Hindawi Publishing Corporation International Journal of Hypertension Volume 2012, Article ID 268013, 7 pages doi:10.1155/2012/268013 Research Article State Anxiety Is Associated with Cardiovascular Reactivity in Young, Healthy African Americans Mildred A. Pointer,1 Sadiqa Yancey,1 Ranim Abou-Chacra,2 Patricia Petrusi,2 Sandra J. Waters,3 and Marilyn K. McClelland2 1 Julius L. Chambers Biomedical/Biotechnology Research Institute, North Carolina Central University, Durham, NC 27707, USA 2 School of Business, North Carolina Central University, Durham, NC 27707, USA 3 Department of Psychology, North Carolina Central University, Durham, NC 27707, USA Correspondence should be addressed to Mildred A. Pointer, mpointer@nccu.edu Received 1 August 2011; Revised 7 October 2011; Accepted 21 November 2011 Academic Editor: Tavis S. Campbell Copyright © 2012 Mildred A. Pointer et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Although several studies have shown that enhanced cardiovascular reactivity can predict hypertension development in African Americans, these ﬁndings have not been consistent among all studies examining reactivity and hypertension susceptibility. This inconsistency may be explained by the inﬂuence of anxiety (state and trait) on the blood pressure response to stress. Therefore, this study sought to determine whether anxiety is associated with blood pressure response to cold pressor (CP) and anger recall (AR) stress tests in young healthy African Americans. Modeling using state and trait anxiety revealed that state anxiety predicts systolic (SBP) and diastolic blood pressure DBP response to CP and AR (P ≤ 0.02). Interestingly, state anxiety predicted heart rate changes only to CP (P < 0.01; P = 0.3 for AR). Although trait anxiety was associated with SBP response to AR and not CP, it was not a signiﬁcant predictor of reactivity in our models. We conclude that anxiety levels may contribute to the variable blood pressure response to acute stressors and, therefore, should be assessed when performing cardiovascular reactivity measures. 1. Introduction Although enhanced cardiovascular reactivity is generally as- sociated with future development of hypertension and other cardiovascular events [1–5], there are studies that have failed to show any relationship between reactivity to stress and future elevation of blood pressure [1, 6–12]. The reason for these inconsistent ﬁndings is unclear. Emerging evidence suggest that some stress tests may be better predictors of future cardiovascular events than other stressors [4, 5, 10]. For example, blood pressure response to arithmetic and star tracing stress tests predicted high blood pressure while reactivity to cold pressor stress test did not [13, 14]. Further- more, metanalysis of studies that assessed mental stress tests and hypertension development revealed variable success of mental tests in predicting hypertension. Among the diﬀerent types of mental stressors, cognitive mental stressors were more consistent in predicting hypertension compared to emotion evoking, interview, and public speaking stressors [10]. The inconsistencies in prediction do not appear to be explained by diﬀerences in the type (mental, physical, or psychophysical) of stress tests for there is inconsistent predictability even among the types of stressors. Another possible explanation for the inconsistencies in reactivity prediction of adverse cardiovascular outcomes is the interaction of psychosocial factors with cardiovascular responses to acute laboratory stressors. Anxiety is one such psychosocial factor that may determine reactivity responses. Metanalysis of over 700 studies revealed that chronic (trait) anxiety is associated with decreased cardiovascular reactivity [15]. In contrast, a study of young European population revealed that acute (state) anxiety was associated with signiﬁ- cantly increased reactivity to cold pressor test but not mental stress test [16]. These observations, when taken together, suggest that individuals may be inaccurately identiﬁed as hyperresponsive if anxiety is not considered as a confounder in the reactivity response to acute laboratory stress tests. Consequently, inaccurate assessment of increased reactivity