Network Stressors, Personal Stressors, and Ambulatory Blood Pressure in African-American Women-Does Superwoman Schema Play a Role?

Objective: Life stressors have been linked to cardiovascular risk; however, studies typically focus on stressors that directly impact the individual, that is, personal stressors. Research suggests that women, particularly African-American women, may be more vulnerable to network stressors that involve family members and friends-potentially due to norms around needing to be a "Superwoman." Yet few studies have examined these phenomena. Method: We examined associations between network, versus personal, stressors, and elevated blood pressure (BP) in N= 392 African-American women aged 30-46. Questionnaire-assessed negative life events were classified into upsetting network or personal stressors. BP was assessed in clinic and via 48-hr ambulatory monitoring. Linear and logistic regression models examined associations between type of stressors and 48-hr daytime and nighttime systolic BP (SBP) and diastolic BP (DBP), and sustained hypertension after adjusting for relevant covariates. Interactions with questionnaire-assessed superwoman schema (SWS) were tested in exploratory analyses. Results: In age and sociodemographic-adjusted models, network stressors were significantly associated with daytime SBP, ss (SE) = 2.01 (0.51), p =.0001, and DBP, ss (SE) = 1.59 (0.37), p =.0001, but personal stressors were not ( p values..10). Associations persisted after adjustment for cardiovascular and psychosocial risk factors. Patterns were similar for nighttime BP and sustained hypertension. There were no interactions with SWS. Conclusions: Network, but not personal, stressors were associated with elevated rates of daytime SBP and DBP, as well as sustained hypertension in African-American women, irrespective of SWS endorsement. Future research is needed to determine whether stress-management interventions focused on network stressors might impact BP in this high-risk population.