title: Depression, stress, and blood pressure in urban African-American women.
abstract: African-American women have disturbingly high rates of hypertension, exceeding those of African-American men and other ethnic groups. Reasons for these disparities are not understood. Depression, more common in women than men, has been linked to endothelial dysfunction, inflammation, metabolic and hematologic abnormalities, and increased sympathetic nervous system activity--all factors associated with cardiovascular disease. A descriptive correlational design was used to test the following hypotheses: 1) African-American women with higher levels of depression will have higher blood pressure (BP) levels, more cardiovascular risk factors, greater stress, and lower social support; and 2) depression will mediate the relationship between stress and BP. A convenience sample of 245 hypertensive African-American women (mean age, 61+/-12.7 years) was recruited through free BP screenings offered in the community. All data were collected during a structured interview and brief physical examination. Pearson r correlation coefficients, analysis of variance, and multiple regression analyses were used to analyze the hypotheses. Women with higher levels of depression had higher diastolic BP and were more likely to smoke, eat fewer fruits and vegetables, and have more stress and less social support. Depression mediated the relationship between stress and diastolic BP. The findings emphasize the importance of assessing both behavioral and psychosocial factors in urban African-American women with hypertension.
authors.affiliation: College of Nursing, Wayne State University, Detroit, MI 48202, USA. n.artinian@wayne.edu
authors.forename: Nancy T
authors.initials: NT
authors.lastname: Artinian
authors.forename: Olivia G M
authors.initials: OG
authors.lastname: Washington
authors.forename: John M
authors.initials: JM
authors.lastname: Flack
authors.forename: Elaine M
authors.initials: EM
authors.lastname: Hockman
authors.forename: Kai-Lin Catherine
authors.initials: KL
authors.lastname: Jen
mesh_terms: D001741:Black or African American / Q000193:education / Q000208:ethnology* / Q000706:statistics & numerical data; D000704:Analysis of Variance; D015992:Body Mass Index; D003863:Depression / Q000150:complications / Q000175:diagnosis / Q000208:ethnology*; D004522:Educational Status; D005247:Feeding Behavior; D005260:Female; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000208:ethnology* / Q000209:etiology; D007182:Income / Q000706:statistics & numerical data; D008019:Life Style; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D009730:Nursing Assessment; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000208:ethnology; D012944:Social Support; D013315:Stress, Psychological / Q000150:complications / Q000175:diagnosis / Q000208:ethnology*; D011795:Surveys and Questionnaires; D014505:Urban Population; D014930:Women / Q000193:education / Q000523:psychology