Higher Levels Of Chronic Stress Research Articles

Disparities in allostatic load, telomere length and chronic stress burden among African American adults: A systematic review

BackgroundThe chronic disease burden among African Americans has continued to rise. Although racial disparities in chronic disease risk are well documented, the role of chronic stress in risk disparities among racial and ethnic minorities is not well understood. This systematic review of studies reporting on the relationship between chronic stress, education, and/or income, and biomarkers of chronic stress (allostatic load and telomere length) longitudinally among African Americans, seeks to contribute to this knowledge gap. ObjectiveTo use the existing literature to both examine the strength of two objective biomarkers--telomere length and allostatic load--as measures of the overactivation of physiological stress processes in African American adults; and determine if existing studies used these two biomarkers to assess the relationship between chronic stress, income and level of educational attainment among African Americans longitudinally. MethodsIn order to identify English-language articles published prior to October 11, 2021, a comprehensive search strategy was developed using five databases: PubMed/Medline, EMBASE, Web of Science Plus, Global Health (Ovid), and PsycINFO. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method was used to record progress on the comprehensive search for studies reporting on allostatic load and/or telomere length biomarkers longitudinally within all bodily fluids and chronic stress among African American adults. ResultsIn total, 7 studies met the search criteria; 902 were excluded. Thus, less than 1% of all studies reporting on biomarkers of chronic stress longitudinally included African Americans. Each of the 7 studies described the relationship between telomere length and/or allostatic load among African Americans and chronic stress, education, and/or income. Higher chronic stress levels and experiences of racial discrimination were associated with telomere shortening while lower income and higher chronic stress levels were associated with an increase in allostatic load among African Americans. DiscussionGiven the limited number of studies reporting on the association between allostatic load, telomere length, and/or the relationship between both in assessing chronic stress severity longitudinally among African American populations, it is impossible to determine whether one biomarker has greater predictive value than the other. However, based on the literature included in this review, higher chronic stress levels and experiences of racial discrimination were associated with shorter telomere length, while lower income and higher chronic stress levels are associated with an increase in allostatic load among African Americans. ConclusionThese data illustrate a gap in the literature on the relationship between the biomarkers of telomere length and allostatic load combined as a potential measure for chronic stress among African Americans. To our knowledge, none the current literature describes the relationship between telomere length and allostatic load longitudinally among African American adults. As the field strives to develop a “gold standard” for measuring chronic stress, the combination of these biomarkers needs to be the subject of scientific inquiry and thus, fully examined. Future longitudinal studies among African Americans are needed to better understand which biomarker, or combination of biomarkers will provide the most accurate measure of physiological stress processes.

Mindfulness-Based Stress Reduction Specifically Improves Social Anhedonia Among Adults with Chronic Stress.

This randomized controlled trial examined the effects of mindfulness on anhedonic symptoms in a sample of adults reporting high levels of chronic stress. Meditation-naïve adults (N = 68, Mage = 32, 62% female) were randomized to either an 8-week group-based MBSR intervention (N = 35), or a waitlist control group (N = 33). We hypothesized that changes in mindfulness would mediate the relationship between condition and changes in anhedonic symptoms. Additionally, the present study aimed to determine if other theoretically linked mechanisms (i.e., stress, negative affect [NA], depression) were involved in producing changes in anhedonic symptoms. Results provided evidence for full mediation of the effect of MBSR on social anhedonia through its essential mechanism of ΔMindfulness. These results highlight specificity of anhedonic symptoms targeted by MBSR, with social anhedonia symptoms being modified by changes in mindfulness whereas other anhedonic domains were not. The specificity of effects to the social anhedonia domain may be in part due to the group-based nature of MBSR. Additionally, although associative relationships were present for stress, depression, NA, and anhedonic symptoms, no mediational relationships emerged. Results presented here should be evaluated in light of study limitations, such as the reliance on self-report measures as well as a lack of information regarding cultural or geographic diversity.

Endothelial dysfunction may be driven by a synergism of epinephrine and TNFα via prolonged STAT3 activation

Background and Aims: Epidemiologic studies have highlighted the association between chronic psychosocial stressors and adverse cardiovascular outcomes; however, the mechanistic relationship between psychosocial stress and atherosclerosis is not well understood. Recent studies have found that epinephrine and tumor necrosis factor-alpha (TNFα) are upregulated in individuals reporting higher levels of chronic stress. Our aim was to evaluate a potential synergistic effect of epinephrine and TNFα (E/T) on human aortic endothelial cells (HAoEC) and elucidate the molecular signaling events that potentially drive stress-induced endothelial dysfunction.

