Reduction of heart disease and stroke are major priorities for proposed Healthy People 2010 Objectives. Blacks are disproportionately represented in prevalence and mortality rates of ischemic heart disease and hypertension; deaths from cardiovascular disease account for the greatest disparity in mortality between Blacks and Whites. Hypertension is a major risk factor in cardiovascular heart disease. Environmental, genetic, and psychosocial factors (e.g., socioeconomic status, stress, lifestyle factors and others) are known to influence the development o hypertension . Racism has been proposed as a variable in health disparities of minorities, and the responses of Blacks to racism, including hostility, suppressed hostility, suppressed anger, effortful coping and denial, have been implicated in high blood pressure measurements. However, the effects of racism on stress, hypertension, and coronary heart disease are poorly understood. Racial identity has been found to influence the interpretation of stress. A healthy racial identity is believed to provide some protection from the negative effects of racism. The conceptual framework proposed by King & Williams describes the interactions of race with biological, cultural, socioeconomic and political factors, and with racism, and their effects on health outcomes. Using a modified version of this framework with a cross-sectional design, a convenience sample will be recruited. This descriptive correlational study proposes to examine the association between specific responses to racism (hostility, effortful coping and denial) and racial identity to cardiovascular health (blood pressure) in two groups, hypertensive and normotensive Black adults, ages 45-65 years. Univariate statistics, canonical correlation, and logistic regression will be performed to assess the relationship between responses to racism and racial identity and whether or not hypertensive or normotensive status can be predicted from responses to racism and racial identity. This study will add to the body of knowledge on this link between responses to racism and adverse health outcomes and will examine racial identity as a variable influencing blood pressure measurement. The study has potential implications for counseling Blacks about stress management, articulation of experiences of racism, and identification of cardiovascular risk factors. If responses to racism and racial identity are found to be predictive of hypertension, the possibility exists to intervene with appropriate counseling of young Blacks to prevent development of hypertension.
