vascular reactivity in Blacks experiencing chronic stress. Furthermore, macrosocial phenomenon, such as lower SES, residence in socially unstable communities, and chronic exposure to racial stress should be positively associated with increased SNS activity and greater sodium retention. Finally, the contextual model would predict that Blacks with more coping resources (e.g., high social support, strong religious orientation, and racial identity) will show lower SNS activity and decreased sodium retention relative to those with fewer coping resources.
In summary, according to the proposed model, race is viewed as a sociocultural designation that denotes differential exposure to chronic social stressors. It is proposed that Black Americans are exposed to significantly more chronic social stressors than White Americans. Many of these chronic social stressors have been associated with hypertension prevalence in epidemiological studies. Furthermore, chronic stress has been shown to augment cardiovascular reactivity to acute stress in both animals and humans and to increase sodium retention in SHRs. Acute stress has also been demonstrated to increase sodium retention in humans. The essential element of this model is that chronic social stressors that are overrepresented within the Black American population due to historical factors are related to an increase in sodium retention and enhanced reactivity. This altered sodium metabolism and reactivity may be further augmented by biological, behavioral, and psychological risk factors for hypertension and modulated by stress coping resources. It is hoped that this model will serve as a stimulus for further research on the biopsychosocial aspects of autonomic reactivity and hypertension in minorities. Disparity in health status will remain a problem in this country until researchers begin to look at ethnic- specific pathways using this type of contextual modeling approach. This is a challenge directed at researchers to test the applicability of this model to other minority populations.
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