Chronic Stress Burden, Visceral Adipose Tissue, and Adiposity-Related Inflammation: The Multi-Ethnic Study of Atherosclerosis.

We investigated the role of chronic stress burden on adiposity and adiposity-related inflammation with two hypotheses: a) greater chronic stress is associated with higher central adiposity and selective accumulation of visceral adipose tissue (VAT) compared with subcutaneous adipose tissue (SAT), and b) associations between VAT and inflammatory biomarkers are exacerbated when chronic stress is high. Data come from 1809 participants included in a Multi-Ethnic Study of Atherosclerosis ancillary study of body composition and adiposity-related inflammation. Chronic psychosocial stress was measured with a five-item version of the Chronic Stress Burden Scale. First, we tested associations between chronic stress (three-level categorical variable) and VAT, SAT, and VAT/SAT ratio. Second, we tested whether associations between VAT and inflammatory biomarkers varied by level of chronic stress. Participants were approximately 65 years, 50% female, and 40.5% White, 25.6% Hispanic, 21.2% African American, and 12.8% Chinese American. About half of the sample reported little to no stress, and a quarter and a fifth of the sample reported medium and high levels of stress. Higher levels of chronic stress were associated with greater VAT and SAT, but not VAT/SAT ratio. Greater levels of VAT were associated with increased levels of adiposity-related inflammation in a graded pattern. These associations did not vary by stress level. Greater chronic stress burden is associated with both central and subcutaneous adiposity. We found no evidence that the associations between VAT and inflammatory biomarkers are exacerbated by chronic stress. Findings contribute to ongoing literature untangling pathways in which psychosocial stress contributes to adiposity-related inflammation.

201 Effect of mild restraint stress on lipopolysaccharide-induced preterm labor in murine model

Prenatal stress leads to a pro-inflammatory state that may prime the immune system to respond aggressively to bacterial stimuli. This robust inflammatory response may be a mechanism for preterm delivery in individuals with high levels of chronic stress. The objective of this study was to assess the impact of antenatal stress on the responsivity of mice to lipopolysaccharide (LPS)-induced preterm labor. Nulliparous mice (n=39) underwent timed breeding at 8-10 weeks of age. Dams were then randomly assigned to either stress or control groups. The mice assigned to stress underwent daily 2-hour periods of restraint in a ventilated clear 50-mL conical centrifuge tube from E1-E15. On E15.5, mice from each group were randomly assigned to a 150-microliter intraperitoneal injection with either 15 micrograms LPS (E. coli O111:B4) or phosphate buffered saline (PBS). This low dose of LPS typically induces preterm labor in about 50% of mice. Mice were monitored in individual cages for the next 48 hours. The primary outcome was the number of dams exhibiting preterm labor (defined as bleeding or delivery of at least 1 fetus) within 48 hours. Mice were then sacrificed and uterine gross pathology inspected. Secondary outcomes were maternal death and presence of resorbed fetuses in the uteri. Outcomes were compared with Fisher’s Exact Test with a significant p-value of .05. In total, 10/10 of the mice exposed to antenatal stress and 7/12 of the control mice demonstrated preterm labor when exposed to low-dose LPS (Figure 1). Fisher’s Exact Test showed the rate of preterm labor after low-dose LPS injection was significantly higher in mice exposed to antenatal stress (p=.04). There were no maternal deaths observed. Two mice in the control-PBS group demonstrated resorbed fetuses. None of the other groups demonstrated resorbed fetuses (p=.52). Chronic mild restraint stress increases the sensitivity of mice to low-dose LPS-induced preterm labor. These data provide insight into a potential cause of increased preterm delivery rates among populations experiencing high rates of chronic stress.

Does Chronic Stress Moderate Age Differences in Emotional Well-Being? Testing Predictions of Strength and Vulnerability Integration.

