title: Hypercoagulation and hyperkinetic blood pressure indicative of physiological loss-of-control despite behavioural control in Africans: The SABPA study.
abstract: OBJECTIVE
  A dissociation between behavioural (in-control) and physiological parameters (indicating loss-of-control) is associated with cardiovascular risk in defensive coping (DefS) Africans. We evaluated relationships between DefS, sub-clinical atherosclerosis, low-grade inflammation and hypercoagulation in a bi-ethnic sex cohort.
  
  
  METHODS
  Black (Africans) and white Africans (Caucasians) (n = 375; aged 44.6 ± 9.7 years) were included. Ambulatory BP, vascular structure (left carotid cross-sectional wall area (L-CSWA) and plaque counts), and markers of coagulation and inflammation were quantified. Ethnicity/coping style interaction was revealed only in DefS participants.
  
  
  RESULTS
  A hypertensive state, less plaque, low-grade inflammation, and hypercoagulation were more prevalent in DefS Africans (27-84%) than DefS Caucasians (18-41%). Regression analyses demonstrated associations between L-CSWA and 24 hour systolic BP (R(2) = 0.38; β = 0.78; p < 0.05) in DefS African men but not in DefS African women or Caucasians. No associations between L-CSWA and coagulation markers were evident.
  
  
  CONCLUSIONS
  Novel findings revealed hypercoagulation, low-grade inflammation and hyperkinetic BP (physiological loss-of-control responses) in DefS African men. Coupled to a self-reported in-control DefS behavioural profile, this reflects dissociation between behaviour and physiology. It may explain changes in vascular structure, increasing cerebrovascular disease risk in a state of hyper-vigilant coping.
authors.affiliation: a Hypertension in Africa Research Team (HART), School for Physiology, Nutrition, and Consumer Science, North-West University , Potchefstroom , South Africa ;
authors.forename: Jacobus De Wet
authors.initials: Jde W
authors.lastname: Scheepers
authors.affiliation: a Hypertension in Africa Research Team (HART), School for Physiology, Nutrition, and Consumer Science, North-West University , Potchefstroom , South Africa ;|b Medical Research Council: Research Unit for Hypertension and Cardiovascular Disease, North-West University , Potchefstroom , South Africa ;
authors.forename: Leoné
authors.initials: L
authors.lastname: Malan
authors.affiliation: a Hypertension in Africa Research Team (HART), School for Physiology, Nutrition, and Consumer Science, North-West University , Potchefstroom , South Africa ;
authors.forename: Andrea
authors.initials: A
authors.lastname: de Kock
authors.affiliation: a Hypertension in Africa Research Team (HART), School for Physiology, Nutrition, and Consumer Science, North-West University , Potchefstroom , South Africa ;
authors.forename: Nicolaas Theodor
authors.initials: NT
authors.lastname: Malan
authors.affiliation: c Medicine Usage in South Africa (MUSA), North-West University , Potchefstroom , South Africa ;
authors.forename: Marike
authors.initials: M
authors.lastname: Cockeran
authors.affiliation: a Hypertension in Africa Research Team (HART), School for Physiology, Nutrition, and Consumer Science, North-West University , Potchefstroom , South Africa ;|d Department of Neurology , Inselspital, Bern University Hospital, and University of Bern , Switzerland ;|e Department of Psychosomatic Medicine , Clinic Barmelweid , Barmelweid , Switzerland.
authors.forename: Roland
authors.initials: R
authors.lastname: von Känel
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D044383:Black People / Q000523:psychology; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology; D013315:Stress, Psychological / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D019851:Thrombophilia / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D066253:Vascular Remodeling; D044465:White People / Q000523:psychology
keywords: Africans; Coagulation; Coping; Dissociation; Structural vascular disease; Vascular remodelling