Psychosocial Correlates of Nocturnal Blood Pressure Dipping in African Americans: The Jackson Heart Study

BACKGROUND: African Americans exhibit a lower degree of nocturnal blood pressure (BP) dipping compared with Whites, but the reasons for reduced BP dipping in this group are not fully understood. The aim of this study was to identify psychosocial factors associated with BP dipping in a population-based cohort of African Americans. METHODS: This cross-sectional study included 668 Jackson Heart Study (JHS) participants with valid 24-hour ambulatory BP data and complete data on psychosocial factors of interest including stress, negative emotions, and psychosocial resources (e.g., perceived support). The association of each psychosocial factor with BP dipping percentage and nondipping status (defined as <10% BP dipping) was assessed using linear and Poisson regression models, respectively, with progressive adjustment for demographic, socioeconomic, biomedical, and behavioral factors. RESULTS: The prevalence of nondipping was 64%. Higher depressive symptoms, higher hostility, and lower perceived social support were associated with a lower BP dipping percentage in unadjusted models and after adjustment for age, sex, body mass index, and mean 24-hour systolic BP (P < 0.05). Only perceived support was associated with BP dipping percentage in fully adjusted models. Also, after full multivariable adjustment, the prevalence ratio for nondipping BP associated with 1 SD (7.1 unit) increase in perceived support was 0.93 (95% CI: 0.88-0.99). No other psychosocial factors were associated with nondipping status. CONCLUSIONS: Lower perceived support was associated with reduced BP dipping in this study. The role of social support as a potentially modifiable determinant of nocturnal BP dipping warrants further investigation

Modifiable Risk Factors Versus Age on Developing High Predicted Cardiovascular Disease Risk in Blacks

Background: Clinical guidelines recommend using predicted atherosclerotic cardiovascular disease (ASCVD) risk to inform treatment decisions. The objective was to compare the contribution of changes in modifiable risk factors versus aging to the development of high 10‐year predicted ASCVD risk. Methods and Results: A prospective follow‐up was done of the Jackson Heart Study, an exclusively black cohort at visit 1 (2000–2004) and visit 3 (2009–2012). Analyses included 1115 black participants without high 10‐year predicted ASCVD risk (<7.5%), hypertension, diabetes mellitus, or ASCVD at visit 1. We used the Pooled Cohort equations to calculate the incidence of high (≥7.5%) 10‐year predicted ASCVD risk at visit 3. We recalculated the percentage with high 10‐year predicted ASCVD risk at visit 3 assuming each risk factor (age, systolic blood pressure, antihypertensive medication use, diabetes mellitus, smoking, total and high‐density lipoprotein cholesterol), one at a time, did not change from visit 1. The mean age at visit 1 was 45.2±9.5 years. Overall, 30.9% (95% CI 28.3–33.4%) of participants developed high 10‐year predicted ASCVD risk. Aging accounted for 59.7% (95% CI 54.2–65.1%) of the development of high 10‐year predicted ASCVD risk compared with 32.8% (95% CI 27.0–38.2%) for increases in systolic blood pressure or antihypertensive medication initiation and 12.8% (95% CI 9.6–16.5%) for incident diabetes mellitus. Among participants <50 years, the contribution of increases in systolic blood pressure or antihypertensive medication initiation was similar to aging. Conclusions: Increases in systolic blood pressure and antihypertensive medication initiation are major contributors to the development of high 10‐year predicted ASCVD risk in blacks, particularly among younger adults

History of Mindfulness-Based Cognitive Therapy Is Associated with Increased Cognitive Reappraisal Ability

Abstract Mindfulness-based cognitive therapy (MBCT) has been shown to be an effective treatment for mood and anxiety disorders. Little is known, however, about the specific psychological skills that may improve with MBCT. The present study investigated the relationship between history of MBCT and emotion regulation ability. Specifically, we examined cognitive reappraisal ability (CRA) in a sample of individuals with a history of MBCT compared with two control groups: a group without a history of any type of therapy and a group with a history of cognitive behavioral therapy (CBT). Groups were matched on key variables including age, sex, education, working memory, emotional reactivity, and life stress. CRA was measured using a standardized laboratory challenge. Results indicated that participants with a history of MBCT demonstrated higher CRA than both the no-therapy control group and the CBT control group. These results suggest that, by guiding people to accept thoughts and feelings without judgment and to focus on the present moment, MBCT may lay the foundation for increased CRA

Seeing the silver lining: cognitive reappraisal ability moderates the relationship between stress and depressive symptoms.

Individuals differ in their adjustment to stressful life events, with some exhibiting impaired functioning, including depression, while others exhibit impressive resilience. The present study examined the hypothesis that the ability to deploy a particularly adaptive type of emotion regulation-cognitive reappraisal-may be a protective factor. It expands upon existing research in three ways. First, participants&apos; ability to use reappraisal (cognitive reappraisal ability: CRA) was measured by using a behavioral challenge that assessed changes in experiential and physiological domains, rather than questionnaires. Second, all participants had been exposed to one or more recent stressful life events, a context in which emotion regulation may be particularly important. Third, a community sample of 78 women aged 20 to 60 was recruited, as opposed to undergraduates. Results indicate that, at low levels of stress, participants&apos; CRA was not associated with depressive symptoms. However, at high levels of stress, women with high CRA exhibited less depressive symptoms than those with low CRA, suggesting that CRA may be an important moderator of the link between stress and depressive symptoms