The Strength and Vulnerability Integration (SAVI) theory posits boundary conditions, such as chronic stress, which place constraints on positive emotional aging. We examine SAVI's prediction that higher levels of chronic stress will attenuate favorable age gradients for multiple indices of well-being. We used cross-sectional data from a diverse systematic probability sample of adults (n = 260, ages 25-65). Multiple regression analysis was used to examine age gradients and test age × chronic stress interactions on 5 measures of well-being relevant for SAVI's prediction: positive and negative affect, life satisfaction, emotional distress, and rumination. Age was unrelated to well-being unless individual differences in health limitations were statistically controlled, in which case older age was associated with more favorable levels of well-being. Chronic stress significantly interacted with age for negative affect, emotional distress, rumination, and life satisfaction; examination of the interactions indicated that age was no longer associated with more favorable levels of well-being at higher levels of chronic stress. Our findings support a key prediction of SAVI by demonstrating that high levels of chronic stress present a boundary condition for favorable age gradients on well-being. We discuss the implications of these findings for understanding the "paradox" of well-being.

Youths’ processing of emotion information: Responses to chronic and video-based laboratory stress

Integrating multiple sources of information about others’ emotional states is critical to making accurate emotional inferences. There is evidence that both acute and chronic stress influence how individuals perceive emotional information. However, there is little research examining how acute and chronic stress interact to impact these processes. The current study examined whether acute and chronic stress interact to influence how children make emotional inferences. Eighty-nine youths (aged 11–15 years) underwent a novel video-based social stressor. Children completed an emotion recognition task prior to and after the stressor in which they saw integrated displays of facial expressions and contexts depicting congruent or incongruent emotional information. Eye tracking assessed changes in attention to the stimuli. Children became more likely to use and attended more to facial information than contextual information when labeling emotions following exposure to acute stress. Moreover, the effect of acute stress on use of facial information to label emotions was stronger for children who experienced higher levels of chronic stress. These data suggest that acute stress shifts attention towards facial information while suppressing processing of other sources of emotional information, and that youths with a history of chronic stress are more susceptible to these effects.

Chronic stress, executive functioning, and real-life self-control: An experience sampling study.

To test the hypothesis that chronic stress impairs the use of cognitive control for self-control, we examined how chronic stress affects the relation between individual differences in general executive functioning (GEF) and self-control in real-life situations. About 338 young adults with varying degrees of chronic stress underwent experience sampling of real-life self-control for 7days and completed a battery of nine executive function tasks from which a latent variable representing individual differences in GEF was derived. Structural equation models showed that higher levels of chronic stress were associated with stronger desires and a less negative relationship between GEF and desire strength. Chronic stress and GEF did not predict desire enactment in situations where effortful resistance was attempted. These findings suggest that chronic stress may impair self-control by reducing the use of cognitive control for "early" desire regulation strategies while leaving "late" resistance strategies unaffected. That relationships between executive functioning and real-life self-control can be moderated by third factors such as chronic stress may to some extent explain the common finding of weak or missing associations between laboratory measures of executive functioning and real-life self-control.

The COVID-19 pandemic and patients with endometriosis: A survey-based study conducted in Turkey.

ObjectiveTo apply rapid online surveying to determine the knowledge and perceptions of the COVID‐19 pandemic on patients with endometriosis in Turkey.MethodsAn online survey was conducted by the Turkish Endometriosis & Adenomyosis Society and administered to patients with endometriosis who agreed to participate in the study. The survey included 25 questions prepared by an expert committee of four professionals (two gynecologists and two endometriosis specialists).ResultsOf the 290 questionnaires sent out, 261 (90%) were returned. A total of 213 (83.86%) patients reported that they were afraid of having endometriosis‐related problems during the pandemic period. In addition, 133 (53.63%) patients thought the management of their endometriosis was affected because of the pandemic.ConclusionClinical studies clearly indicate that endometriosis is a condition associated with high levels of chronic stress. The COVID‐19 pandemic has led the public to experience psychological problems such as post‐traumatic stress disorder, psychological distress, depression, and anxiety. The majority of patients with endometriosis were afraid of having endometriosis‐related problems during the pandemic period. The majority of elective endometriosis surgeries have not been postponed. Patients were highly aware of the pandemic and practiced social distancing and hygiene. Only 4 (1.59%) patients with endometriosis required hospitalization.

Weight Stigma, Chronic Stress, Unhealthy Diet, and Obesity in Chilean Adults.

