Autonomic reactivity and hypertension in blacks: a review and proposed model.

In summary, according to the proposed model, race is viewed as a sociocultural designation that denotes differential exposure to chronic social stressors. It is proposed that black Americans are exposed to significantly more chronic social stressors than are white Americans. Many of these chronic social stressors have been associated with hypertension prevalence in epidemiological studies. Furthermore, chronic stress has been shown to augment cardiovascular reactivity to acute stress in both animals and humans, and to increase sodium retention in spontaneously hypertensive rats. Acute stress has also been demonstrated to increase sodium retention in humans. The essential element of our model is that chronic social stressors that are represented more within the black American population due to historical factors are related to an increase in sodium sensitivity and retention. This altered sodium metabolism may be further augmented by biological, behavioral, and psychological risk factors for hypertension and modulated by stress coping resources. It is hoped that this model will serve as a stimulus for further research on the biopsychosocial aspects of autonomic reactivity and hypertension in blacks.