Search

Objective The goal of this study was to evaluate how black and white men and women responded physiologically to specific laboratory challenges. Methods Hemodynamic responses to an active coping (evaluated speaking) and two inhibitory-passive coping (mirror tracing, cold pressor) tasks were examined in 138 black and white men and women. Results Significant ethnicity by gender interactions occurred for the evaluated speaking task. Black men responded with lower blood pressure, cardiac output or heart rate, or both, than black women, white men, and white women, who did not differ from each other. Black men, relative to the other subgroups, also reported more inhibitory-passive coping, hostility, and pessimism, and less social support. Whites also responded with greater increases in systolic blood pressure during mirror tracing than blacks. Conclusions These findings indicate that black-white differences in physiological responsivity obtained for men may have limited generalizability for women. The results also suggest that environmental and social factors rather than genetic or constitutional factors may play a role in black-white reactivity differences.

In a double-blind, crossover study, five white men with mild-to-moderate hypertension received placebo and fixed doses of atenolol, metoprolol, chlorthalidone, verapamil, and the combination of atenolol and chlorthalidone in a quasi-random order. Daily dosages were: atenolol, 100 mg; metoprolol, 200 mg; chlorthalidone, 50 mg; verapamil, 240 mg; and the same doses of atenolol and chlorthalidone in combination. Standard office and daytime ambulatory blood pressures were assessed at the end of each month-long trial. Atenolol, metoprolol, chlorthalidone, and verapamil controlled office blood pressure with similar reductions. Verapamil did not lower ambulatory blood pressure at this dose (which is lower than is now commonly used), but reductions in ambulatory blood pressure were similar for atenolol, metoprolol, and chlorthalidone. The combination of atenolol and chlorthalidone maintained blood pressure control more effectively than the single drug treatments in both office and ambulatory settings, and the combined hypotensive effects were additive. However, reductions in the office due to the combination appeared to overestimate hypotensive effectiveness in the ambulatory setting. This study suggests that the effectiveness of commonly prescribed antihypertensive regimens varies according to setting as well as drug, and that assessment of treatment effectiveness can be improved by automated ambulatory blood pressure monitoring.