Differential Impact of Stress Reduction Programs upon Ambulatory Blood Pressure among African American Adolescents: Influences of Endothelin-1 Gene and Chronic Stress Exposure

Mathew J Gregoski,Haidong Zhu,Martha S Tingen,Yanbin Dong,Vernon A Barnes,Frank A Treiber

doi:10.1155/2012/510291

Mathew J Gregoski, Haidong Zhu + Show 4 more

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https://doi.org/10.1155/2012/510291

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Abstract

Stress-activated gene × environment interactions may contribute to individual variability in blood pressure reductions from behavioral interventions. We investigated effects of endothelin-1 (ET-1) LYS198ASN SNP and discriminatory stress exposure upon impact of 12-week behavioral interventions upon ambulatory BP (ABP) among 162 prehypertensive African American adolescents. Following genotyping, completion of questionnaire battery, and 24-hour ABP monitoring, participants were randomized to health education control (HEC), life skills training (LST), or breathing awareness meditation (BAM). Postintervention ABP was obtained. Significant three-way interactions on ABP changes indicated that among ET-1 SNP carriers, the only group to show reductions was BAM from low chronic stress environments. Among ET-1 SNP noncarriers, under low chronic stress exposure, all approaches worked, especially BAM. Among high stress exposure noncarriers, only BAM resulted in reductions. If these preliminary findings are replicated via ancillary analyses of archival databases and then via efficacy trials, selection of behavioral prescriptions for prehypertensives will be edging closer to being guided by individual's underlying genetic and environmental factors incorporating the healthcare model of personalized preventive medicine.

Highlights

Essential hypertension (EH) is a major risk factor for cardiovascular disease (CVD), and EH incidence among youth is increasing [1]
We hypothesized that breathing awareness meditation (BAM) would have greater beneficial impact upon ambulatory BP reduction compared to life skills training (LST) and health education control (HEC)
There were no significant differences between the treatment groups, ET-1 genotype, everyday discrimination scale (EDS), or treatment group by ET-1 genotype by EDS interactions on any of these parameters

Summary

Introduction

Essential hypertension (EH) is a major risk factor for cardiovascular disease (CVD), and EH incidence among youth is increasing [1]. AAs display increased levels of resting and ambulatory blood pressure (ABP) compared to other ethnic groups [3,4,5]. Stage I prehypertensive adults (i.e., SBP/DBP 121–129/81– 84 mmHg) have a 40% increased risk and adults with stage II prehypertension (i.e., SBP/DBP 130–139/85–89 mmHg) are twice as likely to develop CVD compared to those with optimal BP (

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