Obesity is highly prevalent around the world, including in Chile. Although various psychological factors have been previously associated with obesity, there has been less attention on the role of weight stigma as a determinant of obesity in Chile. Therefore, the primary aim of this study was to examine the direct effect of weight stigma on obesity and determine whether chronic stress and unhealthy diet mediate the relationship between weight stigma and obesity. Faculty and staff from a Chilean university enrolled in the Chilean Study of Psychological Predictors of Obesity and Metabolic Syndrome and completed anthropometric measurements and measures of weight stigma, chronic stress, and unhealthy diet. Three-hundred and eighty-three participants (Mage = 45 years old; 58% female) were included in the present analysis. Structural equation model analyses demonstrated a direct effect of weight stigma on obesity, chronic stress, and unhealthy diet. However, chronic stress and unhealthy diet did not mediate the relationship between weight stigma and obesity. Weight stigma is an important determinant of obesity and is associated with high levels of chronic stress and unhealthy diet in Chilean adults. Our results provide further support for the multifactorial nature of obesity and can inform future interventions aimed promoting weight loss in people with overweight and obesity.

Psychosocial and physical long-term outcome in patients with a history of takotsubo cardiomyopathy or myocardial infarction - a multi-centered case control study

ABSTRACT Physical long-term impacts of Takotsubo Cardiomyopathy (TTC) remain controversial and an underestimation of their severity becomes increasingly evident. Even less is known about mental long-term impacts of TTC. This study aims at a better understanding of the physical and mental long-term effects of TTC in comparison to myocardial infarctions (MI). On average 5 years after disease onset, 68 TTC patients and 68 age- and sex-matched MI patients were assessed for disease-related quality of life, depression, anxiety, chronic stress, social support, resilience, and life events prior to disease onset. Scores of TTC and MI patients were compared to each other and to normative references values. Regression analyses were used to evaluate the predictive value of the number of life events prior to disease onset for physical and mental long-term outcomes. Both groups displayed higher scores in depression and anxiety, higher levels of chronic stress, and lower scores in physical and mental quality of life in comparison to norm samples, while social support did not differ from norms. No differences between the two patient groups were observed. Within both groups, the majority of patients (TTC: 69.1%; MI: 60.3%) reported stressful life events prior to disease onset. In TTCs and MIs, the number of events had a significant impact on long-term mental health and chronic stress. Notably, both patient collectives scored higher in resilience than healthy controls. Results suggest negative long-term impacts of TTC on mental and physical wellbeing, comparable to those of MI. Besides a good somatic-medical care, psychotherapeutic support, including the development of functional coping strategies, might be warranted for TTC patients. The long-term impact of TTC should be taken as serious as that of MI.

Is Stress a Cause or a Consequence of Endometriosis?

Clinical studies clearly indicate that endometriosis is a condition associated with high levels of chronic stress. The stress intensity correlates with pain severity and disease extension. However, it is unknown whether chronic stress represents a primary cause of endometriosis and, therefore, if avoiding or treating chronic stress may reduce the risk of developing endometriosis. Repeated, uncontrolled stress either before or after experimental endometriosis induction promotes disease mechanisms and accelerates lesion growth in rodents. Furthermore, patients with endometriosis have a heightened risk of other inflammatory and immune-related diseases, many of which have also been associated with stress. Here, we review the latest evidences regarding the relationship between chronic stress and endometriosis and discuss the potential bidirectional aspect of such association. Further research may clarify if endometriosis is a cause and/or a consequence of stress and whether stress-reducing therapies are effective to mitigate symptoms and slow down the development of endometriotic lesions.

Psychosocial Stress and Attitudes Toward Substance Use Among College Students: An Exploratory Study

Substance use occurs on college campuses nationwide and is among the top threats to college-student health. The present study aimed to explore the impact of stress on substance use attitudes. The independent variable was acute psychosocial stress, induced using the Trier Social Stress Test. We measured chronic stress using the Adverse Childhood Experiences questionnaire. The Alcohol Purchase Task (i.e., alcohol demand, alcohol breakpoint, alcohol expenditure) and the Cognitive Appraisal of Risky Events-Revised questionnaire (i.e., expected involvement with substances and expected benefits and consequences of using substances) were the dependent variables. We predicted that participants who completed the acute stress task would report greater attitudes toward substance use behaviors and this would be more pronounced for those with higher levels of chronic stress. Acute stress did not affect willingness to pay for alcohol, F(3, 85) = 0.55, p = .65, ηp2 = 0.02, or expected positive or negative consequences from engaging in substance use, F(3, 85) = 0.44, p = .73, ηp2 = 0.02. There was a small positive association between chronic stress, as measured by adverse childhood experiences, and expected use, ρ(89) = .22, p = .04. In exploratory analyses, we found expected positive benefits of substance use to be significantly associated with expected future involvement, whereas expected negative consequences of substance use was associated with expected future involvement. Our results imply that acute and chronic stress were not significant in predicting substance use behaviors. Rather, those who expect benefits are more likely to use substances.

