Peripheral and Cerebral Vascular Reactivity in Black and White Women: Examining the Impact of Psychosocial Stress Exposure Versus Internalization and Coping


Black women have the highest rates of cardiovascular and cerebrovascular disease prevalence and mortality in part due to blunted vascular function. Psychosocial stress likely also contributes but its relationship to vascular function, remains incompletely understood. Recent studies suggest that internalization and coping strategies are more important than stress exposure alone. We hypothesized that Black women have blunted peripheral and cerebral vascular function and that among Black women, this would be inversely related more with psychosocial stress internalization/coping relative to stress exposures alone. Healthy Black (n = 21; 20 2 yr) and White (n = 16; 25 7 yr) women underwent testing for forearm reactive hyperemia (RH), brachial artery flow-mediated dilation (FMD), and cerebrovascular reactivity (CVR). Psychosocial stress exposure (adverse childhood experiences, ACEs; past week discrimination, PWD) and internalization/coping techniques (John Henryism Active Coping Scale, JHAC12; Giscombe Superwoman Schema Questionnaire, G-SWS-Q) were assessed. RH and CVR (p > 0.05) was similar whereas FMD was lower in Black women (p = 0.007). Neither ACEs nor PWD were associated with FMD in either group (p > 0.05 for all). JHAC12 scores were negatively associated with FMD in Black (p = 0.014) but positively associated with FMD in White (p = 0.042) women. SWS-Motivation to Succeed was negatively associated (p = 0.044) and SWS-Resistance to Being Vulnerable tended to be negatively associated (p = 0.057) with FMD in Black women. These findings indicate that blunted FMD in Black women may be due more to internalization and maladaptive coping than stress exposure alone.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This research was supported by start-up funds from The University of Texas at Arlington (RMB) and NIH R15 HL156128 (RMB). ZTM was supported by an American Heart Association Predoctoral Fellowship (#915133).

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

This protocol was approved by the Institutional Review Board at the University of Texas at Arlington - IRB# 2021-0270..

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Data Availability

These data supporting the findings and conclusions of this study are available, upon reasonable request, from the corresponding author on request

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