Hypertension (HTN) is a major health problem for Black Americans: as a group they have the highest rate of HTN in the world. HTN develops at younger ages, is more severe, and leads to more adverse clinical outcomes and higher death rates for Blacks than for Whites. Chronic psychosocial stressors (e.g., daily hassles, racial discrimination and financial strain) are believed to contribute to the development of HTN. The purposes of the proposed mentored patient-oriented research career development award are to provide the necessary training experiences so that the candidate can achieve independence as an investigator conducting biobehavioral research and to begin to address the question of why some Blacks develop HTN while other Blacks do not. The training goals are to 1) expand knowledge of cardiovascular physiology and pathological mechanisms leading to HTN;2) obtain expertise in the assessment of psychosocial stress and the integration of measures of psychosocial stress with physiological indices of stress;3) obtain expertise in impedance-derived measurement of total peripheral resistance and to become skilled in the assessment of cardiovascular and neuroendocrine responses to acute laboratory-based stressors;4) become proficient in the design, conduct and analysis of longitudinal studies and associated advanced statistical methods;and 5) disseminate results of research and develop a fundable R01 proposal. The candidate will engage in a 3-year intensive, supervised career development plan that will include: a) formal course work in HTN, stress, and advanced research methods;b) hands-on laboratory experiences with her mentors, consultants, and specialists;c) interdisciplinary experiences such as journal clubs, seminars, and conferences;and d) participation in mentors'research team meetings. To compliment the training, the candidate will conduct a study to examine factors related to HTN in 128 Black men and women between the ages of 25 and 55. The study will compare Blacks with and without HTN for differences in indicators of allostatic load (sleep blood pressure, sleep total peripheral resistance, cortisol awakening response, and obesity);in chronic psychosocial stressors (daily hassles, racial discrimination, and financial strain);and in the moderating effect of positive and negative emotions, religious coping, and John Henryism active coping on the influence of chronic psychosocial stressors on indicators of allostatic load. A team of experienced researchers will serve as mentors and consultants in the areas of a) HTN and cardiovascular disease, b) physiological and psychological stress, c) biomedical assessment, and d) design and analysis of longitudinal research.
