Defensive coping, urbanization, and neuroendocrine function in Black Africans: the THUSA study.

Dissociation between β-adrenergic behavioral and physiological defensive active coping (AC) responses was associated with cardiometabolic risk in urban but not rural African males. Whether this is partly driven by underlying neuroendocrine dysfunction is not certain. We aimed to assess the association between coping style, urbanization, and neuroendocrine function. Blood pressure (BP) and serum stress hormones were assessed across levels of urbanization (rural vs. urban) and coping style (active vs. passive) in 178 Black African men. Urban men demonstrated increased hypertension prevalence, α-adrenergic hemodynamic pattern, lower testosterone levels, and a larger cortisol:testosterone ratio (Cort:Test) compared to their rural counterparts. This was particularly evident in urban AC men where cortisol and Cort:Test explained 36-40% of the variance in BP. Dissociation between behavioral and physiological β-adrenergic neuroendocrine responses in urban AC African men was shown. A stressful urban environment might induce an apparent loss of physiological control, thereby facilitating disturbed neuroendocrine AC responses, which could increase cardiovascular disease risk.