Racial Provocation Induces Cortisol Responses in African-Americans*

Ali A. Weinstein, Angela Termini, Joshua B. Kazman, Stacey A. Zeno, Preetha Abraham, Patricia A. Deuster

Center for the Study of Chronic Illness and Disability, George Mason University, Fairfax, USA.
Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, USA.

DOI: 10.4236/ojmp.2013.24023                

Abstract

Purpose: To examine salivary cortisol responses to a racially-charged stimulus in a group of African-American individuals. Methods: A nonrandom sample of 245 (age: 43.8 ± 11.1 years; 64% female) African-American individuals was recruited by advertisements. Specifically, salivary cortisol was assessed prior to and after being exposed to a racially-charged movie clip. In addition, the salivary cortisol was assessed in the morning and evening of the day following exposure to the racially-charged movie clip. Results: A statistically significant increase in cortisol was found (P < 0.005) in the whole sample. High cortisol responders (highest tertile) and low cortisol responders (lowest tertile) were compared. The high cortisol responders had an elevated cortisol level the following morning (P < 0.05) that abated by the evening sample (P > 0.20). In addition, the high cortisol responders who were younger, had lower waist to hip ratios, and experienced less lifetime discrimination than the low cortisol responders (P’s < 0.05). Conclusions: The findings of an increase in cortisol in response to a racial provocation may provide a potential explanatory factor for the increased rates of cardiovascular disease in African-American individuals.

