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Abstract

Research from our laboratory indicates that 30% of African-American adolescents are non-dippers (show <10% decrease in blood pressure (BP) from awake to asleep) which may place them at increased risk for developing hypertension and end organ damage in early adulthood. Anderson's contextual model of hypertension suggests that chronic environmental stress such as violence exposure may increase sympathetic nervous system (SNS) activation that results in release of neuroendocrines. Over time, repeated stress-induced episodes of vascular reactivity may lead to structural changes in the vascular wall, which in turn elevates BP and ultimately leads to the development of hypertension. In the present study, we examined the relationship between violence exposure, catecholamine excretion, and BP non-dipping status in 56 healthy African-American adolescents (27 males, 29 females, ages 11-16 yrs). Participants wore a 24-hour BP monitor, provided 1 day and night collection for determination of epinephrine and norepinephrine excretion, and completed the Richters and Saltzman's Survey of Exposure to Community Violence. Adolescents who were classified as non-dippers (showed <10% decrease in mean BP from awake to asleep) reported experiencing a significantly greater number of violent events (4.2±4.3 vs. 1.5±1.7, p<.05) than those who were classified as dippers. Separate analyses were conducted for hearing, seeing, and being victimized using median splits. Adolescents who reported higher exposure to violence also showed greater levels of daytime epinephrine excretion (4.7±3.2 vs. 2.7±2.2 ng/min, p<.02) and daytime norepinephrine excretion (29.4±26.3 vs. 15.8±13.6 ng/min, p<.03) than those who reported lower levels of violence exposure. Correlational analyses revealed significant associations between hearing about violence and daytime epinephrine excretion (r=.32, p<.03) and daytime norepinephrine excretion (r=.29, p<.04); and between seeing violence and daytime epinephrine excretion (r=.28; p<.05). These correlations remained significant even after controlling for BP, sodium excretion, and potassium excretion. These results are the first to show that violence exposure is directly related to elevated SNS activation and non-dipping BP status in African-American adolescents which may place them at increased risk for developing hypertension and cardiovascular complications in early adulthood.

blood pressure non-dipping status, catecholamine excretion, violence exposure
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© American Journal of Hypertension, Ltd. 2001
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