Paper
Saturday, November 3, 2007

55
This presentation is part of : Global Research in Women's Health Issues
Ambulatory Blood Pressure (ABP) and Heart Rate (HR) Responses in African-American (AA) Women: Environmental Effects
Sandra J. Picot, PhD, RN, FAAN, School of Nursing, University of Maryland, Baltimore, MD, USA and Erika Friedmann, PhD, School of Nursing, University of Maryland, Baltimore, MD, USA.
Learning Objective #1: discuss how the allostasis and allostatic load model proposes that the environment influences ambulatory blood pressures & heart rate in African American women.
Learning Objective #2: articulate implications for future research & interventions of the influence of environment & stress on ambulatory blood pressures & heart rate in African American women.
Theoretical framework: The allostasis & allostatic load model theorizes individuals’ experiences of stress from their environment directly & indirectly (via perceptions) influences ABP & HR responses.

DESIGN: Cross-sectional
SAMPLE: Random sample of 407 community women

Variables: Dependent: awake/sleep systolic BP/diastolic BP, HR; Predictors: living arrangement (0 = alone, 1 = with older adult), marital & employment status (0 = No, 1 = Yes); Perceptions: stress (1-10 cm scale); Covariates: age, exercise (minutes/week), waist circumference (cm).

Methods: After obtaining informed consent, nurses conducted interviews, attached the ambulatory BP-HR monitor and explained the diary to participants. BP-HR were recorded every 30 minutes 6AM-10PM (awake) and 60 minutes 10PM to 6AM (sleep). Awake participants recorded times, body position, activity each time an ABP was measured. Separate hierarchical linear regressions with age, exercise, & waist circumference entered in the first step; stress in the second step; and living arrangement, marital status, and employment status in the final step were conducted for each awake & sleep ABP and HR.

FINDINGS: DESCRIPTIVES: 57.2% lived with older adults, 53.3% married, 47.7% employed; awake & sleep SBP, respectively 132.56 (16.13), 122.40 (16.80); awake & sleep DBP, respectively 78.9 (8.96), 68.64 (9.45); awake & sleep HR, respectively 80.80 (10.73), 73.06 (10.46); stress 3.70 (3.07); age 55.86 (13.48); exercise 193.60 (179.36); waist 94.80 (13.92). RESULTS: ­Age, ­waist, & single explained 18.6% of SBP awake. ­Age & single explained 16.2% of SBP sleep. Neither the awake nor sleep DBP models were significant. Age ­stress, & employment explained 11.4% of HR awake. Age, exercise, ­waist, ­stress, & employment explained 11.1% of HR sleep. CONCLUSIONS: Findings supported the allostasis & allostatic model: The environment directly and indirectly (via perceptions) affected BP & HR. Findings are relevant to future research in & interventions for managing stress responses in AA women subgroups.

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