Keywords

Mental Stress; Racial Stressors; Ethnicity; Cardiovascular Disease

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	M. Cushman, R. A. Cantrell, L. A. McClure, G. Howard, R. J. Prineas, C. S. Moy, E. M. Temple and V. J. Howard, “Estimated 10-Year Stroke Risk by Region and Race in the United States: Geographic and Racial Differences in Stroke Risk,” Annals of Neurology, Vol. 64, No. 5, 2008, pp. 507-513. http://dx.doi.org/10.1002/ana.21493
[2]	K. Fiscella and K. Holt, “Racial Disparity in Hypertension Control: Tallying the Death Toll,” The Annals of Family Medicine, Vol. 6, No. 6, 2008, pp. 497-502. http://dx.doi.org/10.1370/afm.873
[3]	K. A. Jamerson, “The Disproportionate Impact of Hypertensive Cardiovascular Disease in African Americans: Getting to the Heart of the Issue,” The Journal of Clinical Hypertension, Vol. 6, No. 4, 2004, pp. 4-10.
[4]	A. K. Jha, P. D. Varosy, A. M. Kanaya, D. B. Hunning-hake, M. A. Hlatky, D. D. Waters, C. D. Furberg and M. G. Shlipak, “Differences in Medical Care and Disease Outcomes among Black and White Women with Heart Disease,” Circulation, Vol. 108, No. 9, 2003, pp. 1089-1094. http://dx.doi.org/10.1161/01.CIR.0000085994.38132.E5
[5]	A. Bernstein, D. Makuc and L. Bilheimer, “Health, United States 2006,” National Center for Health Statistics, 2007.
[6]	R. B. Williams, “Psychosocial and Biobehavioral Factors and Their Interplay in Coronary Heart Disease,” Annual Review of Clinical Psychology, Vol. 4, 2008, pp. 349-365. http://dx.doi.org/10.1146/annurev.clinpsy.4.022007.141237
[7]	E. C. Suarez, C. M. Kuhn, S. M. Schanberg, R. B. Williams Jr. and E. A. Zimmermann, “Neuroendocrine, Cardiovascular and Emotional Responses of Hostile Men: The Role of Interpersonal Challenge,” Psychosomatic Medicine, Vol. 60, No. 1, 1998, pp. 78-88.
[8]	M. Kumari, E. Badrick, A. Sacker, C. Kirschbaum, M. Marmot and T. Chandola, “Identifying Patterns in Cortisol Secretion in an Older Population. Findings from the Whitehall II Study,” Psychoneuroendocrinology, Vol. 35, No. 7, 2010, pp. 1091-1099. http://dx.doi.org/10.1016/j.psyneuen.2010.01.010
[9]	R. Rosmond, “Role of Stress in the Pathogenesis of the Metabolic Syndrome,” Psychoneuroendocrinology, Vol. 30, No. 1, 2005, pp. 1-10. http://dx.doi.org/10.1016/j.psyneuen.2004.05.007
[10]	S. H. Boyle, R. S. Surwit, A. Georgiades, B. H. Brummett, M. J. Helms, R. B. Williams and J. C. Barefoot, “Depressive Symptoms, Race and Glucose Concentrations: The Role of Cortisol as Mediator,” Diabetes Care, Vol. 30, No. 10, 2007, pp. 2484-2488. http://dx.doi.org/10.2337/dc07-0258
[11]	R. Rosmond, S. Wallerius, P. Wanger, L. Martin, G. Holm and P. Bjorntorp, “A 5-Year Follow-Up Study of Disease Incidence in Men with an Abnormal Hormone Pattern,” Journal of Internal Medicine, Vol. 254, No. 4, 2003, pp. 386-390. http://dx.doi.org/10.1046/j.1365-2796.2003.01205.x
[12]	G. D. Smith, Y. Ben-Shlomo, A. Beswick, J. Yarnell, S. Lightman and P. Elwood, “Cortisol, Testosterone and Coronary Heart Disease: Prospective Evidence from the Caerphilly Study,” Circulation, Vol. 112, No. 3, 2005, pp. 332-340. http://dx.doi.org/10.1161/CIRCULATIONAHA.104.489088
[13]	K. A. Matthews, J. E. Schwartz and S. Cohen, “Indices of Socioeconomic Position across the Life Course as Predictors of Coronary Calcification in Black and White Men and Women: Coronary Artery Risk Development in Young Adults Study,” Social Science & Medicine, Vol. 73, No. 5, 2011, pp. 768-774.
[14]	J. Collins-McNeil, “Psychosocial Characteristics and Cardiovascular Risk in African Americans with Diabetes,” Archives of Psychiatric Nursing, Vol. 20, No. 5, 2006, pp. 226-233. http://dx.doi.org/10.1016/j.apnu.2006.04.005
[15]	W. E. Cross, “Shades of Black: Diversity in African-American Identity,” Temple University Press, Philadelphia, 1991.
[16]	V. R. Clark, “The Perilous Effects of Racism on Blacks,” Ethnicity & Disease, Vol. 11, No. 4, 2001, pp. 769-772.
[17]	L. S. Richman, G. G. Bennett, J. Pek, I. Siegler and R. B. Williams Jr., “Discrimination, Dispositions and Cardiovascular Responses to Stress,” Health Psychology, Vol. 26, No. 6, 2007, pp. 675-683.
