Peripheral and Cerebral Vascular Reactivity in Black and White Women: Examining the Impact of Psychosocial Stress Exposure Versus Internalization and Coping

Black women have the highest rates of cardiovascular and cerebrovascular disease prevalence and mortality in part due to blunted vascular function. Psychosocial stress likely also contributes but its relationship to vascular function remains incompletely understood. Recent studies suggest that internalization and coping strategies are more important than stress exposure alone. We hypothesized that Black women have blunted peripheral and cerebral vascular function and that, among Black women, this would be inversely related with psychosocial stress internalization/coping but not stress exposures. Healthy Black (n = 21; 20 {+/-} 2 yr) and White (n = 16; 25 {+/-} 7 yr) women underwent testing for forearm reactive hyperemia (RH), brachial artery flow-mediated dilation (FMD), and cerebrovascular reactivity (CVR). Psychosocial stress exposure (adverse childhood experiences, ACEs; past week discrimination, PWD) and internalization/coping techniques (John Henryism Active Coping Scale, JHAC12; Giscombe Superwoman Schema Questionnaire, G-SWS-Q) were assessed. RH and CVR (p > 0.05) were not different between groups whereas FMD was lower in Black women (p = 0.007). Neither ACEs nor PWD were associated with FMD in either group (p > 0.05 for all). JHAC12 scores were negatively associated with FMD in Black women (p = 0.014) but positively associated with FMD in White women (p = 0.042). SWS-Succeed was negatively associated (p = 0.044) and SWS-Vulnerable tended to be negatively associated (p = 0.057) with FMD in Black women. These findings indicate that blunted FMD in Black women may be due more to internalization and maladaptive coping than stress exposure alone.