COMMENTARIES Stress Appraisal and Risk Markers for Structural Vascular Disease

Findings from a Sub-Saharan African Cohort An escalating prevalence of hypertension in black Africans, particularly in males, is causing concern, but the jury is still out on causative factors [1,2]. One possible mechanism is sympathetic nervous system (SNS) hyper-responsivity in urban Africans [1-3], which informed the design of the Sympathetic activity and Ambulatory Blood Pressure in Africans (SABPA) prospective cohort study (2008-). In our commentary we will highlight our initial findings on stress appraisal and risk markers for structural vascular disease. Stress Appraisal and Risk for Structural Vascular Disease Personality, environment, previous experiences, and perceptions influence our behavioral responses and a person's perception of the stressor as a challenge or threat [4]. Stress appraisal or coping responses include mainly defensive, social support, and emotional avoidance coping responses [5]. Defensive coping responses entails problem solving, being-in-control, acceptance of the stressor as a reality, and endeavoring to actively eliminate the stressor; "seeking social support " implies an active coping process for comfort and advice in stressful times. Emotional avoidance has been associated with denial, defeat, loss of control, and cardiometabolic pathology [5,6]. Stress appraisal or copin