Conduit Artery and Forearm Microvascular Reactivity in Black and White Females: Examining the Role of Greater Superwoman Schema Endorsement

Abstract

Among females in the United States, Black females suffer from the highest rates of hypertension, stroke, coronary artery disease, heart failure, and total cardiovascular disease (CVD) mortality. Importantly, vascular dysfunction precedes overt CVD and predicts CVD risk. In this regard, a recent study reported that upper limb microvascular but not macrovascular function was blunted in Black relative to White women. However, this is not always a consistent finding and such investigations have not incorporated psychosocial measures, which are known to contribute to race/ethnicity‐related disparities in cardiovascular health. Given the strong relationship between psychosocial stress and health, Woods‐Giscombe, et al. recently developed the Giscombe Superwoman Schema Questionnaire (G‐SWS‐Q), which operationalizes the Superwoman Schema (SWS) Conceptual Framework to quantify psychological stress processes specifically associated with being a Black woman. Accordingly, we tested the hypothesis that Black females would have blunted post‐occlusive upper limb microvascular and macrovascular vasodilation relative to White females and that greater SWS endorsement by Black females would be associated with blunted vascular responses.METHODSSeven Black (age: 22 ± 1 yr; BMI: 27.5 ± 1.6 kg/m2) and 6 White (age: 23 ± 1 yr; BMI: 25.9 ± 1.3 kg/m2) females participated. Post‐occlusive brachial artery flow‐mediated dilation (FMD) and forearm reactive hyperemia were assessed via well‐established procedures. Briefly, brachial artery diameter and blood velocity were measured continuously and recorded via Doppler ultrasound and a video capture system throughout a 2 min baseline, 5 min suprasystolic forearm cuff occlusion, and 3 min recovery. Offline analysis was performed via a continuous edge detection and blood velocity tracking software. Black participants also completed the G‐SWS‐Q, which is a 35‐item instrument designed to measure the cognitive, affective, and behavioral underpinnings associated with being a “Strong Black Woman” in the United States.RESULTSBrachial artery FMD was lower in Black relative to White females (3.99 ± 1.15 vs. 7.34 ± 1.10%; p = 0.03); however, after correcting for post‐occlusive shear rate AUC via ANCOVA, group differences in FMD were less apparent (p = 0.07). Post‐occlusive peak blood velocity and blood flow AUC were not different between groups (p = 0.43 and p = 0.42, respectively). A moderate negative correlation was observed between overall SWS and FMD (r = ‐0.58, p = 0.09). Among the SWS subscales, a strong negative correlation was observed between “Obligation to Present an Image of Strength” and FMD (r = ‐0.70, p = 0.04), whereas “Intense Motivation to Succeed” was moderately negatively correlated with FMD (r = ‐0.64, p = 0.06).CONCLUSIONThese preliminary data indicate that 1) upper limb macrovascular but not microvascular function may be blunted in young Black females and 2) stronger SWS endorsement may be associated with blunted vascular reactivity. Therefore, blunted conduit artery endothelial function in Black females may be partially attributable to greater SWS internalization.