[18]	S. B. Wyatt, D. R. Williams, R. Calvin, F. C. Henderson, E. R. Walker and K. Winters, “Racism and Cardiovascular Disease in African Americans,” The American Journal of the Medical Sciences, Vol. 325, No. 6, 2003, pp. 315-331. http://dx.doi.org/10.1097/00000441-200306000-00003
[19]	S. A. Everson, J. W. Lynch, G. A. Kaplan, T. A. Lakka, J. Sivenius and J. T. Salonen, “Stress-Induced Blood Pressure Reactivity and Incident Stroke in Middle-Aged Men,” Stroke A Journal of Cerebral Circulation, Vol. 32, No. 6, 2001, pp. 1263-1270. http://dx.doi.org/10.1161/01.STR.32.6.1263
[20]	M. Hamer and A. Steptoe, “Cortisol Responses to Mental Stress and Incident Hypertension in Healthy Men and Women,” The Journal of Clinical Endocrinology & Metabolism, Vol. 97, No. 1, 2012, pp. E29-34. http://dx.doi.org/10.1210/jc.2011-2132
[21]	T. W. Kamarck, J. R. Jennings, T. T. Debski, E. Glickman-Weiss, P. S. Johnson, M. J. Eddy and S. B. Manuck, “Reliable Measures of Behaviorally-Evoked Cardiovascular Reactivity from a PC-Based Test Battery: Results from Student and Community Samples,” Psychophysiology, Vol. 29, No. 1, 1992, pp. 17-28. http://dx.doi.org/10.1111/j.1469-8986.1992.tb02006.x
[22]	R. Klabunde, “Cardiovascular Physiology Concepts,” 2nd Edition, Lippincott Williams & Wilkins, 2011.
[23]	W. C. Chumlea, S. S. Guo, R. J. Kuczmarski, K. M. Flegal, C. L. Johnson, S. B. Heymsfield, H. C. Lukaski, K. Friedl and V. S. Hubbard, “Body Composition Estimates from NHANES III Bioelectrical Impedance Data,” International Journal of Obesity and Related Metabolic Disorders, Vol. 26, No. 12, 2002, pp. 1596-1609. http://dx.doi.org/10.1038/sj.ijo.0802167
[24]	R. S. Paffenbarger Jr., S. N. Blair, I. M. Lee and R. T. Hyde, “Measurement of Physical Activity to Assess Health Effects in Free-Living Populations,” Medicine & Science in Sports & Exercise, Vol. 25, No. 1, 1993, pp. 60-70. http://dx.doi.org/10.1249/00005768-199301000-00010
[25]	M. A. Pereira, S. J. FitzerGerald, E. W. Gregg, M. L. Joswiak, W. J. Ryan, R. R. Suminski, A. C. Utter and J. M. Zmuda, “A Collection of Physical Activity Questionnaires for Health-Related Research,” Medicine & Science in Sports & Exercise, Vol. 29, No. 6, 1997, pp. S1-205.
[26]	H. Landrine, E. A. Klonoff, I. Corral, S. Fernandez and S. Roesch, “Conceptualizing and Measuring Ethnic Discrimination in Health Research,” Journal of Behavioral Medicine, Vol. 29, No. 1, 2006, pp. 79-94. http://dx.doi.org/10.1007/s10865-005-9029-0
[27]	A. T. Beck, R. A. Steer and G. K. Brown, “BDI-II, Beck Depression Inventory: Manual,” Psychological Corporation, 1996.
[28]	D. J. Buysse, C. F. Reynolds 3rd, T. H. Monk, S. R. Berman and D. J. Kupfer, “The Pittsburgh Sleep Quality Index: A New Instrument for Psychiatric Practice and Research,” Psychiatry Research, Vol. 28, No. 2, 1989, pp. 193-213. http://dx.doi.org/10.1016/0165-1781(89)90047-4
[29]	A. Gentili, D. K. Weiner, M. Kuchibhatla and J. D. Edinger, “Test-Retest Reliability of the Pittsburgh Sleep Quality Index in Nursing Home Residents,” Journal of the American Geriatrics Society, Vol. 43, No. 11, 1995, pp. 1317-1318.
[30]	S. Cohen, T. Kamarck and R. Mermelstein, “A Global Measure of Perceived Stress,” Journal of Health and Social Behavior, Vol. 24, No. 4, 1983, pp. 385-396. http://dx.doi.org/10.2307/2136404
[31]	R. Clark, N. B. Anderson, V. R. Clark and D. R. Williams, “Racism as a Stressor for African Americans. A Biopsychosocial Model,” American Psychologist, Vol. 54, No. 10, 1999, pp. 805-816. http://dx.doi.org/10.1037/0003-066X.54.10.805
[32]	E. K. Adam, L. C. Hawkley, B. M. Kudielka and J. T. Cacioppo, “Day-to-Day Dynamics of Experience—Cortisol Associations in a Population-Based Sample of Older Adults,” Proceedings of the National Academy of Sciences, Vol. 103, No. 45, 2006, pp. 17058-17063. http://dx.doi.org/10.1073/pnas.0605053103
[33]	D. R. Williams, H. W. Neighbors and J. S. Jackson, “Racial/Ethnic Discrimination and Health: Findings from Community Studies,” American Journal of Public Health, Vol. 93, No. 2, 2003, pp. 200-208. http://dx.doi.org/10.2105/AJPH.93.2.200
[34]	J. Stevens, E. G. Katz and R. R. Huxley, “Associations between Gender, Age and Waist Circumference,” European Journal of Clinical Nutrition, Vol. 64, No. 1, 2010, pp. 6-15. http://dx.doi.org/10.1038/ejcn.2009.101