Frozen by stress: Stress increases scope insensitivity.

Stress has become a widely experienced state all around the world, and previous literature has found that stress impacts individuals’ cognition, emotion, coping behaviors and psychological well-being in general. Relatively little is known about how stress influences individuals’ perception of stimuli changes, a ubiquitous phenomenon known as scope sensitivity. In the current work, we explore whether individuals with higher levels of chronic stress are sensitive to stimuli changes, such as price and quantity differences. Two empirical studies consistently show that chronically stressed individuals exhibit scope insensitivity, as they rated the expensiveness of two hotel rooms with different prices as being less different and indicated a smaller difference in their willingness-to-buy five CDs versus ten CDs. Possible explanations and theoretical and practical implications in the broader field are discussed.

Intergenerational Transmission of Emotion Dysregulation: The Role of Authoritarian Parenting Style and Family Chronic Stress

Although studies support a direct association between parent and child emotion regulation, little work has considered potential mechanisms, such as family context. For example, parents who have difficulty regulating their emotions may be more likely to adopt an authoritarian parenting style, especially under high family chronic stress, and this parenting style may then influence children’s development of emotion regulation. The current study examined authoritarian parenting style as a potential mechanism of the intergenerational transmission of emotion regulation. We also examined how maternal emotion regulation and family chronic stress interact to influence parenting behaviors. A total of 218 mother-adolescent dyads (M age = 15.5 years, 55% female) were recruited from the community and assessed using a mix of self-report measures of emotion dysregulation and parenting style, and interview-based measures of family chronic stress. Results showed maternal emotion dysregulation predicted authoritarian parenting style that, in turn, predicted adolescent emotion dysregulation, with a significant indirect effect. Family chronic stress strengthened the association between maternal emotion dysregulation and authoritarian parenting style, such that the indirect effect of maternal emotion regulation on adolescent emotion regulation via authoritarian parenting style was stronger at high levels of chronic stress. Results suggest that authoritarian parenting style and family chronic stress serve as important factors in the intergenerational transmission of emotion regulation.

Can Adults with Mild Cognitive Impairment Build Cognitive Reserve and Learn Mindfulness Meditation? Qualitative Theme Analyses from a Small Pilot Study.

High levels of chronic stress negatively impact the hippocampus and are associated with increased incidence of mild cognitive impairment (MCI) and Alzheimer's disease. While mindfulness meditation may mitigate the effects of chronic stress, it is uncertain if adults with MCI have the capacity to learn mindfulness meditation. 14 adults with MCI were randomized 2:1 to Mindfulness Based Stress Reduction (MBSR) or a wait-list control group. We conducted qualitative interviews with those who completed MBSR. Transcribed interviews were: a) coded using an emergent themes inductive approach informed by grounded theory; b) rated 0-10, with higher scores reflecting greater perceived benefit from, and understanding of, mindfulness meditation. Ratings were correlated with daily home practice times and baseline level of cognitive function. Seven themes emerged from the interviews: positive perceptions of class; development of mindfulness skills, including meta-cognition; importance of the group experience; enhanced well-being; shift in MCI perspective; decreased stress reactivity and increased relaxation; improvement in interpersonal skills. Ratings of perceived benefit and understanding ranged from 2-10 (mean = 7) and of 0-9.5 (mean = 6), respectively. Many participants experienced substantial benefit/understanding, some had moderate, and a few had minimal benefit/understanding. Understanding the key concepts of mindfulness was highly positively correlated with ≥20 minutes/day of home practice (r = 0.90) but not with baseline cognitive function (r = 0.13). Most adults with MCI were able to learn mindfulness meditation and had improved MCI acceptance, self-efficacy, and social engagement. Cognitive reserve may be enhanced through a mindfulness meditation program even in patients with MCI.

Chronic stress in superb fairy‐wrens occupying remnant woodlands: Are noisy miners to blame?

