this model, the hypotheses will be tested in a multi-site sample of 720 American-born Black and Latino men and women drawn from urban primary care medical practices. These practices are located in culturally diverse communities, serving patients from a range of socioeconomic backgrounds. Participants will wear an ambulatory blood pressure monitor for 24 hours.Questionnaires will be used to assess past exposure to ethnic/racial discrimination. Diaries completed at the time of each ambulatory blood pressure reading wilt be used to identify day-of-testing negative and potentially discriminatory interactions. Both characteristic styles of coping and episode-specific strategies for coping with ethnic discrimination are examined. Demographic and personality variables likely to affect perceptions of ethnic discrimination will be examined and controlled.Structural equation modeling will be employed to evaluate the relationships among perceived ethnic discrimination to coping and ABP. Additional analyses will examine the association of gender, SES, and race/ethnicity to the use of different styles and strategies for coping with ethnic discrimination, and the effects of these characteristics on the relationship of coping to ABP. The study has implications for theories concerning the relationship of psychosocial stress to risk for HT and for the development of interventions to reduce racial disparities in health status.