The study responds to evidence that adolescents at high risk for cardiovascular disease, particularly males and African Americans, exhibit a distinct pattern of hemodynamic responses that is most evident during social encounters that arouse anger, defensiveness and distrust. The central feature of this cluster of hemodynamic responses, which are related to a cluster of cardiovascular disease risk factors, is insulin resistance. These hemodynamic responses constitute the pathway via which exposure to chronically stressful environments may increase cardiovascular disease risk. These possibilities are investigated by studying hemodynamic responses to social and nonsocial stressors, ambulatory blood pressure, fasting insulin, fasting glucose, lipid profiles, and central obesity in black, white, male, and female high school students from a wide range of SES backgrounds. Following initial blood pressure screening sessions, an equal number of black and white participants and white and African American participants debate with a same sex/race peer. Levels of hostile distrust during this interaction are thought to be correlated with diastolic blood pressure responses during the interaction. Both increased hostility and diastolic blood pressure reactivity during the debate task are hypothesized to predict diastolic blood pressure reactivity and total peripheral resistance during the social competence interview (a structured interview assessing responses to a personal stressor).
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