AbstractInteractions between competing species may be intensified when they are restricted to small patches of remnant habitat, potentially increasing physiological stress in individuals. The effects of interspecific competition on stress in wildlife remain largely unexplored. In Australia, remnant woodlands are often dominated by aggressive honeyeaters, especially the noisy miner (Manorina melanocephala). Harassment of smaller birds by miners may result in their exclusion from suitable woodland habitat. We tested whether the presence of noisy miners is also associated with elevated stress in a model species of small passerine bird, the superb fairy‐wren (Malurus cyaneus). We sampled wrens from six sites, three remnant woodlands with noisy miners and three larger fragments of reserved habitat without noisy miners. Differential white blood cell counts were used to infer levels of chronic stress. We also assessed variation in body condition and the prevalence of blood parasites (Haemoproteus spp.) to test for associations between stress and parasitemia. The mean heterophil‐to‐lymphocyte (H:L) ratio was 1.8 × higher among superb fairy‐wrens living in miner‐dominated woodlands, suggesting higher levels of chronic stress. Individuals with higher stress appeared to be in poorer condition, as indicated by fat scores and residual body mass. Prevalence of blood parasites was generally high and was highest in reserved habitat (59%) where miners were absent. Birds with blood parasites living in these habitats had higher H:L ratios but the intensity of infection and H:L ratio was inversely related. Our results suggest that birds persisting in the presence of noisy miners might experience chronic stress, but further study is necessary to separate the relative importance of noisy miner aggression from other potential stressors in small patches of degraded woodland. Stress induced by interspecific aggression should be considered in future studies of wildlife living in remnant vegetation.

Abstract P179: Hypertension Awareness is Associated With Negative Psychosocial Outcomes in Africans Americans in the Jackson Heart Study (JHS)

Introduction: Although treating hypertension (HTN) reduces the risk of cardiovascular disease, being aware of a HTN diagnosis may have unintended consequences, including psychological distress and poorer perceived health. We hypothesized that African Americans meeting criteria for HTN, who are aware of a HTN diagnosis, would report higher levels of stress and depressive symptoms and poorer perceived health than those who are unaware. Methods: Our sample included 2,815 participants with HTN from the Jackson Heart Study, a community-based cohort of African Americans. HTN was defined as blood pressure ≥140/90 mm Hg or taking antihypertensive medication. Awareness of HTN was defined based on participants’ self-report of having been told by a health care provider that they had HTN or high blood pressure. Outcomes included depressive symptoms (Center for Epidemiologic Studies Depression score ≥16 vs. <16), chronic stress (Global Perceived Stress Scale, highest quartile vs. all others), weekly stress (Weekly Stress Inventory, highest quartile vs. all others) and self-rated health (poor or fair vs. good or excellent). Cross-sectional associations between HTN awareness and psychosocial outcomes were tested using multivariable Poisson regression with adjustment for age, sex, systolic blood pressure, diastolic blood pressure, antihypertensive medication, body mass index, comorbidities and health behaviors. Analyses were also stratified by recency of diagnosis (i.e., HTN diagnosed ≤3 vs. >3 years). Results: The majority of participants (2,572, 91.4%) were aware of having HTN while 243 (8.6%) were unaware. Among the aware participants, 15.5% were diagnosed ≤3 years ago and 84.5% were diagnosed >3 years ago. Aware participants were older (60.2 vs. 57.9, p=.002) and more likely to be female (68.4% vs. 47.7%, p<.001) than unaware participants. In fully adjusted models, HTN awareness was associated with higher levels of chronic stress (RR=1.55, 95% CI=1.09-2.22, p=0.016) and lower self-rated health (RR=1.55, 95% CI=1.05-2.29, p=0.028), and was marginally associated with higher weekly stress (RR=1.70, 95% CI=1.00-2.86, p=.053) and depressive symptoms (RR=1.60, 95% CI=0.95-2.70, p=.081). Overall, results did not differ based on recency of HTN diagnosis, except for a stronger association between awareness and weekly stress in the subgroup diagnosed >3 years ago. Conclusions: In a community-based sample of African Americans with HTN, participants who were aware of having a HTN diagnosis reported higher levels of stress and depressive symptoms and lower self-reported health compared to participants who were unaware. Prospective studies of the potential psychosocial consequences of diagnosing HTN are warranted, particularly in light of recent changes to BP treatment guidelines that result in an increased prevalence of HTN.

