Racial differences in stress-induced cardiovascular reactivity and hypertension: Current status and substantive issues.

Essential hypertension is perhaps the number-one health problem of Black Americans. Research has indicated that stress-induced cardiovascular hyperreactivity may be a significant contributor to essential hypertension. The high prevalence of hypertension among Blacks suggests that this group, in comparison with Whites, may be particularly susceptible to cardiovascular hyperreactivity. The first portion of this article reviews research to date that has examined racial differences in resting and stressor-induced cardiovascular activity. The second half of this article overviews some critical methodological and conceptual issues involved in the study of racial differences in reactivity. These issues include the effects of Black-White differences in plasma renin levels and sodium excretion, the effects of experimenter race, and differences in perceptions of the laboratory environment. Additionally, the issue of racial group classification and the implications this has for interpreting Black-White differences in reactivity is discussed. Two perspectives on racial group classification, the genetic and the sociocultural, are addressed in some detail, and the relevance of each to research on racial differences in stress reactivity is presented.