title: Chronic distress and acute vascular stress responses associated with ambulatory blood pressure in low-testosterone African men: the SABPA Study.
abstract: It is known that low testosterone (T) and high cortisol levels are associated with hypertension as well as with chronic stress, linking stress with elevated blood pressure (BP). However, the association between acute stress-, chronic stress responses and BP is not clear in Africans. Therefore, we examined the association between cortisol, psychological distress and BP responses in low- and high-T male subgroups. Beat-to-beat and ambulatory blood pressure (ABPM) and electrocardiogram measures were obtained. Serum samples were collected and analyzed for sex hormones and cortisol. Chronic psychological distress was verified with the General Health Questionnaire and acute stress with the cold pressor test. More chronic psychological distress was observed in both low- and high-T Africans compared with the Caucasians. The low-T Africans tended to have more ischemic events (P=0.06) and ABPM values (P⩽0.01) than any of the other groups. Both chronic distress (cortisol) and acute stress (total peripheral resistance cold pressor responses) were associated with ABPM in the low-T African group. Acute and chronic stress may contribute to increased BP in low-T African men. Their cortisol and vascular responses supported a tendency for ischemia, increasing their risk for coronary artery disease.
authors.affiliation: Hypertension in Africa Research Team (HART), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.
authors.forename: N T
authors.initials: NT
authors.lastname: Malan
authors.affiliation: Department of Psychology, Technische Universität Dresden, Dresden, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Stalder
authors.affiliation: Human Neurotransmitters and Neurovascular Hypertension and Kidney Disease Laboratories, Baker IDI Heart and Diabetes Institute and Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.
authors.forename: M P
authors.initials: MP
authors.lastname: Schlaich
authors.affiliation: Human Neurotransmitters and Neurovascular Hypertension and Kidney Disease Laboratories, Baker IDI Heart and Diabetes Institute and Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.
authors.forename: G W
authors.initials: GW
authors.lastname: Lambert
authors.affiliation: 1] Hypertension in Africa Research Team (HART), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa [2] Department of Epidemiology and Public Health, University College of London, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Hamer
authors.affiliation: Hypertension in Africa Research Team (HART), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.
authors.forename: A E
authors.initials: AE
authors.lastname: Schutte
authors.affiliation: Hypertension in Africa Research Team (HART), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.
authors.forename: H W
authors.initials: HW
authors.lastname: Huisman
authors.affiliation: Hypertension in Africa Research Team (HART), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.
authors.forename: R
authors.initials: R
authors.lastname: Schutte
authors.affiliation: Hypertension in Africa Research Team (HART), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.
authors.forename: W
authors.initials: W
authors.lastname: Smith
authors.affiliation: Hypertension in Africa Research Team (HART), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.
authors.forename: C M C
authors.initials: CM
authors.lastname: Mels
authors.affiliation: Hypertension in Africa Research Team (HART), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.
authors.forename: J M
authors.initials: JM
authors.lastname: van Rooyen
authors.affiliation: Hypertension in Africa Research Team (HART), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.
authors.forename: L
authors.initials: L
authors.lastname: Malan
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D044383:Black People; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods; D015984:Causality; D002908:Chronic Disease; D015331:Cohort Studies; D015897:Comorbidity; D016001:Confidence Intervals; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D006973:Hypertension / Q000097:blood* / Q000208:ethnology / Q000503:physiopathology; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D013019:South Africa; D013315:Stress, Psychological / Q000097:blood* / Q000208:ethnology; D013739:Testosterone / Q000097:blood / Q000172:deficiency*; D014655:Vascular Resistance / Q000502:physiology*; D044465:White People
chemical_list: D013739:Testosterone; D006854:Hydrocortisone