Abstract P237: Relationships Among Perceived Stress, Hair Cortisol Concentration, Coping Strategies, and Blood Pressure in Young, Low-Income Adults
Authors: Lauren M Pageau, Jiying Ling, Barbara A Given, Lorraine B Robbins, Pallav Deka, Emma C Schlegel
Journal: Circulation (2024)

Introduction: Young adults living in poverty typically experience more stressors with greater severity and chronicity and are at an increased risk for developing high blood pressure at an earlier age than other populations. However, the mechanisms linking chronic stress to elevated blood pressure are not fully understood. Certain coping strategies may be more adaptive than others in easing the burden of stress on the cardiovascular system over time. Understanding how young, low-income adults use various coping strategies in response to stress may contribute to a better understanding of the influence of stress on cardiovascular health. Therefore, the purpose of this study was to examine the associations among perceived stress, hair cortisol concentration (HCC), coping strategies, and blood pressure among a sample of young, low-income adults. Methods: A secondary analysis of baseline data from a quasi-experimental trial and a cluster randomized controlled trial was conducted. PROCESS version 4 for SPSS 28 (Model 80) was used to conduct path analysis modeling to assess the relationships among perceived stress (measured by the 10-item Perceived Stress Scale [PSS-10]), hair cortisol concentration (HCC), coping strategies (emotion-focused, problem-focused, and avoidant measured by the Brief COPE), and blood pressure (SBP/DBP) among a sample of young adults with an annual household income below the 2022 U.S. federal poverty level. Results: A total of 63 individuals (mean age = 29.7 ± 5.1 years, 96.8% female, 60.3% White), were included in this study. There was a small, negative association between perceived stress and HCC ( B = -0.02, p = 0.02); however, perceived stress and HCC were both positively associated with SBP and DBP (all p s &lt; 0.05). Emotion-focused coping was negatively associated with HCC, while problem-focused and avoidant coping were positively associated with HCC ( p s &lt; 0.05). There was a negative indirect effect of perceived stress on SBP through emotion-focused coping and HCC ( B = -0.14, 95% CI: -0.309, -0.007), while a positive indirect effect of perceived stress on SBP through problem-focused coping and HCC was observed ( B = 0.09, 95% CI: 0.002, 0.245). Similarly, the indirect effects of perceived stress on both SBP and DBP through avoidant coping and HCC were positive and significant (SBP: B = 0.21, 95% CI: 0.043, 0.427; DBP: B = 0.15, 95% CI: 0.015, 0.332). Conclusions: Overall, this study's findings highlight the importance of coping on the relationship between stress and blood pressure within a low-income population. Emotion-focused coping appears to be more adaptive for this population compared to problem-focused and avoidant strategies. Future research, especially studies measuring these constructs over time, is needed to confirm these findings and to comprehensively understand the complex relationships among stress, coping, and blood pressure.