Abstract 134: Dysbiosis of gut microbiota in chronic stressed patients with endometriosis

Abstract Although endometriosis is a benign disease, it has malignant characters such as invasion and migration. Besides, there is an endometrial type of ovarian cancer, which means endometriosis is similar to malignant disease at some extent. Existing researches showed that patients with endometriosis often have high level of chronic stress. Furthermore, chronic stress can promote the growth of endometriosis by activating the β-adrenergic signaling pathway. Gut microbiota is reported to be related to the stress level through the gut-brain axis. So we wonder whether gut microbiota is associated with chronic stress level in endometriosis patients, which may provide a new clinical intervention method to improve prognosis. We grouped the endometriosis patients into stress group and control group with GAD-7 and PHQ-9 questionnaires and collected patients' fecal and tissues samples. Gut microbiota compositions were analyzed by the 16SrRNA gene sequencing-based method and we performed Immunohistochemistry (IHC) to detect the activation of inflammatory pathways in endometriosis tissues. We found that in patients with endometriosis, dysbiosis of gut microbiota is associated with patients' stress levels and Paraprevotella, Odoribacter, Veillonell and Ruminococcus show significant differences with reduced levels in chronic stressed endometriosis patients group, which represents a disease-specific change of gut microbiota on the genus level. Besides, compared to the control group, the expression level of inflammatory cytokines, NF-κB p65 and COX-2, increased in the chronic stressed patients group, which means that dysbiosis of gut microbiota may active the inflammatory pathway of gut-brain axis. In conclusion, we found new disease-specific changes of gut microbiota in chronic stressed patients with endometriosis, which can be a new examination target of chronic stress level and may provide an adjuvant therapy method for clinical psychological intervention, reducing the stress level and improving the prognosis of endometriosis patients. Citation Format: Jing Xu, Yu Kang, Yinhua Yu. Dysbiosis of gut microbiota in chronic stressed patients with endometriosis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 134.

Mapping Hair Cortisol Concentrations Across Body Sites to Study Health Disparities

Perceived discrimination, poverty, and environmental stress stimulates the release of cortisol, the primary stress hormone, through the hypothalamic–pituitary–adrenal (HPA) axis. Chronic stress, a long‐term form of stress, increases the risk of various diseases, including; diabetes, hypertension, and inflammatory and autoimmune disorders among all populations. Unfortunately, ethnic minorities experience higher levels of chronic stress, and bear the burden of health disparities. Hair cortisol is a retrospective biological marker for cortisol exposure and can be used as an integrated measure of long‐term HPA activity and chronic stress. However, studies that use hair from the scalp may face collection challenges due to the symbolic and spiritual meaning that is carried by locks of hair among populations particularly affected by health disparities. Therefore, identifying alternatives for the measurement of chronic cortisol exposure would enable inclusion of diverse population in health disparities research. The purpose of this study is to determine if hair across body sites can be used for cortisol analysis to investigate chronic stress among populations affected by health disparities. I hypothesized that hair from arms, legs, and pelvic area will be correlated to scalp hair cortisol levels, and could be used to assess chronic cortisol levels. In this study, participants were asked to provide hair samples from the following four regions of the body; the scalp, arms, legs, and pelvic region. Hair samples were processed, and cortisol was extracted using the established methanol method. Cortisol was quantified using an Enzyme‐Linked Immunosorbent Assay. A total of eight participants were recruited, five females and three males. Participants represented 4 different ethnic groups and were of recruited from a University. 25% of participants provided samples from all four hair sites, while 62.5% provided all but pubic hair. Average cortisol levels ranged from 236 pg/ml in the scalp to 1020 pg/ml in the legs. Linear correlation analysis was conducted to determine the relationship between hair cortisol concentration (HCC) from the scalp and other areas of the body. Our preliminary analysis shows trends suggesting that arm and leg hair may be culturally appropriate samples for hair cortisol analysis. In conclusion, this study revealed cortisol levels across body hair sites, and highlights the need to incorporate culturally acceptable biomarkers to address and eliminate health disparities.Support or Funding InformationCCSF/SMCCD/SFSU BRIDGES TO THE BACCALAUREATE PROGRAM: R25 GM050078SFSU SF BUILD: ENABLING STUDENTS TO REPRESENT IN SCIENCE‐ TL4 GM118986This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.