Psychobehavioral factors, arterial stiffness, and blood pressure in Korean Americans

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  • March 22, 2019
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  • Logan, Jeongok G.
    • Affiliation: School of Nursing
Abstract
  • High levels of psychological stress and a high prevalence of hypertension (HTN) have been reported in Korean Americans (KAs). Immigration may be one source of stress which contributes to HTN in KAs. Arterial stiffness is another cardiovascular condition which is also related to both stress and hypertension. Traditionally, arterial stiffness was viewed as the result of HTN, but longitudinal studies have shown that arterial stiffness may itself predict progression of HTN in non-hypertensive people. Thus, this study explored the associations among stressors (acculturation and time in the U.S.), psychobehavioral responses (psychological stress, chronic active coping, and stress emotions of anger, anxiety, and depression), and physiological responses (blood pressure and arterial stiffness) in KAs. In this study, a convenient sample of 102 KAs (aged 21-60 years, 60% women) was recruited. Subjects were asked to complete the seven psychobehavioral scales and a demographic questionnaire. Physiological data including weight, height, blood pressure (BP), and arterial stiffness were also measured. The collected data were analyzed using SAS (version 9.2). Descriptive analysis, Pearson correlation, and multiple regressions were used to analyze the data. Age and mean arterial pressure (MAP) were the major determinants of arterial stiffness as measured by carotid-femoral pulse wave velocity (cfPWV) and augmentation index adjusted at heart rate 75 (AI_75). When age and MAP were controlled, state anger and state & trait anxiety significantly and independently predicted levels of cfPWV. Women had a significantly higher AI_75 than men. Perceived stress significantly predicted AI_75 after controlling age, MAP, and gender. Anger, anxiety, and perceived stress were related to arterial stiffness but not BP. Age was an independent predictor of cfPWV but not of BP; thus, age-associated increases in BP reported in previous studies may actually be the effect of age-associated increases and related effects of PWV on BP. More studies are needed to compare psychobehavioral factors and arterial stiffness in KAs and other racial groups, and to explore specific mechanisms by which psychobehavioral factors are implicated in the pathological process of arterial stiffness.
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  • ... in partial fulfillment of the requirements for the degree Doctor of Philosophy in the School of Nursing.
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  • Barksdale, Debra
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