The proposed study will investigate psychosocial and dietary influences on blood pressure in a community probability sample of 25-50 year old Black men and women residing in Pitt County, North Carolina. The psychosocial variables of greatest interest include socioeconomic status (SES), John Henryism, social support and anger-coping style. The dietary variable of greatest interest include sodium, potassium, calcium and alcohol. The major objective of the study is to identify those factors of which make an important and statistically significant contribution to increased levels of blood pressure in low SES Blacks. Prior work by our group has implicated both high John Henryism (a strong behavioral predisposition to cope actively with psychosocial environmental stressors) and low social support (especially instrumental support), as potentially important modifiers of the SES/blood pressure relationship in young and early middle-age Blacks. The proposed study will seek to confirm these associations in a more economically diverse Black population. In addition, the study will assess to what degree habitual anger suppression as well as selected dietary factors (sodium, potassium, etc.) are associated with blood pressure and, more specifically, influence the SES/blood pressure relationship in Blacks. Sample size permitting, the expected SES x John Henryism interaction on blood pressure will be re-examined after stratifying for social support, anger-coping style, and diet. The above research questions will be tested cross-sectionally, with blood pressure as a continuous outcome and linear regression as the multivariable analytic technique. However, the sample will be selected so as to provide a sufficient number of normotensive individuals for a prospective test of SES, John Henryism, and changes in blood pressure over a three year follow-up. Support for this longitudinal component will be sought in the final year of work proposed in this application. The long term objective is to develop explanatory public health models for elevated blood pressure in Blacks that can also be used to design effective primary prevention programs for members of this population.
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