Cardiovascular reactivity and oxidative stress in young and older adults: the African-PREDICT and SABPA studies

Internalized Shame and Social Stress-Induced Blood Pressure Patterns among Young Black Women

Background

The increasing prevalence of hypertension among young Black women warrants further exploration of hypertension risk factors in this population. Social cognitive pathways that increase hypertension risk have been understudied among Black women. Shame, an emotional response to social evaluative threats, may be important to understanding the contribution of social emotions to hypertension risk. The current study examined the association of internalized shame on systolic (SBP) and diastolic blood pressure (DPB) patterns of reactivity and recovery in a sample of Black women.

Methods

Black women (N=32) aged 18-22 were recruited from a public university in August 2019 and January 2020. Participants completed the Internalized Shame Scale, Self-Esteem subscale, and the Perceived Stress Scale. All participants completed the Trier Social Stress Test (TSST) and subsequent blood pressure readings were recorded at baseline and 1 min, 15 min, 30 min, 45 min, and 60 min post-TSST. Two separate repeated measures ANOVAs examined time and group effects of low shame (ISS score ≤ 39.9) vs high shame (ISS score ≥ 40) on blood pressure reactivity patterns.

Results

A significant effect of shame on DBP responses to the TSST was observed (P=.020). DBP for women in the low shame group peaked immediately following the TSST relative to baseline (M =81.2 mm Hg vs M =72.2 mm Hg) and remained stable during 60-minute recovery. DBP for women in the high shame group did not peak until 45 min post-TSST relative to baseline (M =84.2 mm Hg vs M =68.0 mm Hg) only slightly decreasing at 60 min post-TSST.

Implications

These results highlight the need to further examine the role of shame on hypertension risk among young Black women.

Gender Differences in the Association between Frailty, Cognitive Impairment, and Self-Care Behaviors Among Older Adults with Atrial Fibrillation

Atrial fibrillation (AF), common in older adults, increases the risk of heart failure, stroke, and all-cause mortality. Self-care behaviors help avoid adverse events in older patients with AF. However, while frailty and cognitive impairment can contribute to poor self-care behaviors, few studies have explored these relationships in older adults with AF. This cross-sectional study aims to determine associations between frailty, cognitive impairment, and self-care behaviors among older adults with AF by gender. A total of 298 patients with AF aged 60 and over were assessed with a self-reported questionnaire consisting of the Korean version of the FRAIL scale, modified mini-mental state examination, and self-care scale for AF. Prevalence of frailty and prefrailty in men and women was around 11% and 48.4% and 28% and 47.4%, respectively. According to the hierarchical linear regression analysis, in men, prefrailty (β = -2.874, p = 0.013) and frailty (β = -7.698, p < 0.001) were associated with self-care behaviors; in women, frailty (β = -5.476, p = 0.003), and cognitive impairment (β = -3.350, p = 0.044) were associated with self-care behaviors. Developing individualized care plans will require periodic screening of older patients with AF to determine their frailty status and cognitive function.