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In this study we examined the effect(s) of race, sex socioecological stress, and habitual anger-coping systolic/diastolic blood pressure levels and risk for being classified hypotensive. A total of 495 black/white males and 511 black/white females, residing in high/low stress areas of Detroit, were classified in terms of high, medium, and low levels of anger expression to various provocative interpersonal situations. Results indicated that: 1) race and anger expression were major determinants of diastolic pressure; 2) race and sex influence systolic pressure; 3) anger expression was related to systolic pressure, but only for female respondents; 4) all four behavioral factors were independently related to one's relative risk of being labeled hypertensive; and 5) the odds of being hypertensive by a multiple 1.56 with the addition of each behavioral risk factor. These findings extended our understanding of both the important role played by sociodemographic factors and socioecological niche in predisposing humans to vascular disease and the magnitude of difference in mean blood pressure and risk for hypertension attributable to chronic suppressed anger. The present finding also provide a basis for identifying subgroups of individuals who are especially at risk for hypertension and, similarly, a basis on which to calculate the amount of potential therapeutic benefit resulting from attempts at modifying one or more risk factors.

Literature on medical care utilization by Mexican-Americans suggests that patterns of utilization can be explained, in part, by acculturation, social class and social isolation. The relative importance of these variables is explored in a survey of a rural Mexican-American community in Southern Texas. Data on 152 families are analyzed using a logit analysis, with utilization as the outcome variable. The results suggest that acculturation has a direct effect, while social class and social isolation interact to have a weak effect independent of acculturation. These results confirm the importance of understanding all three variables in planning and implementing medical care programs in Mexican-American communities.

Patients (303) who had had carotid territory transient ischemic attacks were randomly assigned to aspirin or placebo treatments. Patients with amaurosis fugax responded as well to aspirin as those with hemisphere events. Patients with lesions of the appropriate carotid artery responded better to aspirin therapy than patients with no lesion or an occlusion. The aspirin effect was the same across all risk-factor groups. Smoking had no effect on clinical outcome.