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(Circulation. 2000;101:2284.)
© 2000 American Heart Association, Inc.

Clinical Investigation and Reports

Racial Differences in Hemodynamic Responses to Environmental Thermal Stress Among Adolescents

Robert M. Kelsey, PhD; Bruce S. Alpert, MD; Stephen M. Patterson, PhD; Marie Barnard, BA

From the University of Tennessee College of Medicine, Memphis.

Correspondence to Bruce S. Alpert, MD, Department of Pediatrics, University of Tennessee at Memphis, 777 Washington Ave, Suite 215, Memphis, TN 38105. E-mail rkelsey{at}utmem.edu

Background—Previous studies by our laboratory and others have shown that blood pressure (BP) responses to many short-term laboratory stressors are greater in black than in white children. We sought to determine the cardiac and vascular contributions to these differences in BP reactivity and whether racial differences in vascular reactivity involve excessive vasoconstriction or deficient vasodilation.

Methods and Results—We evaluated BP, heart rate, and impedance cardiographic measures of preejection period (PEP) and total peripheral resistance (TPR) in healthy black (n=76) and white (n=60) adolescents (mean age, 14.8 years) during passive exposure to a vasoconstrictive cold chamber (8°C to 10°C) and a vasodilatory heat chamber (40°C to 42°C). Results indicated greater decreases in PEP and increases in TPR in blacks than whites during cold exposure (P<0.05) but no group differences during heat exposure. Covariance analyses indicated that the racial differences during cold exposure probably reflected greater ß-adrenergic cardiac reactivity and -adrenergic vasoconstrictive reactivity in blacks than whites.

Conclusions—Blacks and whites exhibited comparable myocardial and vasodilatory responses to heat stress, but blacks exhibited heightened myocardial and vasoconstrictive reactivity to cold stress. These results suggest that the locus of racial differences in vascular reactivity involves vasoconstrictive rather than vasodilatory function. The pattern of racial differences during cold stress raises the possibility that both myocardial and vasoconstrictive mechanisms may contribute to the increased risk of hypertension in blacks.

Key Words: : stress • vasoconstriction • vasodilation • cardiac output • hemodynamics

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